Onset may be:
(1) during the decompression
(2) shortly after the decompressive episodes
(3) several hours after the decompression
Clinical findings:
(1) joint discomfort that may range from mild aching to severe pain
(2) pain is aggravated by joint movement
(3) external compression provides relief
Joints affected:
(1) usually affect the large joints (knees, elbows, other)
(2) small joints of the hands and feet may be affected
(3) any joint that underwent significant active motion during the decompressive episode
Hyperbaric therapy is given if:
(1) the pain is severe
(2) the pain is not relieved by a return to normal pressure (altitude-related)
(3) signs of Type II DCS are present
Relief of pain is used as an outcome measure for hyperbaric therapy, so analgesics should not be given if hyperbaric therapy is being contemplated.
