Efficacy and safety of hyperbaric oxygen therapy for women with fibromyalgia: a systematic review and meta-analysis of randomized controlled trials.

INTRODUCTION: The use of currently recommended treatments for fibromyalgia (FM), combining pharmacological and exercise-based therapies, is often challenging in clinical practice. Poor efficacy and adverse effects of the available drugs and low adherence to exercise-based therapies resulting from physical fatigue have often led to inadequate FM-related chronic pain relief. Hyperbaric oxygen therapy (HBOT) has been reported to be a potential emerging therapy for FM, offering pain relief with minimal physical burden and adverse effects. This review aims to evaluate the efficacy and safety of HBOT in managing FM, explicitly in female populations. MATERIAL AND METHODS: A systematic review and meta-analysis was performed in accordance with the PRISMA flowchart in three databases, PubMed/MEDLINE, Cochrane Library, and ScienceDirect, to identify studies published up to the year 2025. The Cochrane risk of bias 2.0 tool was used to assess the quality of the included studies. Statistical analyses were conducted using RevMan 5.4.1 software on studies that reported the required numerical outcomes. RESULTS: This review included 5 eligible studies with a total of 227 female participants with FM. The results indicated that HBOT was associated with a significantly greater reduction in pain compared to the control (mean difference [MD] = -3.41, 95% CI: from -6.24 to -0.59). Patients treated with HBOT showed reduced symptom severity compared to the control (MD = 5.27, 95% CI: 2.11-8.44). Quality of life was enhanced in HBOT, though it was not statistically significant. Furthermore, HBOT was well tolerated, with no serious adverse events reported. CONCLUSIONS: HBOT appears to be a promising adjunctive treatment for FM, demonstrating significant pain reduction, with no serious adverse events reported. However, the current evidence is limited, and further high-quality studies are needed to confirm its effects on quality of life and long-term outcomes.