Weekly ozone injection in the knee could ease osteoarthritis
- The treatment is thought to work by dampening down release of chemicals
- Prostaglandins are triggered by inflammation in a damaged joint
- ‘Laboratory tests have shown [ozone] has anti-inflammatory effects’
The treatment is thought to work by dampening down the release of prostaglandins – chemicals that are triggered by inflammation in a damaged joint and that send pain signals to the brain.
It is prostaglandins that are targeted by non-steroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen, naproxen and diclofenac, which are commonly prescribed for osteoarthritis.
The problem is that osteoarthritis patients need this medication at high doses and many take the drugs for years – prolonged use can lead to dangerous side-effects such as gastric bleeding and heart attacks.
Other treatments include steroid injections to dampen inflammation, but these can be painful and aren’t suitable for all patients.
Despite available treatments, around 60,000 people a year in Britain end up needing a knee replacement because their joints are too badly eroded.
Chemicals are triggered by inflammation in a damaged joint and that send pain signals to the brain
Ozone gas is found naturally in the Earth’s atmosphere, where it shields us from the sun’s harmful ultraviolet rays.
At ground level, ozone in the air is a pollutant that is harmful to inhale, causing symptoms such as chest pain, coughing and throat irritation.
The gas forms mostly in hot weather when other pollutants mix with sunlight.
But in recent years ozone has attracted interest for its potential uses in medicine.
For example, it has been used in dentistry as a way to halt tooth decay, as it destroys harmful bacteria that rot teeth and gums.
Now Brazilian scientists have found ozone jabs could also help with osteoarthritis.
In an eight-week trial, doctors at the Federal University of Sao Paulo gave 63 patients ozone injections weekly and another 35 patients had placebo injections of air into their sore knees.
The results, presented at the recent American College of Rheumatology conference, showed that the ozone group experienced significant improvements in pain relief and mobility. Four months after the treatment stopped, there were no signs of these improvements waning. Patients also reported no side-effects.
Those who received air injections saw no change in their condition.
Dr Virginia Fernandes Moca Trevisani, one of the researchers, said: ‘We think ozone can give patients a better quality of life, with less pain and more independence in daily life activities. It might even delay the need for joint replacement surgery.’
The researchers plan more studies using ultrasound scans to monitor changes inside the knee.
Commenting on the research, Philip Conaghan, a professor of musculoskeletal medicine at the University of Leeds, said ‘using ozone this way is certainly plausible because laboratory tests have shown the gas has anti-inflammatory effects’.
However, a potential problem is that patients don’t usually like injections and this trial involved eight weekly jabs, so ‘we need more research to see if fewer injections can have the same effect’, he said.
Meanwhile, black pepper could have anti-inflammatory effects to help ease arthritis pain.
Researchers in Thailand gave 66 patients the NSAID drug diclofenac or a traditional Thai black pepper supplement known as sahastara to take three times a day for four weeks.
Results showed there was a similar reduction of pain levels or joint stiffness for each treatment, according to the journal Evidence-Based Complementary and Alternative Medicine.