Medical Ozone Therapy: Can It Help Your Spine?

Research on stenosis, disc herniation, spondylolysis, and more

Medical consultation, general practitioner refers to model of spine while discussing elderly patient
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A trip to the dentist for a root canal or other infection-related tooth problem may possibly have acquainted you with medical ozone, a treatment in which a specific kind of gas is introduced into your tooth to help kill bacteria.

Your spine may benefit from ozone as well. Small studies on using ozone to treat disc herniation, pain related to failed back surgeries, and even spinal stenosis and spondylolisthesis are so far yielding promising results.

What Is Medical Ozone?

Medical ozone therapy is a percutaneous treatment that introduces ozone (O3) into a troubled area. Percutaneous means the treatment is administered through the skin.

An effective disinfectant, ozone is a potent form of oxygen. It’s used in industry as an air and water purifier as well as for bleaching things like oil, wax, and other substances. You may have experienced ozone after rain, when the air smelled very fresh.

According to Dr. Edward Kondrot, a board-certified ophthalmologist, ozone is like supercharged oxygen and is classified as an oxidative therapy. In lower concentrations, the gas that is produced by an ozone generator (whether in a medical setting, which produces medical grade ozone, or via a home generator which ozonates water or oil) has a very strong and even offensive odor; just the same, this substance is known for its robust fighting power against micro-organisms such as bacteria and fungi.

Short History of Ozone

Ozone was discovered in the mid-nineteenth century and was used to treat infected soldiers in World War I. Currently, numerous municipal water systems around the world are purified with ozone treatment.

Kondrot comments that since the 1950s, ozone has also been used to disinfect donated blood, which he says has helped slow, or even stop the transmission of contagious diseases such as HIV, hepatitis, and syphilis.

And a fun fact: Fidel Castro was very pro-ozone, having donated millions of dollars to further research and development in Cuba.

Medical Benefits

Ozone is only beginning to gather steam in the medical world. Currently, and as alluded to above, it’s most developed in the dental industry but researchers are also evaluating its appropriateness for treating a wide variety of health conditions, including but not limited to asthma, SARS, eye diseases, and back pain.

Among other potential benefits, anti-inflammatory properties that may lead to pain relief have been identified in medical grade ozone. Not only that, but ozone seems to impose few, if any, side effects. As you probably already know, both features are of keen interest to those seeking relief for their back pain.

For Lumbar Spinal Stenosis

Degenerative spinal stenosis is the most common reason back surgery is given to people over the age of 65. As this age group increases in numbers, experts predict the number of procedures given will rise accordingly.

But surgery isn’t always necessary, according to the North American Spine Society. The Society suggests invasive pain management in the form of decompression surgery only for those with moderate to severe lumbar spinal stenosis (LSS) symptoms.

Translated, if your pain or other symptoms are simply unbearable, or if they progress significantly, at that point surgery may make sense. Otherwise, a number of pain management protocols exist that may help make life bearable.

From drugs and physical therapy to steroid injections, back doctors have traditionally turned to conservative care for viable non-invasive ways to help patients manage their lumbar spinal stenosis symptoms. While such treatments serve as the only possible options for many who have undergone numerous back surgeries, they’ve also helped first time spinal stenosis patients avoid “the knife.”

Steroid Injections vs. Ozone Therapy

Short of surgery, steroid injections are the most invasive of all LSS treatment options. The steroid medication that is injected into your back is an anti-inflammatory; as it decreases the inflammation, pain may be abated.

Now, medical ozone is being looked at and it may one day rival steroid injections in terms of LSS symptom relief. According to a study published in the International Journal of Ozone Therapy, the pain-fighting chemistry of ozone may be similar, if not exactly the same, as a steroid injection. It is usually mixed with oxygen when administered for common spine conditions.

In the test tube, O3 blocks an inflammatory enzyme known as phospholipase A2, the same enzyme blocked by steroid injections to relieve pain. The strong potential for few, if any, side effects is also a benefit over steroid injections.

As of early 2018, the use of medical ozone to alleviate the spinal stenosis symptoms is in its early infancy. But the author of the International Journal of Ozone Therapy study noted above found that 74 percent of the 58 patients who received this treatment realized excellent and good results within a year, with no significant side effects.

