Decompression sickness is a condition that can affect divers that experience a sudden change in pressure. It may affect recreational divers and experienced divers alike and should never be underestimated.
If you’re planning a dive or a flight soon, it’s important to be aware of the signs and symptoms of decompression sickness, also known as “the bends.” These symptoms can range from mild to severe and can include joint pain, fatigue, numbness, dizziness, and even paralysis.
In this post, we’ll explore the signs and symptoms of decompression sickness and discuss the importance of seeking immediate medical attention if you suspect you may be experiencing this condition.
Decompression sickness is caused by an excess of nitrogen in a person’s tissue. This is often caused by emerging from a dive too soon and can make someone feel extremely nauseous or feel extreme amounts of bone and muscle pain. In more extreme cases, people might even experience numbness or rashes.
In this post, we will explore in more detail what causes decompression sickness, a more in-depth list of its symptoms, treatment methods, how to prevent it, and what recent studies show about decompression sickness.
What Causes Decompression Sickness?
There are a variety of situations that can lead to decompression sickness. The most common is not depressurizing correctly when emerging from a dive. For example, an uncontrolled ascent, or skipping a safety stop may lead to incorrect depressurization.
Other events that have been known to cause decompression sickness are flying in unpressurized vehicles and ascending too quickly, flying within a day of diving, and any situation where there is a sudden change in air pressure with differing gas ratios.
The issue occurs when a person’s body goes through a process that causes nitrogen bubbles to form. When you are diving with air, which is made approximately of 21% oxygen and 79% of nitrogen, nitrogen accumulates in your body throughout the dive.
The higher the pressure surrounding you, the more nitrogen will be released in your body.
While ascending from a dive, nitrogen is released from your body tissues in the form of very tiny bubbles. If your ascent rate is too fast, those tiny nitrogen bubbles will become bigger and usually get stuck close to your joints (e.g. shoulders, elbows), causing the famous “bends”, also known as decompression sickness.
Stated in more scientific terms, when a diver goes from a high-pressure environment to a lower-pressure environment too quickly, nitrogen will not have enough time to dissolve properly, causing DCS.
There are two types of decompression sickness: Type I Decompression Sickness has physical symptoms while Type II Decompression Sickness has neurological symptoms.
Symptoms
Type One Decompression Sickness and Type Two Decompression Sickness express themselves differently. People can also have both types simultaneously. Here is a list of the common symptoms of each and some important things to consider.
Type One Decompression Sickness
Type One expresses itself physically and is often painful.
- Weakness in Extremities
- Numbness
- Skin Rash
- Nausea
- Joint Pain
- Stomach Pain
- Lung Issues
- Inability to Straighten Limbs
- Itching
- A Burning Sensation when Breathing
Type Two Decompression Sickness
Type Two Decompression Sickness expresses itself through neurological symptoms.
- Paralysis
- Headache
- Sensory Dysfunction
- Confusion
- Speech Difficulties
- Convulsions
- Personality Changes
- Shock Symptoms
Things that Demand Immediate Treatment
Suppose someone is experiencing any kind of neurological symptoms after diving. In that case, they should go to the hospital immediately, as these symptoms can be a sign of brain damage, ear damage, or other issues that need attention as soon as possible.
Other than that, if someone experiences any lung pain, that can also be a sign of an arterial gas embolism, which can cause a stroke or other life-threatening conditions. Even if the symptoms are not deemed urgent, if someone has previously had or currently has heart or lung issues, they should also immediately go to the hospital. DCS is a serious illness and should never be underestimated.
Treatment Methods
Unlike other sicknesses, there really is only one treatment method for decompression sickness that is effective. The treatment involves using a hyperbaric chamber to help the body correctly decompress. Oftentimes, these are not super common, so professionals will use different methods to help make symptoms manageable until a center is found.
They will often put a patient on oxygen and fluids, and will not give patients pain medication. They won’t provide pain medication because it can mask symptoms. From there, they will transfer patients to a place that has a hyperbaric chamber where the staff is trained in recompression. Divers with suspected DCS will in most cases undergo a neurological evaluation before deciding the course of action.
How to Prevent Decompression Sickness
The best way to prevent decompression sickness is to follow proper protocols for reemerging from a dive. Some of these include following the indications of your dive computer or using dive tables to calculate how long it is safe to be at different depths, diving down slowly and reemerging slowly, and monitoring different activities before and after diving.
