What Are ‘The Bends’?

The bends might sound like a dance move or a  cool hangout. The reality is much less fun, I promise you. 

The bends is a common term used to refer to decompression sickness. It’s a condition that primarily affects deep sea divers but it can also happen at high altitudes to mountain climbers or air passengers. 

Caused by a sudden change in pressure, the bends can kill in extreme cases. Even mild cases can cause long-lasting damage to your tissues, joints, and lungs. 

So let’s take a closer look at the bends and how you can avoid it. 

Causes

When you dive with compressed air your body gets more oxygen and nitrogen than it’s used to at the surface. The oxygen is used by your muscles and organs to continue functioning. 

The nitrogen is not used. It dissolves into your blood and hangs out there until it can be filtered out by the liver and the kidneys. 

The deeper you go, the more pressure your body is put under. This pressure encourages the gases in your body to dissolve into your blood more quickly and efficiently. This goes for the good and bad gasses. 

When it’s time to come to the surface the pressure decreases as you swim upwards. This reduces the pressure on your body. Less pressure means that the gases that were previously dissolved in your blood become gas again. 

Think of it like a bottle of soda. Before you open the bottle it looks liquid. When you turn the cap, bubbles rise out of nowhere to the surface. This is because the pressure within the bottle is reduced when it’s opened. 

Now, think about what happens when you open an agitated bottle of soda. It fizzes over, right? Well, that’s what the bends is. 

If you rise to the surface too quickly, the dissolved nitrogen turns back into gas and bubbles out of your tissues. In large quantities, this causes significant problems for your tissues.

After all, your blood and other bodily tissues are not designed to have huge amounts of high energy bubbles ripping through them.

Symptoms

The symptoms of the bends develop within 48 hours of the dive though in extreme cases they can develop within the first hour. Mostly, you’ll notice symptoms developing within about 6 hours. 

The symptoms mostly affect the muscular-skeletal system and the nervous system.

One of the first symptoms of the bends is severe joint pain. It affects big joints like shoulders, hips, and elbows most severely. In fact, this symptom is why decompression sickness came to be known as the bends. It would cause the joints to bend leaving the sufferer bent double. 

With the joint pain comes numbness and tingling in extremities, lower back pain, and numbness, or paralysis in the lower body. The bubbles cause huge damage to the tissues that supply the body with oxygen and nutrients. Without oxygen, the limbs and organs can’t function properly. 

The reduced oxygen also affects the brain. People suffering from the bends might find that they are confused, fatigued, unbalanced, and short of breath. 

Treatment

The bends is usually diagnosed by your diving history and symptoms. Blood tests and x-rays don’t usually show the problem. 

If you notice a member of your party is suffering from the bends you need to get them to a hospital as quickly as possible. 

You will need to make sure that the emergency services know that the person is suffering from the bends as adjustments will need to be made. 

First and foremost, a person suffering from the bends needs to be transported lying flat on their back. If they are going to be airlifted, the helicopter needs to fly below 1000 feet or be pressurized to sea level. This is to prevent exacerbating the problem. 

The treatment for the bends requires a hyperbaric chamber. You’ll need to make sure that the hospital you are headed for has one available. You can search for your closest hyperbaric chamber online. 

Once admitted, you will spend up to 12 hours in a hyperbaric chamber. The time will depend on the severity of the case. 

A hyperbaric chamber is a pressurized chamber that replicates the pressure of a deep-sea dive. It allows the gas bubble to shrink and be reabsorbed into the bloodstream. The chamber is slowly depressurized and the gases are safely removed.

The chamber also provides huge amounts of oxygen to damaged cells to allow them to repair themselves. 

Prognosis

The prognosis of patients suffering from the bends is generally good providing they can access medical care. Usually, one hyperbaric treatment is sufficient to cure the bends. 

Some symptoms like joint pain and fatigue can linger for days or weeks after treatment. If you are not better after your treatment, your doctor may recommend further treatments. 

Prevention

There are a number of ways to reduce the risk of getting the bends. The most important thing is to remember to rise slowly. You need to take time at different depths to adjust to the pressure. 

You should also not spend longer than the recommended time at your maximum depth. There are tables that allow you to work out how long you can stay at different depths. 

Avoid flying within 24 hours after you’ve been diving. You need to avoid putting your body under unnatural pressures while the gases safely escape your body. 

It is also a good idea to maintain general healthy practices before and after diving. You should not drink alcohol before diving, avoid hot tubs, saunas, and steam rooms after diving, and avoid diving if you have been feeling unwell. 

Final Thoughts

The bends is a painful condition that can cause serious, long-lasting damage if not treated. 

In the early years of diving, the bends was often fatal. However, as technology and medical understanding improved, divers are more aware of the dangers of the bends, and doctors are better equipped to treat it. 

Despite being curable, the bends is not something you want to experience. Avoid it at all costs where possible. 

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