REVIEW PAPER
Analgetic effect of ozone therapy: myths of reality?
 
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1
National Pirogov Memorial Medical University, Vinnytsya, Ukraine
 
2
University Clinic of National Pirogov Memorial Medical University, Vinnytsya, Ukraine
 
3
Scientific and Research Institute of Invalid Rehabilitation, Educational Scientific Treatment Complex of National Pirogov Memorial Medical University, Vinnytsya, Ukraine
 
 
Submission date: 2019-11-07
 
 
Acceptance date: 2020-02-02
 
 
Online publication date: 2020-03-21
 
 
Corresponding author
Iryna Vladimirovna Baranova   

University Clinic of National Pirogov Memorial Medical University, Vinnytsya, 21001, Kotsubinskiy 6, Ukraine. Tel.: +38096 442 02 43.
 
 
Pol. Ann. Med. 2020;27(1):62-67
 
KEYWORDS
TOPICS
ABSTRACT
Introduction:
Administration of an oxygen-ozone mixture is one of the innovative techniques used in single-drug or complex therapeutic schemes for treatment of many degenerative-dystrophic pathologies of the musculoskeletal system and related neurological complications.

Aim:
The aim was to determine the mechanisms of physiological action of the oxygen-ozone mixture in order to substantiate its efficacy for treatment of chronic pain syndrome with underlying degenerative-dystrophic pathologies of the musculoskeletal system.

Material and methods:
The article covers biochemical and pathomorphological studies that explain the mechanism of the pain syndrome and the potential effect of the ozone therapy.

Results and discussion:
The treatment schemes and benefits of different routes of ozone administration (intramuscularly, intravenously, intradiscally and intraarticularly) were analyzed. Diverse research data demonstrated influence on the causes of chronic pain, pathophysiological phases, and possible complications. The prospects of further studies for development of the most effective techniques for treatment of various pain syndromes were assessed.

Conclusions:
Ozone therapy is one of the alternative rehabilitation methods with a substantial pain relieving effect. As of today, the possibility of using the oxygen-ozone mixture for treatment of chronic back pain related to intervertebral disk hernia and fibromyalgia has been substantially confirmed.

ACKNOWLEDGEMENTS
We thank our colleague from National Pirogov Memorial Medical University, who helped us in collecting of the data research.
FUNDING
None declared.
CONFLICT OF INTEREST
Authors declare no conflicts of interests.
REFERENCES (50)
1.
Alyan S, Zaghol R, Mustafa SA. Efficacy of combined paravertebral ozone (O2O3) therapy with physiotherapy in patients with chronic mechanical low back pain. Eg Rheum Rehab. 2018;45(3):106–111. https://doi.org/10.4103/err.er....
 
2.
Rowen RJ, Robins H. Ozone Therapy for Complex Regional Pain Syndrome: Review and Case Report. Curr Pain Headache Rep. 2019;23:41–49. https://doi.org/10.1007/s11916....
 
3.
Duenas M, Ojeda B, Salazar A, Mico JA, Failde I. A review of chronic pain impact on patients, their social environment and the health care system. J Pain Res. 2016;9:457–467. https://dx.doi.org/10.2147%2FJ....
 
4.
Dinakar P, Stillman AM. Pathogenesis of Pain. Semin Pediatr Neurol. 2016;23(3):201–208. https://doi.org/10.1016/j.spen....
 
5.
Berger JM, Zelman V. Pathophysiology of Chronic Pain. PMJUA. 2016;1(2):29–49.
 
6.
Blohina VN, Melikjan JeG, Ivanova DC, et al. Modern approach to rehabilitating patients after operations on the lumbar microdiscectomy level. Vest Pirogov’s Nation Univer. 2014;9(3):93–98 [in Ukrainian].
 
7.
Vivekananda SP, Garampalli A, Patil SN. Ozone nucleolysis in lumbar intervertebral disc herniation: non-randomized prospective analysis. J Evolution Med Dent Sci. 2015;4(37):6456–6466. https://doi.org/10.14260/jemds....
 
8.
Braidy N, Izadi M, Sureda A, et al. Therapeutic relevance of ozone therapy in degenerative diseases: Focus on diabetes and spinal pain. J Cell Physiol. 2018;233(4):2705–2714. https://doi.org/10.1002/jcp.26....
 
9.
Bocci V, Borelli E, Zanardi L, Travagli V. The usefulness of ozone treatment in spinal pain. Drug Des Devel Ther. 2015;9:2677–2685. https://dx.doi.org/10.2147%2FD....
 
10.
Boszenko NL. Pain back syndroms: some psychologycal aspects and possibility of correction. Nov Pharm Med. 2013;8(62):15–19 [in Russian].
 
