Ozone is a safe, inexpensive, and effective clinical tool with a wide range of therapeutic applications. Pain management is an area where ozone excels, and many studies have been done to demonstrate its analgesic properties. Numerous clinical trials and research studies have been conducted to investigate the effects of ozone therapy. Ozone has been shown to be beneficial for a wide range of conditions, including pain, cardiovascular disease, mitochondrial dysfunction, infection, and non-healing skin lesions. Clinical practice has also shown benefit in neurological disorders, autoimmunity, fatigue, and others. The discussion of ozone in this article will be limited to the area of pain. For a comprehensive overview of ozone therapy, Principles and Applications of Ozone Therapy – A Practical Guide for Physicians, by Frank Shallenberger MD, is an excellent resource.
METHODS OF ADMINISTRATION
Ozone can be administered in numerous ways. For the purpose of treating acute and chronic pain, ozone is traditionally administered as an injection (often referred to as a “prolozone”). Patients suffering from chronic pain of a systemic origin (e.g., fibromyalgia, chronic Lyme/coinfections, CFIDS, environmental illness, etc.) may require similar injection therapies and/or intravenous (IV) administration of ozone.
OZONE ADMINISTRATION
- IV administration
- Injection
- Limb bagging
- Cupping
- Rectal insufflations
- Bladder insufflations
- Vaginal insufflations
Intravenous administration of ozone is traditionally administered as major autohemotherapy (MAH). MAH involves removing 60 to 250 mL of venous blood into an IV bag, mixing it with ozone gas, and a small amount of heparin (to prevent clotting). It is then re-infused into the patient. Unlike local injections, MAH provides a system-wide exposure to the effects of ozone, hence its applicability to systemic diseases, as mentioned above. Ozone can also be administered to the whole body through IV ozonated-saturated saline, rectal insufflations of ozone gas, or cutaneous absorption via cupping or limb bagging.
CLINICAL APPLICATIONS FROM THE LITERATURE
Ozone therapy has excellent versatility in treating musculoskeletal sources of acute and chronic pain. Many studies have been conducted on the use of ozone injections for back pain, especially that related to herniated discs. These studies have shown positive clinical outcomes with one trial demonstrating better efficiency than steroid. Analgesic effects of ozone have also been demonstrated in the treatment of sciatica, headache, temporomandibular joint (TMJ) disorder, sensitive-tooth pain, and radiotherapy-induced proctitis.
In clinical practice, ozone injections have a high frequency of success in treating joint pain. Knees, hips and shoulder joints are very responsive to treatment. Our patient’s with frozen shoulder often experience complete resolution in 1-3 treatments.
Dental pain also tends to respond well to treatment, whether it is post-root canal, trauma-induced, or idiopathic (unknown cause). Our physicians have observed trigger points and symptom-inducing scar tissue to regularly resolve more easily when ozone is added into the treatment protocol. Nasal inhalation of ozone gas that has been bubbled through olive oil frequently works very well for pain from acute or chronic sinusitis. Patients suffering from chronic infections such as Lyme often have faster symptom relief when using ozone injections in painful muscles or joints. Successful results from treatments may be due to a combination of the anti-inflammatory effects of ozone and its antimicrobial properties.
Another area where ozone shines is the use in cosmetics. We notice a decrease in the appearance of cellulite and acne scars. This is a newer area in ozone therapy. The doctors at Lake Oswego Health Center frequently lecture on ozone and platelet rich plasma (PRP) in cosmetics and overall regenerative medicine.
SAFETY
Ozone is known to be toxic to lung tissue when it is directly inhaled. Long-term exposure to inhaled ozone can contribute to the formation of asthma, COPD, allergies, and cardiovascular disease. For this reason, we do not offer direct ozone inhalation.
CONCLUSION
Ozone therapy is a highly versatile clinical tool. Ozone has a long clinical history and a wealth of positive effects reported in practice.
Ozone therapy in all its forms to be an invaluable addition to Lake Oswego Health Center’s practice. Even equipped with core naturopathic modalities, injection therapies (neural therapy, prolotherapy, neural prolotherapy, platelet-rich plasma, IV therapies, and other integrative therapies. We have found ozone to be of inimitable value for many of our patients suffering from pain and chronic illness.
SOURCES
- Rubin MB. The History of Ozone. The Schönbein Period, 1839–1868. Bull Hist Chem. 2001;26(1):40-56. http://www.scs.illinois.edu/~mainzv/HIST/bulletin_open_access/v26-1/v26-1%20p40-56.pdf. Accessed April 15, 2014.
- Elvis AM, Ekta JS. Ozone therapy: A clinical review.J Nat Sci Biol Med. 2011;2(1):66-70.
- Stoker G. Ozone in Chronic Middle-Ear Deafness. The Lancet. 1902;160(4131):1187-1188.
- Shallenberger F. Principles and Applications of Ozone Therapy: A Practical Guide for Physicians. CreateSpace Independent Publishing Platform; 2011.
- Fuccio C, Luongo C, Capodanno P, et al. A single subcutaneous injection of ozone prevents allodynia and decreases the over-expression of pro-inflammatory caspases in the orbito-frontal cortex of neuropathic mice. Eur J Pharmacol. 2008;603:42–49.