Some activities which may increase the risk of DCS should not be done before diving, including drinking alcohol. People should also consult their doctor if they have any concerns about diving, including heart or lung issues or previous injuries.
Previous injuries or diseases can make someone more vulnerable to getting decompression sickness. People should also not plan on flying, going to a sauna or hot tub, or taking a hot bath after diving. Changing pressures quickly after diving can cause decompression sickness to occur.
Particularly for beginner divers, or if you have not been scuba diving for a while, I often recommend to chose your diving holidays also based on the available medical facilities. Note that not all diving destinations have easily reachable local emergency medical services that can treat DCS.
What Studies Say About Decompression Sickness
In 1990, a study was done about decompression sickness that showed some interesting findings. One of the ways in which the study assessed the likelihood of developing decompression sickness is by measuring the gas bubble levels. When people scored within a certain range, they were deemed to have high gas bubble levels.
One of the most interesting findings the study came up with is that people who dive multiple times within a couple of days have high levels of gas bubbles and thus have a greater chance of developing decompression sickness. Those that dive infrequently or daily for six to eight days tend to have a lower level of gas bubbles and a smaller likelihood of developing decompression sickness.
The study also found that there is a correlation between gas bubbles, gender, and age. Men are more likely to have high levels of gas bubbles than females. Older men have a 20 percent increase in gas bubbles than younger men.
Older women have 55 percent more gas bubbles than younger females. However, additional studies show that women are more likely to get decompression sickness than men. This could show that women are more sensitive to gas bubbles in their system than men.
With all of this in mind, it becomes easier to understand what is happening to a diver if they suddenly get ill. This can also help people get the treatment they need quickly and not develop decompression sickness again.
Decompression Sickness FAQs
What is the difference between decompression sickness and decompression illness?
Decompression sickness and decompression illness are often used interchangeably to describe the same condition, but technically decompression sickness refers specifically to the symptoms caused by nitrogen bubbles forming in the bloodstream or tissues, while decompression illness can include other symptoms caused by changes in pressure, such as air embolisms or barotrauma. However, in practical terms, the two terms are often used to refer to the same condition and the treatment is typically the same regardless of the specific cause of the symptoms.
What is hyperbaric oxygen therapy?
Hyperbaric oxygen therapy (HBOT) is a medical treatment that involves breathing pure oxygen in a pressurized chamber. The increased atmospheric pressure helps the lungs absorb more oxygen, which is then delivered to the body’s tissues at a higher rate than normal. HBOT has been shown to be effective in treating a variety of conditions, such as decompression sickness, carbon monoxide poisoning, wounds that won’t heal, and certain infections. It can also improve the body’s ability to fight infections, reduce inflammation, and promote healing.
Hyperbaric Oxygen Therapy is typically administered in a specialized medical facility by trained professionals.
Is DCS more likely after deep or long dives?
Both deep and long dives increase the risk of decompression sickness (DCS), but the risk factors differ. Deep dives, particularly those beyond recreational dive limits, expose divers to higher levels of nitrogen that can cause bubbles to form in the bloodstream and tissues. Long dives increase the overall exposure to nitrogen and can also cause fatigue, which can increase the risk of DCS.
The risk of DCS is also influenced by the diver’s age, weight, physical fitness, and other factors, and can vary from person to person.
Is DCS more likely in cold water?
There is some evidence to suggest that exposure to cold water can increase the risk of decompression sickness (DCS). This may be because cold temperatures cause the body to conserve blood flow to the extremities, which can result in a slower elimination of nitrogen from the tissues. Additionally, cold water diving may require thicker wetsuits or drysuits, which can increase the weight and bulk of diving equipment and make it more difficult to move, potentially increasing the risk of DCS.
However, the exact relationship between water temperature and DCS risk is not fully understood and may vary depending on other factors such as dive depth and duration.
What is caisson disease?
Caisson disease, also known as the bends or decompression sickness, is a condition caused by the rapid release of pressure on the body. It was originally named for the workers who built the caissons (waterproof chambers) used to construct the foundations of bridges and other structures. When workers emerged from the pressurized caissons too quickly, they developed symptoms such as joint pain, fatigue, and breathing difficulties. Today, DCS is most commonly associated with scuba diving and other activities that involve changes in pressure, and it can range from mild to severe, even life-threatening, symptoms.