Rheumatoid Arthritis

Rheumatoid arthritis (RA) is a systemic inflammatory disease of a chronic nature that is characterized primarily by a pattern of involvement of the synovial joints. The inflammatory process may involve soft tissues such as tendons, ligaments, and muscle and may invade the bone. The etiology of the disease remains uncertain; suspected causes include immunological disturbances and infectious agents. Hypoxia of the arthritic patient is evidenced by low synovial pO2 levels but these are not specific to rheumatoid arthritis.


  • Increased metabolic demand for oxygen by an inflamed joint
  • Decrease of blood flow to the joint by raised intra-articular pressure

There is a fall in the synovial fluid of a rheumatoid knee joint after exercise. The hypoxic condition of many inflamed joints may be responsible for microinfarction of particulate collagens in joint fluid that are qualitatively and quantitatively identical to the collagens of the synovial membrane.

Experimental Studies

HBO can suppress sterile inflammation due either to immunologic factors or microbial infection. Thus, arthritis induced in rats by injections of adjuvant is suppressed if HBO is started within 2 days after injection. Moreover. daily HBO therapy suppresses the inflammatory response even if given when the arthritis is fully developed. Shakhbazyan et al. (1988) studied the effect of HBO (1.5 ATA and 3 ATA) on the development of clinical, immunological, and morphological manifestations of adjuvant arthritis in C57BL/6 mice. In comparison with the control group. HBO was found to inhibit the development of clinico-morphological manifestations of adjuvant arthritis and hindered the development of the process. The treatment was more effective in the early stages of the disease. Pressure of 3 ATA was more effective than 1.5 ATA but toxic manifestations were seen with 3 ATA in the pulmonary vessels.


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