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.

Increasingly more medical ozone is used in the treatment of pain. So much so that recently the Spanish Ministry of Health has included ozone therapy in the portfolio of pain units.The effectiveness, safety and good tolerability of ozone, in ltrated as well as administered systemically, justify the extent of its use in recent years.Because little is known in general on this subject, the aim of this revision is to update current knowledge about ozone therapy in pain medicine.Key words: Ozone. Medical ozone. Pain medicine. RESUMENCada vez se emplea más el ozono médico en el tratamiento del dolor. Tanto es así que recientemente el Ministerio de Sanidad español ha incluido la ozonoterapia en la cartera de servicios de las unidades de dolor.La efectividad, seguridad y buena tolerabilidad del ozono, tanto in ltrado como administrado por vía sistémica, justi can la extensión de su uso en los últimos años.Debido al escaso conocimiento que en general hay acerca del tema, pretendemos, con esta revisión, poner al día los conocimientos actuales en torno a la ozonoterapia en medicina del dolor.Palabras clave: Ozonoterapia. Ozono médico. Medicina del dolor. INTRODUCCIÓNLa ozonoterapia en medicina es una realidad, y cada vez hay más profesionales haciendo uso del ozono médico como complemento terapéutico para diferentes enfermedades relacionadas con el estrés oxidativo, incluido el dolor crónico.Ya existe una organización médica en torno a la ozonoterapia, y hay asociaciones profesionales que garantizan la buena praxis, y se enseña la ozonoterapia en másteres y cursos de experto de diversas universidades (Curso de experto universitario en ozonoterapia, Universidad de Sevilla, www.aepromo.org, www.seot.es, www.aceoot. org).Se calcula que en el mundo hay más de 26.000 médicos expertos en ozonoterapia, y en Europa son tratados anualmente en torno a los 10 millones de pacientes (1).Recientemente, el Ministerio de Sanidad español ha incluido la ozonoterapia en la cartera de servicios de las unidades de dolor, por lo que se hace necesario que el médi-co experto en el tratamiento del dolor conozca el fundamento científico de la ozonoterapia médica y cómo actúa, tanto a nivel local como sistémico.El ozono es una molécula formada por tres átomos de oxígeno (O 3 ) en lugar de los dos de los que se compone la molécula de oxígeno (O 2 ). La ozonoterapia consiste en la aplicación de una mezcla de oxígeno médico con ozono; la mezcla ha de ser producida in situ para cada aplicación, y en ella nunca habrá más de un 5 % de ozono. REVISIONES MBA

The purpose of this article was to assess the effectiveness of ozone therapy as an adjunct to mechanical therapy in periodontitis patients. Thirty-two patients diagnosed with generalized periodontitis were selected, with a total of 655 teeth examined. Each patient’s mouth was divided into four quadrants (the split-mouth model) to be randomly treated with four sessions of gaseous ozone or air. The following clinical variables were recorded: the gingival index, the periodontal clinical attachment loss, the Miller’s mobility index and the clinical improvements, as assessed through the visual analog scale (VAS). In addition, the microorganisms were qualitatively compared. After four weeks of treatment, the teeth of the ozone-treated quadrants showed statistically significant reductions in the gingival index and an improvement in the clinical attachment (p < 0.0001). The same treatment also significantly improved mobility by between 70% and 86% compared to the control group (p < 0.0001). Statistically significant differences were also recorded for the VAS (p < 0.0001). In the qualitative study of the subgingival flora, significant differences were observed (p < 0.0001). The overall results of this trial support the view that ozone treatment is effective and well tolerated in cases of generalized chronic periodontitis.

Injuries associated with the hamstring muscles in the running athlete are increasingly investigated due to the economic and functional consequences associated with them. Although hardly used in the treatment of sports injuries, medical ozone is effective and very well tolerated in the treatment of musculoskeletal pain, it was decided to add a series of medical ozone infiltrations to the treatment. The evolution of the case was recorded by medical thermography, in addition to measuring pain intensity (visual analog scale) and functional capacity (toe touch test). Pain intensity (visual analog scale) decreased from seven at baseline to two at the end of treatment (after two ozone infiltrations, one weekly). Mobility of the damaged area (toe touch test) improved from a distance of 8 cm at baseline to 0 cm at the end of treatment. Regarding medical thermography, after the first and second infiltration of ozone, the temperature rose to a significant increase in perfusion from baseline from 31.2 to 31.8 °C and from 31.2 to 32 °C, respectively. These results suggest the possible interest of medical ozone as an adjuvant treatment for the recovery of sports tendinopathies and encourage us to carry out further studies.