How does Ozone work in musculoskeletal pathologies?

Ozone therapy has different methods of administration for the treatment of musculoskeletal pathologies. Depending on the method with which the therapy is carried out, the oxygen-ozone mixture has different mechanisms of action. Let's see them together.

Discolysis: an effective treatment for reducing herniated discs

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In the context of herniated discs, ozone therapy has proven to be a valid treatment option.

Specifically, its mechanism of action can allow a reduction of herniated discs, since:

• dissolving in the interstitial water, ozone reacts with the molecules present generating free radicals (ROS), which mainly consist of H2O2.

• These free radicals act directly on the proteoglycans of the nucleus pulposus, breaking their long chains and starting a process of volumetric reduction of the hernia.

• This phenomenon not only relieves compression on the nervous structures, but also lowers axonal sensitivity, reducing the irritative matrix.

• Ozone also demonstrates an anti-inflammatory action within the intraforaminal space, further contributing to the reduction of the hernia and the consequent symptomatic improvement.

This approach offers a non-surgical treatment route for herniated discs, revolutionizing the way these conditions are treated. 

Paravertebral injection with ozone: rapid pain relief with long-term effects

Paravertebral injection of an oxygen-ozone mixture represents an important development in the management of musculoskeletal pain. Specifically, this treatment option involves rapid pain relief, which with repeated therapy has notable long-term results.

Its mechanism of action in detail:

• in the first instance the needle stimulates complex chemical and neurological reactions, leading to a rapid reduction in pain in a notable percentage of cases (70-80%).

• The ozone then dissolves in the muscle interstitium, generating free radicals (ROS), which are responsible for stimulating local C nociceptors. The latter could cause temporary and bearable pain in the patient, which is significantly reduced if the injection is carried out very slowly. It is important to remember that with repeated treatments a long-lasting analgesic effect is obtained.

Intra-articular administration: rapid relief for pain

In the context of musculoskeletal pathologies, intra-articular administration of ozone has proven to be highly effective. The action of ozone is activated on the patient's local nociceptors, triggering an effective and immediate response to pain. In fact, this procedure offers:

• quick pain relief

• a restoration of mobility

• a reduction in periarticular edema.

Several studies have validated the mechanism of action of ozone for this type in pathologies, specifically during the intra-articular administration of the mixture in the knee, hip and lumbar area, using strategic landmarks. In particular:

• ozone has the ability to dissolve in synovial fluid, which contains proteins, Vitamin E and other antioxidants (such as GSH, SOD and PUFA).

• Lipid Peroxidation Products (LOP) and free radicals (ROS) are then generated, the formation of which involves:

  • inhibition of the release of proinflammatory cytokines and proteolytic enzymes;

  • the release of antioxidant enzymes (SOD, Catalase and GSH-P) and immunosuppressive and anti-inflammatory cytokines, modulating the response to chronic oxidative stress and promoting tissue repair;

  • the induction of the proliferation of fibroblasts and chondrocytes essential for the maintenance of joint tissue.

Systemic administration of oxygen and ozone for muscular and skeletal diseases

For those who have widespread diseases of the spine, generalized pain in multiple body sites, it is not possible to distribute the ozone in a localized way, given the vastness of the sites to be reached.

In this case it is possible to proceed by bringing the ozone to all areas of the body, with systemic administration, and possibly intensifying the action of the ozone with a local treatment in the most painful areas.

Here ozone acts as a generalized anti-inflammatory.

The two possible methods of administering ozone at a systemic level for musculoskeletal problems are:

• the intravenous route, also called GAEI

• rectal insufflation