- Chen H, Yu B, Lu C, Lin Q. The effect of intra-articular injection of different concentrations of ozone on the level of TNF-α, TNF-R1, and TNF-R2 in rats with rheumatoid arthritis.Rheumatol Int. 2013;33(5):1223-1227.
- Chang JD, Lu HS, Chang YF, Wang D. Ameliorative effect of ozone on cytokine production in mice injected with human rheumatoid arthritis synovial fibroblast cells.Rheumatol Int. 2005;26(2):142-151.
- Bocci V, Valacchi G, Corradeschi F, et al. Studies on the biological effects of ozone: 7. Generation of reactive oxygen species (ROS) after exposure of human blood to ozone. J Biol Regul Homeost Agents. 1998;12(3):67-75.
- Larini A, Bocci V. Effects of ozone on isolated peripheral blood mononuclear cells. Toxicol In Vitro. 2005;19(1):55-61.
- Valacchi G, Bocci V. Studies on the biological effects of ozone: 10. Release of factors from ozonated human platelets. Mediators Inflamm. 1999;8(4-5):205-209.
- Martínez-Sánchez G, Delgado-Roche L, Díaz-Batista A, et al. Effects of ozone therapy on haemostatic and oxidative stress index in coronary artery disease. Eur J Pharmacol. 2012;691(1-3):156-162.
- Borrelli E, Diadori A, Zalaffi A, Bocci V. Effects of major ozonated autohemotherapy in the treatment of dry age related macular degeneration: a randomized controlled clinical study. Int J Ophthalmol. 2012;5(6):708-713.
- Ciborowski M, Lipska A, Godzien J, et al. Combination of LC-MS- and GC-MS-based metabolomics to study the effect of ozonated autohemotherapy on human blood. J Proteome Res. 2012;11(12):6231-6241.
- Giunta R, Coppola A, Luongo C, et al. Ozonized autohemotransfusion improves hemorheological parameters and oxygen delivery to tissues in patients with peripheral occlusive arterial disease. Ann Hematol. 2001;80(12):745-748.
- Bocci V. Oxygen-Ozone Therapy. A critical evaluation. Dordrecht, The Netherlands: Kluwer Academic Publishers; 2002.
- Alam J, Kim YC, Choi Y. Potential Role of Bacterial Infection in Autoimmune Diseases: A New Aspect of Molecular Mimicry. Immune Netw. 2014;14(1):7-13.
- Johansson E, Claesson R, van Dijken JW. Antibacterial effect of ozone on cariogenic bacterial species. J Dent. 2009;37(6):449-453.
- Halbauer K, Prskalo K, Janković B, et al. Efficacy of ozone on microorganisms in the tooth root canal. Coll Antropol. 2013;37(1):101-107.
- Zaky S, Kamel SE, Hassan MS, et al. Preliminary results of ozone therapy as a possible treatment for patients with chronic hepatitis C. J Altern Complement Med.2011;17(3):259-263.
- Alberto PO. Ozone the one and only drug. Acta Neurochir Suppl. 2011;108:143-146.
- Zhang Y, Ma Y, Jiang J, et al. Treatment of the lumbar disc herniation with intradiscal and intraforaminal injection of oxygen-ozone. J Back Musculoskelet Rehabil. 2013;26(3):317-322.
- Rahimi-Movaghar V, Eslami V. The major efficient mechanisms of ozone therapy are obtained in intradiscal procedures. Pain 2012;15(6):E1007-E1008.
- Melchionda D, Milillo P, Manente G, et al. Treatment of radiculopathies: a study of efficacy and tollerability of paravertebral oxygen-ozone injections compared with pharmacological anti-inflammatory treatment. J Biol Regul Homeost Agents. 2012;26(3):467-474.
- Magalhaes FN, Dotta L, Sasse A, et al. Ozone therapy as a treatment for low back pain secondary to herniated disc: a systematic review and meta-analysis of randomized controlled trials. Pain 2012;15(2):E115-E129.
- Bonetti M, Fontana A, Cotticelli B, et al. Intraforaminal O(2)-O(3) versus periradicular steroidal infiltrations in lower back pain: randomized controlled study. Am J Neuroradiol. 2005;26(5):996-1000.
- Clavo B, Santana-Rodriguez N, Gutierrez D, et al. Long-term improvement in refractory headache following ozone J Altern Complement Med. 2013;19(5):453-458.
- Daif ET. Role of intra-articular ozone gas injection in the management of internal derangement of the temporomandibular joint. Oral Surg Oral Med Oral Pathol Oral Radiol. 2012;113(6):e10-e14.
- Dähnhardt JE, Gygax M, Martignoni B, et al. Treating sensitive cervical areas with ozone. A prospective controlled clinical trial. Am J Dent. 2008;21(2):74-76.
- Clavo B, Ceballos D, Gutierrez D, et al. Long-term control of refractory hemorrhagic radiation proctitis with ozone therapy. J Pain Symptom Manage. 2013;46(1):106-112.
- Bocci V. Is it true that ozone is always toxic? The end of a dogma. Toxicol Appl Pharmacol. 2006;216(3):493-504.