What Is Medical Ozone Therapy For the Spine?

Doctor talking to patient in hospital room

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In This Article

Ozone spine injection is a type of procedure that has been used in the treatment of chronic back pain associated with spinal disc herniation or other similar structural spine problems. It's a controversial treatment that is not approved in the US. Recent experimental research studies have begun to document the pros and cons of this interventional therapy.

Ozone injections utilize oxygen gas in the form of O3, rather than O2 (O2 is the form of the oxygen in the air we breathe). The mechanism by which the gas injection may work isn't completely understood, but researchers suggest that the O3 molecules produce a chemical reaction that reduces pain and inflammation and induces degeneration of pain-inducing spine or disc protrusions.

Purpose of the Procedure

Chronic back pain due to spine (backbone) issues is managed using a number of approaches, such as physical therapy, oral medications, and local injections—including nerve blocks and steroids. Surgery is a treatment option as well, although it doesn't always yield good outcomes and may entail revision spine surgery.

Pain-inducing spine problems, which tend to be more common among those who are over age 65, tend to limit a person's physical activity. Often, with these spine conditions, the spinal bones or the cartilaginous discs in between the spinal vertebrae compress on the spinal nerves and other structures near the spine, causing pain.

In the treatment of chronic back pain, ozone injection has been used in the setting of herniated disks, spine fractures, and spinal stenosis (narrowing of the spine around the spinal cord), and failed back surgery syndrome.

This procedure is typically considered an adjunct to other back pain treatments, such as steroid or anesthetic injections.

Results of a 10 year follow up study of patients who were treated with ozone injection for disc herniation with chronic back pain suggested that the procedure was safe and helped them avoid surgery and injections.

Risks and Contraindications

While several studies have suggested that ozone spine injection is largely safe, there are concerns regarding adverse events and inconsistency regarding the injection techniques.

The procedure may cause complications, including spine infections, septicemia (dangerous infection in the blood), and abscesses of the spine.

It has also been associated with rare side effects, such as heart damage and pulmonary embolism (PE).


Several companies are working on the development and manufacturing of this treatment and studying its effects.

A number of international studies are in progress evaluating the effects of the spinal ozone injection procedure and the outcomes are being reported in scientific research journals. It has been proposed as a possible option when established treatments, especially steroid injections, are contraindicated.

There are some controversies regarding this treatment, and the Food and Drug Administration (FDA) has stated that "Ozone is a toxic gas with no known useful medical application in specific, adjunctive, or preventive therapy."

The Procedure

The surgical intervention is performed in a sterile environment such as an operating room or a procedural suite. Anesthesia sedation and surgical monitoring are required.

Patients who have this treatment are positioned in a fetal position so the surgeon can optimally access the spine for injection. The skin must be cleaned with antiseptic immediately prior to the procedure.

The oxygen gas, which is obtained from the supplier ahead of time, is inserted through the skin with a needle and released near the spine in the area of pain. The injection is done with the guidance of real-time imaging, such as computerized tomography. While there are a few methods, the most common involves injecting the gas directly into the cartilaginous disk.

During and immediately after the procedure, the surgical team uses imaging techniques to observe the gas as it travels in and around the region of the needle placement.

Ozone treatment of the spine requires an overnight hospital stay. You should have neurology examinations to check on your spine and spinal nerve function, as well as close medical monitoring so that complications, such as infections, can be caught as early as possible.

Recovery and Follow-Up

After treatment and discharge from the hospital, reports suggest that patients generally do not experience frequent complications. People may resume activities such as going back to work or physical therapy exercises after one week. 

It is not completely clear how long it takes for the procedure to be effective. In fact, back pain can resolve over time due to issues like weight changes and modified physical activity, so some experts are not sure whether reported improvement occurs due to ozone therapy or to the spontaneous improvement of the back pain.

A Word From Verywell

In the US, ozone injections are not an approved therapeutic approach for treating back pain. Nevertheless, there are a number of international studies examining the potential of this treatment and there are companies working on developing and manufacturing it. The results and the theory behind the treatment are interesting, but leave some questions unanswered.

If you are suffering from chronic back pain, it's important that you seek medical help so you can work with your doctor to find the best treatment to relieve your symptoms and improve your quality of life.

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