The use of oxygen ozone therapy in the treatment of cervicobrachial pain: case series study

This retrospective, observational, uncontrolled case series study was carried out to evaluate the clinical efficacy and safety of intramuscular paravertebral injections of an oxygen-ozone (O2-O3) mixture in patients with cervicobrachial pain. One hundred and sixty-eight subjects affected by cervicobrachial pain, referred to Ozone Therapy Unit at San Pietro Fatebenefratelli Hospital in Rome (Italy), were enrolled in the study. All the subjects (n=168, 106 females and 62 males) completed the treatment and the follow-up visits. Subjects received 12 cervical intramuscular injections of an O2-O3 mixture (5 mL) with an O3 concentration of 16 μg/mL once a week. The overall reduction of pain was measured by the change in mean of Visual Analogue Scale (VAS) score from baseline to the end of treatment and from baseline to one, two, three, four and five years of follow-up. Patient satisfaction was assessed at the end of treatment, by modified MacNab Questionnaire. Possible adverse events related to the treatment were recorded. The mean (± standard deviation) VAS pain score at baseline, at the end of treatment, and during the follow-up at one, two, three, four and five years were 7.82 (±1), 1.6 (±1.5), 1.5 (±1.4), 1.4 (±1.3), 1.6 (±1.2), 1.5 (±1.3) and 1.60 (±1.2), respectively, showing a significant reduction in pain over time (p<0.001). Of 156 patients who responded to treatment, 128 (82.05%) were pain free at one year, 110 (70.51%) at second year, 103 (66.02%) at third year, 94 (60.25%) at fourth year and 86 (55.12%) at fifth year follow-up visit. According to pain distribution all subjects showed a significant reduction in pain over time in each group (p<0.05). No significant differences were observed between groups. No serious adverse events were observed during the entire study. We suggest the use of intramuscular paravertebral injections of an oxygen-ozone (O2-O3) mixture in patients with cervicobrachial pain as an effective and safe treatment option to consider before surgical intervention.