WebMD Health News
Louise Chang, MD
March 9, 2009 -- An experimental treatment that involves injections of ozone gas into the spine is showing promise for the relief of herniated disc-related lower back pain.
Its supporters say ozone therapy could become a standard treatment for the condition within the next five years in the United States, but a back pain specialist who spoke to WebMD remains unconvinced.
A researcher who has treated close to 50 people with a combination of ozone and oxygen since 2005 says between 50% and 60% of patients with pain from herniated discs could be good candidates for the minimally invasive procedure.
Interventional radiologist Kieran Murphy, MD, of the University of Toronto says ozone therapy could even help some patients avoid back surgery.
Murphy presented findings from his own animal studies today at the annual meeting of the Society of Interventional Radiology in San Diego.
The studies suggest that ozone therapy works by shrinking herniated discs.
As many as 80% of adults in the U.S. suffer from lower back pain at some point in their lives, and for many, the cause is a herniated disc.
The condition occurs when the spongy cushions, or discs, that serve as shock absorbers for the spine become inflamed and bulge or break open. A herniated disc of the lower spine can cause pain in the back, buttocks, and legs with numbness and weakness when bulging discs press against nearby nerves.
About half of the people with herniated disc-related pain will recover within a month, and nine out of 10 will get better within three to six months without surgical treatment.
“About 10% of people with herniated discs end up requiring surgery, and about 90% of patients who have surgery get better,” says Scott D. Boden, MD, who directs the Emory Orthopedics and Spine Center in Atlanta.
Because so many people with pain from herniated discs get better on their own, Boden tells WebMD that it is hard to prove that treatments like ozone therapy actually work.
“It is difficult to determine if patients who report less pain are responding to these treatments or just getting better on their own,” he says.
Murphy tells WebMD that in recent years more than 14,000 lower back pain patients have been treated with ozone therapy in Europe, mostly in Italy, where the procedure was developed.
He says he first became aware of the treatment in 2003 while attending a medical conference in Venice.
“When I first heard about it, I thought, ‘This is either madness or genius,’” he says.
He became so intrigued by the treatment that he invented and patented his own oxygen/ozone delivery device that is about the size of a cigar.
Computer imaging guides the needle used to deliver the ozone/oxygen treatment to the herniated disc. Patients require no more than a local anesthetic, and Murphy says most of his patients have reported improvements in pain within 48 hours of the treatment.
At the San Diego meeting, Murphy presented his analysis of 12 studies involving more than 8,000 patients treated with the ozone/oxygen in Italy and elsewhere in Europe.
He says the analysis suggests that ozone therapy is as effective as surgery for relieving pain caused by a herniated disc, with a much lower incidence of complications and much quicker recovery times.
“I do believe that this will become a standard therapy, but I understand why many people within the (medical) community would be skeptical,” he says.
Boden is one of those people.
He says until rigorously designed studies are conducted, the usefulness of ozone therapy for the treatment of herniated disc pain remains unknown.
SOURCES:Society of Interventional Radiology Scientific Meeting 2009, San Diego,
March 7-12, 2009.Kieran J. Murphy, MD, interventional neuroradiologist; vice chair and chief
of medical imaging, University of Toronto, Ontario, Canada.Scott D. Boden, professor of orthopedic surgery, Emory University School of
Medicine; director, Emory Orthopedics and Spine Center, Atlanta; spokesman,
American Academy of Orthopedic Surgeons.
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