11.
Artus M, van der Windt D, Jordan KP, Croft PR. The clinical course of low back pain: a meta-analysis comparing outcomes in randomised clinical trials (RCTs) and observational studies. BMC Musculoskelet Disord. 2014;15:68–75. https://dx.doi.org/10.1186%2F1....
 
12.
Seyam O, Smith NL, Reid I, Gandhi J, Jiang W, Khan SA. Clinical utility of ozone therapy for musculoskeletal disorders. Med Gas Res. 2018;8(3):103–110. https://doi.org/10.4103/2045-9....
 
13.
Ozgocmen S, Ozyurt H, Sogut S, Akyol O, Ardicoglu O, Yildizhan H. Antioxidant status, lipid peroxidation and nitric oxide in fibromyalgia: etiologic and therapeutic concerns. Rheumatol Int. 2006;26(7):598–603. https://doi.org/10.1007/s00296....
 
14.
Clauw DJ. Fibromyalgia: A clinical review. JAMA. 2014;311(15):1547–1555. https://doi.org/10.1001/jama.2.... 3266.
 
15.
Altindag O, Celik H. Total antioxidant capacity and the severity of the pain in patients with fibromyalgia. Redox Rep. 2006;11(3):131–135. https://doi.org/10.1179/135100....
 
16.
Kaufman EL, Carl A. Biochemistry of Back Pain. Open Spine J. 2013;5:12–18.
 
17.
Steeds C. The anatomy and physiology of pain. Surgery. 2016;34(2):P55–59. https://doi.org/10.1016/j.mpsu....
 
18.
Feizerfan A, Sheh G. Transition from acute to chronic pain. BJA Edu. 2015;15(2):98–102. https://doi.org/10.1093/bjacea....
 
19.
Yam MF, Loh YC, Tan CS, Khadijah Adam S, Abdul Manan N, Basir R. General Pathways of Pain Sensation and the Major Neurotransmitters Involved in Pain Regulation. Review Int J Mol Sci. 2018;19(8):pii:E21643. https://doi.org/10.3390/ijms19....
 
20.
Al-Gebouri HG, Al-Mashhadani Z, Al-Osami MH, Turki KM. Lipid peroxidation and oxidative stress in patients with fibromyalgia syndrome. Iraqi Postgr Med J. 2011;10(1):101–105.
 
21.
Igon’kina SI. [Paticipation Gamk A-receptors in mehanism of development of central neuropatic pain]. Rus J Pain. 2013;1(36):10–12 [in Russian].
 
22.
Iqbal R, Mughal MS, Arshad N, Arshad M. Pathophysiology and antioxidant status of patients with fibromyalgia. Rheumatol Int. 2011;31:149–152. https://doi.org/10.1007/s00296....
 
23.
Re L, Sanchez GM, Mawsouf N. Clinical evidence of ozone interaction with pain mediators. Saudi Med J. 2010;31(12):1363–1367.
 
24.
Olmarker K, Rydevik B. Pathophysiology of sciatica. Orthop Clin North Am. 1991;22(2):223–234.
 
25.
Staal JB, de Bie RA, de Vet HC, Hildebrandt J, Nelemans P. Injection therapy for subacute and chronic low back pain: an updated Cochrane review. Spine(Phila Pa 1976). 2009;34(1):49–59.
 
26.
Katz JN. Lumbar disc disorders and low-back pain: socioeconomic factors and consequences. J Bone Joint Surg Am. 2006;88(Suppl 2):21–24. https://doi.org/10.2106/JBJS.E....
 
27.
Oder B, Loewe M, Reisegger M, Lang W, Ilias W, Thurner SA. CT-guided ozone/steroid therapy for the treatment of degenerative spinal disease: effect of age, gender, disc pathology and multi-segmental changes. Neuroradiology. 2008;50(9):777–785. https://doi.org/10.1007/s00234....
 
28.
Alonso AJC, Joya CM, Hidalgo PS. Prospective and randomized study in patients with low back pain or sciatic pain with ozonetherapy treatment Patologia del Aparato Locomotor. 2007;5(1):46–54.
 
29.
Alberto PO. Ozone the one and only drug. Acta Neurochir Suppl. 2011;108:143–146. https://doi.org/10.1007/978-3-....
 
30.
Plopper CG, Duan X, Buckpitt AR, Pinkerton KE. Dose-dependent tolerance to ozone. IV. Site-specific elevation in antioxidant enzymes in the lung of rats exposed for 90 days or 20 months. Toxicol Appl Pharmacol. 1994;127(1):124–131. https://doi.org/10.1006/taap.1....
 
