Localized deep pain, ranging from mild to excruciating. Sometimes a dull ache, but rarely a sharp pain. Active and passive motion of the joint aggravates the pain. The pain may be reduced by bending the joint to find a more comfortable position. If caused by altitude, pain can occur immediately or up to many hours later.
Type 1 DCS is usually characterized by musculoskeletal pain and mild cutaneous, or skin, symptoms. Common Type 1 skin manifestations include itching and mild rashes (as distinct from a clear mottled or marbled and sometimes raised discoloration of the skin — a condition that is known as cutis marmorata that may presage the development of the more serious symptoms of Type 2 DCS). Less common but still associated with Type 1 DCS is obstruction of the lymphatic system, which can result in swelling and localized pain in the tissues surrounding the lymph nodes — such as in the armpits, groin or behind the ears.
Skin mottling like this is characteristic of cutis marmorata, a condition that can warn of likely development of more serious Type 2 symptoms. Past experience in diving medicine has shown that patients initially presented with only this symptom have a high likelihood of progression to neurological, Type II, DCS without prompt treatment. The marbling does not resolve until few days after treatment, but any pruritus (itching) will likely disappear upon initial recompression.
Altered sensation, tingling or numbness (paresthesia), increased sensitivity (hyperesthesia) Confusion or memory loss (amnesia) Visual abnormalities Unexplained mood or behaviour changes Seizures, unconsciousness
Ascending weakness or paralysis in the legs Urinary incontinence and fecal incontinence Girdling (also referred to as girdle, banding, or tightening feeling) around the abdominal region and/or chest
Headache Unexplained fatigue Generalised malaise, poorly localised aches
Loss of balance Dizziness, vertigo, nausea, vomiting Hearing loss
Dry persistent cough Burning chest pain under the sternum, aggravated by breathing Shortness of breath