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Treatments & Injections

Use of Ozone Injection for Musculoskeletal Issues

Due to the rising prevalence of osteoarthritis, providers and patients are looking for viable treatment options.

G
Greg Rubin
Sports Medicine Physician · August 18, 2024 · 3 min read

Overview

Due to the rising prevalence of osteoarthritis, providers and patients are looking for viable treatment options. The use of oxygen and ozone have been studied as an injection option for osteoarthritis and low back pain. Ozone (O 3 ) is an unstable form of oxygen that has been shown to have effects on disc induced low back pain.

Symptoms

The O 2 O 3 combination has been found to decrease proteoglycans that are involved in reducing disk volume and the combination of oxygen and ozone has been found to have direct anti-inflammatory effects. By inhibiting prostaglandin synthesis, there is an analgesic effect to the patient. Ozone is also thought to increase tissue oxygenation, which can aid in healing.

Causes and Risk Factors

One of the challenges to date is to find an appropriate doze of ozone therapy. The therapeutic window for ozone is considered to be between 1µg/mL to 100µg/mL. Ozone also is a gas and is available now as a solution.

Treatment Options

Comparison of steroids and ozone injections after one, three, and six months of treatment according to Mac Nab criteria in female patients. The graph represents the percentage of patients and their response to either type of injection. This response is classified as Excellent, good, fair, bad and no modification, with differences in the results between ozone and steroids injection after one month (p-value: 0.304), three months (p-value: 0.738), and six months (p-value: 0.008).

Recovery

Proposed mechanisms of action of ozone (O3) therapy in osteoarthritis (OA). ROS formed during OA activates NFκB pathways by increasing its translocation into the nuclei and this causes the activation of intracellular inflammation pathways such as IL-1β, IL-6, TNF-α and COX-2 which then open the apoptotic cascade. O3 can inhibit apoptosis and degradation of the cartilage matrix by inhibiting the activation NFκB resulting in cell survival.

When to See a Doctor

If you are experiencing symptoms that may be related to use of ozone injection for musculoskeletal issues, it is important to see a sports medicine physician. Early evaluation and treatment typically lead to better outcomes. Do not ignore pain or symptoms that are limiting your activity.

*This article is for educational purposes only and does not substitute for professional medical advice. Always consult a qualified healthcare provider.*

Treatments & InjectionsInjections
G
Greg Rubin
Sports Medicine Physician
Sports Medicine Review contributor

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