31.
Bocci VA. Scientific and medical aspects of ozone therapy. State of the art. Arch Med Res. 2006;37(4):425–35. https://doi.org/10.1016/j.arcm....
 
32.
Borrelli E. Mechanism of action of oxygen ozone therapy in the treatment of disc herniation and low back pain. Acta Neurochir Suppl. 2011;108:123–125. https://doi.org/10.1007/978-3-....
 
33.
León Fernández OS, Pantoja M, Díaz Soto MT, et al. Ozone oxidative post-conditioning reduces oxidative protein damage in patients with disc hernia. Neurol Res. 2012;34(1):59–67. https://doi.org/10.1179/174313....
 
34.
Coppola L, Verrazzo G, Giunta R, Luongo C. Oxygen/Ozone therapy and haemoreological parameters in peripheral chronic arterial occlusive diseases. Thromb Atheroscler. 1992;3(1):83–89.
 
35.
Marfella R, Luongo C, Coppola A, et al. Use of a non-specific immunomodulation therapy as a therapeutic vasculogenesis strategy in no-option critical limb ischemia patients. Atherosclerosis. 2010;208(2):473–479. https://doi.org/10.1016/j.athe....
 
36.
Di Mauro R, Cantarella G, Bernandini R, et al. The Biochemical and Pharmacological Properties of Ozone: The Smell of Protection in Acute and Chronic Diseases. Int J Mol Sci. 2019;20(3):634–638. doi: 10.3390/ijms20030634.
 
37.
Xiao W, Tang H, Wu M, et al. Ozone oil promotes wound healing by increasing the migration of fibroblasts via PI3K/Akt/mTOR signaling pathway. Biosci Rep. 2017;37(6):58–69. https://doi.org/10.1042/BSR201....
 
38.
Marx J. Immunology. Antibodies kill by producing ozone. Science. 2002;298(5597):1319–1325. https://doi.org/10.1126/scienc....
 
39.
Michaudel C, Maillet I, Fauconnier L, et al. Interleukin-1α Mediates Ozone-Induced Myeloid Differentiation Factor-88 Dependent Epithelial Tissue Injury and Inflammation. Front Immunol. 2018;9:916–921. https://doi.org/10.3389/fimmu.....
 
40.
Miller DB, Snow SJ, Schladweiler MC, et al. Acute Ozone-Induced Pulmonary and Systemic Metabolic Effects Are Diminished in Adrenalectomized Rats. Toxicol Sci. 2016;150(2):312–322. https://doi.org/10.1093/toxsci....
 
41.
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(1–3):42–49. https://doi.org/10.1016/j.ejph....
 
42.
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. https://doi.org/10.1007/s00296....
 
43.
Bocci V, Borelli E, Travagli V, Zanardi I. The ozone paradox: ozone is a strong oxidant as well as a medical drug. Med Res Rev. 2009;29(4):646–682. https://doi.org/10.1002/med.20....
 
44.
Kallewaard JW, Terheggen MA, Groen GJ, et al. Discogenic low back pain. Pain Pract. 2010;10(6):560–579. https://doi.org/10.1111/j.1533....
 
45.
Buric J, Molino Lova R. Ozone chemonucleolysis in non-contained lumbar disc herniations: a pilot study with 12 months follow-up. Acta Neurochir Suppl. 2005;92(Suppl):93–97.
 
46.
Balestrero R, Franzini M. Use of oxygen-ozone therapy in the treatment of fibromyalgia. Ozone Ther. 2017;2(1):15–27. https://doi.org/10.4081/ozone.....
 
47.
Cordero MD, Alcocer-Gomez E, Cano-Garcia FJ. Clinical symptoms in fibromyalgia are better associated to lipid peroxidation levels in blood mononuclear cells rather than in plasma. PLoS One. 2011;6(10):e26915. https://doi.org/10.1371/journa....
 
48.
Esin RG, Esin OR, Lotfullina NZ, Khayrullin IK, Muradimova LN. [Fibromialgia is the syndrome of generalized pain without trigger zones: Modern principles of diagnostics and treatment]. Prakt Med. 2015;9:2677–2685.
 
49.
Alexandre A, Corò L, Azuelos A, et al. Intradiscal injection of oxygen-ozone gas mixture for the treatment of cervical disc herniations. Acta Neurochir Suppl. 2005;92:79–82. https://doi.org/10.1007/3-211-....
 
50.
de Oliveira JO, Veloso Lages G. Ozone therapy for Lumbosciatic pain. Rev Dor. São Paulo. 2012;13(3):261–270. https://doi.org/10.1590/S1806-....
 
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