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.
Highlights
Ozone (O3 ) is an inorganic molecule with allotrope properties consisting of three atoms of oxygen with a cyclic structure isolated for the first time in 1839 by ChristianFriedrich Schönbein [1]
Medicine (PRM) is a specialist area of medicine focused on the complex management of functioning impairments and disabling sequelae related to several chronic conditions, and musculoskeletal disorders account for a significant portion of its clinical tasks [24]
Ultrasonography has been recently proposed as a non-invasive and real-time technique that could guide O2 O3 injection, allowing the physician to precisely target the area of interest and to monitor the gas spreading in the tissues, in order to reduce the occurrence of adverse events [69]
Summary
Ozone (O3 ) is an inorganic molecule with allotrope properties consisting of three atoms of oxygen with a cyclic structure isolated for the first time in 1839 by Christian. Medicine (PRM) is a specialist area of medicine focused on the complex management of functioning impairments and disabling sequelae related to several chronic conditions, and musculoskeletal disorders account for a significant portion of its clinical tasks [24]. In this scenario, conservative and mini-invasive treatment options are extremely functional to the PRM framework [24,25,26,27,28]; the interest in O2 O3 therapy application in this field has considerably increased in recent years [13]. The present review aims at describing the state-of-the-art regarding the mechanisms of action, treatment modalities and potential side effects of O2 O3 therapy in the complex management of the most common musculoskeletal disorders in the PRM field
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