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Review
. 2022 Feb 23:13:840623.
doi: 10.3389/fphys.2022.840623. eCollection 2022.

Updated Review on Ozone Therapy in Pain Medicine

Francisco Javier Hidalgo-Tallón  1 , Luis Miguel Torres-Morera  2 , Jose Baeza-Noci  3 , Maria Dolores Carrillo-Izquierdo  4 , Rosa Pinto-Bonilla  3
Affiliations
Review

Updated Review on Ozone Therapy in Pain Medicine

Francisco Javier Hidalgo-Tallón et al. Front Physiol. .

Abstract

The use of medical ozone in the treatment of chronic pain is progressively expanding in Spain and today it is used both in public and private medical centers. However, there is a great lack of knowledge about this technology not only in primary care but also in medical specialties. Although its biochemical bases are well determined and there are various systematic reviews and meta-analyses in the literature that justify its use in pain medicine, some professionals still are prejudiced against it. The evidence level of using medical ozone according SIGN (Scotish Intercollegiate Guideline Network) criteria is similar or superior to most of the techniques used in a Pain Unit. In this paper, we have done a review on ozone therapy in pain medicine, compiling the evidence published about it.

Keywords: chronic pain; medical ozone; ozone injections; ozone therapy; pain medicine.

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Conflict of interest statement

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Figures

Figure 1
Figure 1
The chemical reaction between ozone and PUFA (poli-unsaturated fatty acids) in the insterstitial water (or plasma) produce several ROS, mainly H2O2, and several LOPs, mainly 4-HNE (4-hydroxynonenal). Almost all H2O2 is kidnaped by erythrocytes (not reflected in this figure) if present. In nucleated cells, LOPs activates the NRF2 pathway, inducing the production of ARE (antioxidant response elements) and blocking the NFKB pathway. A small amount of H2O2 stimulates the NFKB pahtway, usually balanced with the NRF2 blocking action, producing a inmmunomodulation.
See this image and copyright information in PMC

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