After Failed Back Surgery

Called failed back surgery syndrome, an invasive spinal procedure that fails to deliver the expected symptom abatement is a challenge to all involved.  

At this point in the journey, options you deem tolerable may be limited. For example, you may be a candidate for a revision back surgery. The problem is, with each passing surgery the likelihood for complications increase, while those for successful pain relief decrease. At some point, you may be proclaimed inoperable.

Once that occurs, your only option is pain management. Luckily, pain management treatments take a number of forms, from exercise and holistic therapies to neuromodulation.

There are two types of neuromodulation: Spinal cord stimulation and drug pumps. Both involve minor surgeries to implant devices that give you a way to control the amount of pain relief treatment—whether it’s a drug or a signal—that is delivered on a daily, and even hourly, basis. Drug pumps tend to be a last resort for chronic spine pain patients.

Spinal cord stimulation, on the other hand, is well-respected in the spine care industry, and has helped many people dealing with years of severe pain to reclaim some or all of their former quality of life.

We may one day add medical ozone treatment to the list of pain management options

According to a study published in Revista da Associação Médica Brasileira, up to 40 percent of spine surgery patients are still in pain after the procedure. The study authors reviewed the records of 19 such patients who had received ozone injections for the post-surgical pain. Within 21 days, the patients’ pain was significantly reduced. That said, no improvement in physical functioning was noted by the researchers.

Two reasons why medical ozone treatment may one day be preferred over spinal cord stimulation are: It does not require a surgery and, as with lumbar spinal stenosis, it’s known for imposing few, if any side effects.

For Herniated Disks

When it comes to discs, ozone treatments are administered in one of two ways, or both: Either directly into the disc or into the paravertebral muscles. Technically called the erector spinae, the paravertebrals are the long muscles that go lengthwise down either side of your spine.

A 2012 systematic review and meta-analysis concluded that for long-term pain relief, injecting ozone into the disc deserved a strong recommendation, but that the recommendation is based on low-quality studies. (Recommendations may change should higher quality evidence become available.) That said, the researchers showed that ozone into the disc yields more benefits than risks or complications.

Ozone into the paraspinal muscles fared a bit bitter. Again, the researchers strongly recommend medical ozone treatment for spinal muscles that affect the nerve root, but in this case the evidence was of moderate quality, rather than low quality. At this level of evidence, ozone into the surrounding muscles applies to most patients in most situations.

If you've experienced a lumbar herniated disc, most likely your symptoms included radiating nerve pain down one leg. A 2014 study published in the Bangladesh Medical Journal found that 90 percent of study participants who underwent treatment with a  mixture of ozone and oxygen, along with physical therapy sessions, reported relief of this symptom for at least four weeks. The researchers therefore recommend a combination of ozone treatment and physical therapy for management of radiculopathy due to disc herniation.

And a study published in the American Journal of Radiology looked at 600 patients with confirmed nerve root compression due to a disc problem and compared oxygen-ozone injection treatment only with oxygen-ozone injection plus corticosteroid injection. Both groups, over 70 percent of patients got either excellent or good pain relief outcomes.

For Spondylosis and Spondylolisthesis

As with spinal stenosis, and to a lesser extent herniated disc, research on medical ozone treatment for spondylolysis and spondylolisthesis is sparse but encouraging.

Spondylolysis refers to a stress fracture in an obscure area of the spine known as the pars interarticularis. Spondylolisthesis is a progressed form of spondylolysis where an entire spinal bone slips either forward (anteriolisthesis) or backward (retrolisthesis) relative to the bone below.

A 2005 study published in the journal Acta Neurochirugica looked at 18 patients diagnosed with spondylolisthesis or spondyloysis who also had a mix of oxygen and ozone administered into their spinal cord. The researchers report that 83 percent of the study participants got complete relief of their pain, with none of them experiencing a recurrence later. They credit ozone’s anti-inflammatory characteristics with the excellent outcomes of their small study.

A Word From Verywell

While medical ozone treatment may not be available at your corner clinic, it seems to offer excellent results for those interested or adventurous enough to try it. It's more prevalent in the natural therapies world, but the key here is to be sure your practitioner is knowledgeable and reputable. If you can, try to find a natural medicine practitioner who is also an M.D. to give you ozone treatment for your back.

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