In this article, David N. Woznica, MD discusses Ozone therapy for chronic pain.
Prolozone™ is a Prolotherapy technique developed by Frank Shallenberger, MD, that utilizes ozone gas, along with other therapeutic substances to stimulate healing and reduce pain in injured soft tissues and joints.
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Dr. Shallenberger describes it as a regenerative and pain relieving procedure that involves the proliferative principles of Prolotherapy, the cell membrane repolarizing principles of neural therapy, the stem cell stimulation of homeopathic therapy, and the metabolic principles of ozone therapy.
Therapeutic injections of ozone into soft tissue structures, such as muscles, tendons and ligaments as well as arthritic joints for the relief of pain has been utilized for decades in medical clinics around the world.
A 1989 study from the University of Bologna in Italy examined the effects of oxygen-ozone mixture (the so-called medical ozone) locally injected.
- 156 patients were treated and divided into 3 groups:
- post-traumatic knee disorders,
- Arthritis without marked bone deformities and
- Arthritis with marked bone deformities.
- In the first two groups optimal results were obtained while for the third other therapies were then added to stop the advancing degenerative process. In conclusion, knee joint disorders can very successfully be treated by means of oxygen-ozone mixture locally administered.1
In a study out of Iran, doctors at Shahid Beheshti University of Medical Sciences suggested.
- Ozone is a pain blocker and has an antinociceptive effect (an agent that blocks nerve pain), that can be more effective and long-term than narcotic medications.2
Researchers in Italy and Canada have published a new study in the Journal of the Canadian Association of Radiologists in which they cite that in European trials and in a trans-Canadian clinical trial, ozone has been used successfully. In total over 50,000 patients have been treated safely. Ozone has a potent oxidizing power; it has been used for percutaneous intradiscal injection combined with oxygen at very low concentrations for 15 years in Europe.
The patients who can benefit the most are patients with back pain with or without radicular pain but without motor deficits, which have been non-respondsive to 4-6 weeks of conservative therapies. Its mechanism of action on the disc is mechanical (volume reduction by subtle dehydration of the nucleus pulposis) and anti-inflammatory.
The intradiscal ozone injection is performed with a thin needle (18-22 gauge) image guided by computed tomography or angiofluoroscopy and is usually complimented by periganglionic injection of corticosteroids and anesthetics.
This combination gives immediate pain relief and allows time for the ozone to act. It is a cost-effective procedure that presents a very low complication rate (0.1%). The radicular pain is resolved before the back pain does, as is seen with microdiscectomy. Peer-reviewed publications of large randomized trials, case series, and meta analysis from large samples of patients have demonstrated the procedure to be safe and effective in the short and the long terms, with benefits recognized up to 10 years after treatment.3
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1 Sanseverino E. Knee joint disorders treated by oxygen-ozone therapy. Europa Medicophysica. 1989;3:163-170.
2 Hashemi M, Jalili P, Mennati S, et al. The Effects of Prolotherapy With Hypertonic Dextrose Versus Prolozone (Intraarticular Ozone) in Patients With Knee Osteoarthritis. Anesthesiology and Pain Medicine. 2015;5(5):e27585. [Pubmed]
3 Giurazza F, Guarnieri G, Murphy KJ, Muto M. Intradiscal O2O3: Rationale, Injection Technique, Short- and Long-term Outcomes for the Treatment of Low Back Pain Due to Disc Herniation. Can Assoc Radiol J. 2017 May;68(2):171-177. [Pubmed]