Myths and truths about the safety and efficacy of medical ozone in the treatment of pain.
03The use of medical ozone in the treatment of chronic pain is an expanding practice
that, although it has institutional backing in countries such as Spain, is still surrounded by
controversy and contradictory perceptions. The following are the main myths and
truths about its safety and efficacy based on the sources provided.
Myths about medical ozone
– “Ozone is always toxic to humans”: This is one of the most common misconceptions
. Although ozone is a toxic gas when inhaled, as it damages lung tissue
and airways, its medical use is safe when administered by appropriate
routes (infiltrative, topical or systemic) and in controlled doses. Medical ozone is never
inhaled and consists of a mixture where ozone represents at most 5% and
oxygen 95%.
– “There is no scientific evidence to support its use”: Although some sectors
consider it “quackery”, there are many meta-analyses and systematic reviews in
indexed journals that support its efficacy, especially for the treatment of lumbar disc herniation
and knee osteoarthritis. In fact, in Spain it has been officially included
in the portfolio of services of pain units since 2011.
Truths about its efficacy and safety.
– Efficacy in spine and joint pathology: The truth is that ozone therapy has
demonstrated very good results when used as a “discolytic” agent in herniated
discs, but with the advantage of being an outpatient and minimally invasive treatment.
It acts by “mummifying” the nucleus pulposus, which reduces the volume of the disc
and decreases nerve compression. In osteoarthritis of the knee, it has a high level of evidence
, improving pain and function.
– Biological mechanism of action: Ozone acts by inducing a controlled “micro-oxidation”
that activates the cellular antioxidant system (NRF2 pathway), blocks inflammatory pathways
and promotes the regeneration of tissues such as cartilage. It has analgesic,
anti-inflammatory and antiseptic properties and improves tissue oxygenation.
– High safety profile: Assuming that it must be performed by
trained professionals and with precision generators for medical use, the risk of adverse effects is
extremely low (approximately 0.0007% in systemic applications such as
autohemotherapy). Most of the serious complications reported in the literature are
due to bad practices, such as direct intravenous injection (prohibited) or infections
due to lack of hygiene in the puncture, and not to the ozone molecule itself.
– Specific contraindications: It is a medical truth that ozone therapy is
strictly contraindicated in patients with favism (G6PD enzyme deficiency), since
can cause hemolysis. It is also not recommended in cases of uncontrolled hyperthyroidism
, pregnancy and severe cardiovascular pathologies.
In conclusion, medical ozone is neither a universal therapy nor risk-free, but rigorous studies
confirm that it is a safe and effective tool for the management of musculoskeletal and pain diseases
, provided that standardized protocols are followed and certified medical technology
is used.
Author: Kike del Cojo
Director of the MIVI Cáceres Pain Unit