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This article was first published in 

There are private clinics now offering hyperbaric oxygen therapy. Many claim it will heal everything from sports injuries to Lyme disease to autism. Some parents think it will improve sports performance and help their children achieve the competitive edge it takes to go pro. But hyperbaric oxygen is not pseudo-science. It is a valid medical therapy. It just won’t do any of the above. And you shouldn’t have to pay for it out of pocket.

The treatment involves putting a patient in a hyperbaric chamber and delivering pure oxygen, or sometimes just normal air, at high pressures — generally two to three times higher than atmospheric pressure. A collapsed lung would be an absolute contraindication, while other forms of lung disease do not necessarily preclude the treatment. High-concentration oxygen is toxic to the central nervous system, so anyone with a history of seizures should be wary, as seizures are a known complication. The high pressure can also be damaging to the eardrum and sinuses in some circumstances, but these are generally mild and short-lived issues. While relatively safe overall, the procedure is not benign.

In some settings, the benefits of using hyperbaric oxygen therapy are clear because it will increase the amount of oxygen in your blood. Most of the oxygen in your blood is bound to hemoglobin in your red blood cells. When you measure your oxygen saturation with a pulse oximeter (a clip on your finger), you are measuring the percentage of hemoglobin that has oxygen bound to it. A healthy person breathing room air (21 per cent oxygen) should have an oxygen saturation around 95 per cent. If most of your hemoglobin is already carrying oxygen, the only practical way to increase the oxygen content of your blood is to dissolve it directly in the plasma. This can only be accomplished by delivering the oxygen at a high pressure in a hyperbaric chamber. A regular face mask or nasal prongs won’t be enough.

Theoretically this makes sense, but there aren’t many situations in which it’s necessary. A patient with a severe pneumonia could be seriously deprived of oxygen, but anyone that sick would probably get intubated, which would make the consideration of a hyperbaric chamber moot. If you were oxygen deprived because of severe anemia, hyperbaric oxygen therapy would be useful, but a blood transfusion would be the more direct and practical solution to the problem.

One situation in which hyperbaric oxygen is practically useful is in . Carbon monoxide binds to hemoglobin much more readily than oxygen and essentially blocks your red blood cells from picking up and delivering oxygen to your body’s tissue. Hyperbaric oxygen not only increases the amount of oxygen in your blood, but also helps displace carbon monoxide from the hemoglobin.

The other major condition for which hyperbaric oxygen is useful is decompression sickness, also known as the bends. However, in this case the benefit may be more about the high pressures shrinking the nitrogen bubbles in the scuba diver’s bloodstream, rather than the high oxygen delivery.

There is some debate in the medical literature about whether hyperbaric oxygen helps in wound healing. The data for  is underwhelming. Chronic wounds like  showed short term, but not long term, improvement, while benefits were seen in one trial of patients with .

Hyperbaric oxygen has a long track record of use. In some cases the benefits are clear and in others the data are more equivocal. In some cases there is no justification for it. There is no reason to seek it out privately and  or many other claims you might see online.

The risks of hyperbaric oxygen therapy are low. Most people will not have complications if they seek out this therapy from private clinics. They will just waste their money.