Ozone Therapy for Herniated Disks: Genius or Madness?

A new treatment that uses oxygen and ozone to provide pain relief from herniated disks will become standard practice in the US in less than 10 years, predicted one author of a new study presented at the Society of Interventional Radiology’s 34th Annual Scientific Meeting.

Researchers at the University of Toronto analyzed more than 8,000 patients who were treated with ozone therapy to reduce pain, disability, and risk of complications. The treatment injects a gas mixture of oxygen and ozone into a herniated disk, which reduces pain and inflammation by reducing the volume of the disk.

The estimated mean of improvement for patients was based on the 10-point visual analog scale (VAS), a standard measure for evaluating back pain that holds 0 as no pain and 10 as the worst pain. Participants treated with ozone therapy reported a mean improvement change of 3.9.

The researchers also looked results using a second rating system, the Oswestry Disability Index (ODI), which measures “one’s ability to manage everyday life.” The estimated mean of improvement on the ODI was nearly 26 percent (an ODI score of 61 percent or higher represents back pain that has an impact on all aspects of daily living).

Improvement scores for both VAS and ODI outcomes were “well above both the minimum clinically important difference and the minimum (statistically significant) detectable change,” which shows that the decrease in pain and the increased ability to function were very clearly felt by the patient.

Kieran J. Murphy, MD, interventional neuroradiologist and vice chair and chief of medical imaging at the University of Toronto in Toronto, Ontario, Canada, predicted that this technique will become standard practice in the US in the next five years while at the Society of Interventional Radiology’s 34th Annual Scientific Meeting in San Diego, CA.

Murphy told WebMD that he “first became aware of the treatment in 2003 while attending a medical conference in Venice. He said he remembers thinking “This is either madness or genius” when he first heard about the treatment that has been used in more than 14,000 lower back pain patients in Europe (the procedure was developed in Italy).

“The estimated improvement in pain and function is impressive when we looked at patients who ranged in age from 13 to 94 with all types of disk herniations,” said Murphy. “Equally important, pain and function outcomes are similar to the outcomes for lumbar disks treated with surgical diskectomy, but the complication rate is much less (less than 0.1 percent). In addition, recovery time is significantly shorter for the oxygen/ozone injection than for the diskectomy.”

What is your opinion on this and other “treatments” for which there is a decided lack of rigorous, well-designed, controlled studies? How willing are you to implement relatively unknown procedures in practice? What about in cases where a patient has not responded to conventional, accepted therapies and approaches?