06/30/2026
https://www.mdpi.com/2076-3271/14/3/360
Could Hyperbaric Oxygen Therapy Help Patients with Neuromuscular Scoliosis? Here's What the Science Says...
A new review that my colleague Dr. Megan Strauchman and I recently published highlights an important issue in hyperbaric medicine: Hyperbaric Oxygen Therapy (HBOT) and Mild Hyperbaric Oxygen Therapy (mHBOT) are NOT the same treatment. Unfortunately, the two are often used interchangeably, creating confusion for both patients and healthcare providers.
Medical-grade HBOT uses 100% oxygen at pressures typically between 2.0 and 3.0 ATA, while mild hyperbaric therapy generally uses lower pressures (1.1-1.4 ATA) with room air or oxygen from a concentrator. These different treatment "doses" produce very different biological effects.
At higher pressures, HBOT has been shown to:
✔️ Improve oxygen delivery to tissues
✔️ Stimulate angiogenesis (new blood vessel formation)
✔️ Mobilize stem cells
✔️ Reduce inflammation
✔️ Improve mitochondrial function
✔️ Influence important repair pathways involving VEGF, nitric oxide, HIF-1α, and other signaling molecules involved in healing and recovery.
Our review also points out something equally important: mild hyperbaric therapy is not biologically inactive. Research suggests it can influence autonomic function, exercise recovery, immune activity, and several neurological conditions. However, the current evidence simply does not support treating it as equivalent to medical HBOT. Each intervention deserves to be studied independently.
So what does this have to do with neuromuscular scoliosis?
Children and adults with neuromuscular scoliosis often have much more than a spinal curvature. Many also experience:
• impaired muscle activation
• chronic inflammation
• reduced tissue oxygenation
• mitochondrial dysfunction
• fatigue
• impaired motor control
• progressive weakness
These are all biological systems that hyperbaric therapies may influence.
Could improving oxygen delivery enhance muscle performance or rehabilitation?
Could reducing neuroinflammation improve motor learning?
Could improved mitochondrial function increase endurance during scoliosis-specific rehabilitation?
Could better tissue oxygenation improve recovery from surgery or intensive therapy?
These are exciting questions—but they remain questions.
At this point, we simply do not have high-quality clinical trials evaluating HBOT specifically for neuromuscular scoliosis. While the underlying biology is certainly intriguing, it's important not to assume that benefits seen in traumatic brain injury, wound healing, cerebral palsy, or other neurological conditions automatically apply to scoliosis. That's exactly the type of evidence extrapolation our paper cautions against.
The next generation of scoliosis research should move beyond simply asking "Does HBOT work?" Instead, we should be asking:
• Which scoliosis patients are most likely to benefit?
• What pressure and oxygen dose are optimal?
• Which biological pathways are actually changing?
• Can HBOT enhance the effectiveness of scoliosis rehabilitation rather than replace it?
Answering these questions could open an entirely new avenue for treating neuromuscular scoliosis with a precision medicine approach.
The future isn't about replacing established scoliosis therapies—it's about combining biomechanics, neurology, metabolism, and regenerative medicine to improve outcomes for patients.
Background/Objectives: Hyperbaric oxygen therapy (HBOT) and mild hyperbaric oxygen therapy (mHBOT) are two terms commonly used by hyperbaric chamber sellers, hyperbaric oxygen therapy practitioners, and even by many scientists as if they were synonymous. The following review of hyperbaric oxygen the...
