Oxygen-Ozone Therapy in the Rehabilitation Field: State of the Art on Mechanisms of Action, Safety and Effectiveness in Patients with Musculoskeletal Disorders

Alessandro de Sire, Francesco Agostini, Lorenzo Lippi, Massimiliano Mangone, Simone Marchese, Carlo Cisari, Andrea Bernetti, Marco Invernizzi, Alessandro de Sire, Francesco Agostini, Lorenzo Lippi, Massimiliano Mangone, Simone Marchese, Carlo Cisari, Andrea Bernetti, Marco Invernizzi

Abstract

In recent years, the interest in oxygen-ozone (O2O3) therapy application has considerably increased in the field of rehabilitation. Despite its widespread use in common clinical practice, the biochemical effects of O2O3 are still far from being understood, although its chemical properties seem to play a pivotal role in exerting its positive effects on different pathological conditions. Indeed, the effectiveness of O2O3 therapy might be partly due to the moderate oxidative stress produced by O3 interactions with biological components. O2O3 therapy is widely used as an adjuvant therapeutic option in several pathological conditions characterized by chronic inflammatory processes and immune over-activation, and most musculoskeletal disorders share these pathophysiological processes. The present comprehensive review depicts the state-of-the-art on the mechanisms of action, safety and effectiveness of O2O3 therapy in the complex scenario of the management of musculoskeletal disorders. Taken together, our findings suggest that O2O3 therapy seems to reduce pain and improve functioning in patients affected by low back pain and knee osteoarthritis, as reported by several studies in the literature. However, to date, further studies are warranted to clearly investigate the therapeutic effects of this promising therapy on other musculoskeletal disorders in the field of rehabilitation.

Keywords: fibromyalgia; low back pain; neck pain; osteoarthritis; oxygen ozone; oxygen–ozone therapy; ozone; pain management; rehabilitation; tendinopathy.

Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
Ozone (O3) formation mechanism and intracellular and intranuclear pathways involved in inflammation and oxidative stress.
Figure 2
Figure 2
The main means of administration of O2O3 therapy in the field of rehabilitation.

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