Hyperbaric Oxygen Therapy (HBOT) and Concussion Recovery: What You Should Know

A research-informed overview from NCX Brain Recovery

Hyperbaric Oxygen Therapy (HBOT) is a treatment many individuals inquire about during concussion recovery. While HBOT is not a core service at NCX Brain Recovery, we believe in supporting informed choices and providing educational resources about a wide range of therapeutic options. Here’s what the research shows—and how HBOT fits into the larger conversation around brain healing.

What Is Hyperbaric Oxygen Therapy?

HBOT involves breathing 100% oxygen in a pressurized chamber. The increased pressure allows more oxygen to dissolve into blood plasma and other bodily fluids, potentially delivering oxygen to areas with reduced circulation, including parts of the brain.

HBOT is FDA-approved for several conditions, such as:

Decompression sickness
Carbon monoxide poisoning
Radiation tissue damage
Severe anemia (when transfusion is not possible)
Crush injuries and burns
Full list from UHMS

However, concussion and mild traumatic brain injury (mTBI) are not currently FDA-approved indications.

If you’d like to learn more about HBOT click here.

Why Is HBOT Being Considered for Brain Injury?

HBOT is sometimes explored for concussion and post-concussion syndrome (PCS) due to its potential to:

Increase oxygen delivery to the brain
Reduce neuroinflammation
Support neuroplasticity and energy metabolism

These theoretical benefits, along with anecdotal symptom improvements, have generated public interest and a growing number of clinical conversations.

What Does the Research Say?

Severe Traumatic Brain Injury (TBI)

Some studies show promise for HBOT in acute severe TBI cases:

A study of 56 children with severe TBI found that those treated with HBOT had improved neurological outcomes compared to controls (Boussi-Gross et al., 2013).

Mild TBI and Post-Concussion Syndrome (PCS)

Research here is more limited and mixed:

A 2016 review of 12 randomized trials concluded there was no significant difference in recovery between individuals who received HBOT and those who received placebo treatments (Crawford et al., 2017).
The U.S. Department of Defense (DoD) funded five major studies on HBOT for PCS and reported no statistically significant benefit (DoD, 2018 report).

Why Might HBOT Be Limited in Concussion Recovery?

Many post-concussion symptoms are linked to neurovascular coupling dysfunction—a disruption in how neurons and blood vessels coordinate oxygen delivery in the brain.

A study conducted at UCLA found that breathing 100% oxygen could constrict cerebral blood vessels, reducing oxygen delivery to certain brain regions despite high oxygen availability (Hadanny & Efrati, 2016).

This suggests that simply increasing oxygen in the bloodstream may not solve the underlying issue in PCS—and in some cases, may even counteract the brain’s oxygen regulation processes.

NCX Brain Recovery’s Perspective

We focus on research-backed interventions.
Our Multi-Sensory Integration Therapy is built on neuroscience and designed to restore the brain’s regulation of blood flow, sensory integration, and cognitive function.
We support informed decision-making.
Every recovery journey is different. If HBOT is part of a patient’s plan and is guided by a qualified provider, we support a thoughtful and safe approach.
We value multidisciplinary collaboration.
Our goal is to help individuals access the support they need—whether that’s within our clinic or through coordinated care with other trusted providers.

Considering HBOT? Ask Yourself:

Is the facility medically supervised and certified?
What are the expected costs and number of sessions?
Is HBOT being used alongside proven, research-backed care?

Final Thoughts

HBOT continues to be a topic of interest in the brain injury community. While we do not currently offer HBOT, we support education and open dialogue between patients, providers, and clinics. The best outcomes often come from combining multiple approaches tailored to the individual.

Author: Kaylee Blair, NCX Brain Recovery

References

UHMS HBO Indications
Hadanny, A., & Efrati, S. (2016). Treatment of persistent post-concussion syndrome due to mild traumatic brain injury: Current status and future directions. Expert Review of Neurotherapeutics, 16(8), 875–887. PubMed
Crawford, C., et al. (2017). Is hyperbaric oxygen therapy effective for traumatic brain injury? A rapid evidence assessment. J Head Trauma Rehabil, 32(3), E27–E38. PMC
U.S. Department of Defense. (2018). Report on hyperbaric oxygen therapy for mild TBI. Health.mil
Boussi-Gross, R., et al. (2013). HBOT can improve post-concussion syndrome years after mTBI – randomized prospective trial. PLoS ONE, 8(11), e79995. PubMed