Ozone Therapy as Add-On Treatment in Fibromyalgia Management by Rectal Insufflation: An Open-Label Pilot Study

Abstract

At the dose and number of sessions used in this study, ozone therapy by rectal insufflation seems to be beneficial for physical symptoms and depression of fibromyalgia.

Use of oxygen-ozone therapy in the treatment of fibromyalgia

“…4 NO also promotes the excessive release of excitatory amino acids and substance P from presynaptic terminals afferent to the dorsal horn of the spinal cord, which are hyperstimulated, 5,15 which seems to partly explain the alterations in processing the painful stimulus. 5,16 At the same time, there were also effects at the level of the muscle layer. In fact, damage to the sarcolemma produced by ROS would cause pain as well as muscle stiffness, 7 so much that there were significant correlations between the levels of antioxidants (in both serum and plasma) and the pains and stiffness, as assessed by appropriate measurement scales.…”

“…5 Despite generalised pain being considered the cardinal symptom, others like tiredness and being easily fatigued, non-restorative sleep and mood disorders in the sense of anxietydepression, play a significant role in determining the degree of disability characteristic of this disease. 5 Even the pathogenesis of FM is very complex and, as mentioned earlier, many factors converge 12 In affected patients in particular, an increased level of certain cytokines (including IL-6 and IL-8, the release of which in turn is probably stimulated by other systems upstream like the sympathetic nervous system, could intervene in causing the symptoms of FM. In fact, as is known, IL-8 promotes sympathetic pain and IL-6 induces hyperalgesia, fatigue and depression.…”

“…Oxidative stresses and ROS such as for example, NO seem therefore to be mainly involved in the pathogenesis of FM even if it is not yet known whether redox equilibrium alterations are a cause or effect of this pathology. 5,6 Studies to date have shown how various mechanisms come into play in the body. For example, the cause of H2O2 increases in the neutrophils of these patients, similar to an increase of superoxide of mitochondrial origin in the mononuclear cells of the peripheral blood, 4,14 can be explained by a CoQ10 deficiency in patients with FM.…”

“…3 Finally, in recent years, oxidative stress has assumed a leading role in the pathophysiology of FM 4 although it is not yet known whether its increase is a causative factor in the disease or a consequence of the patient's general condition. 5,6 In patients with FM, an increase in the concentrations of malonyldialdehyde have been found, alongside a low concentration of antioxidant enzymes like catalase, glutathione peroxidase and superoxide dismutase. 5,7 Ozone is known to exert a mild, transient and controlled oxidative stress that promotes upregulation of antioxidant systems and modulation of the immune system.…”

“…5,6 In patients with FM, an increase in the concentrations of malonyldialdehyde have been found, alongside a low concentration of antioxidant enzymes like catalase, glutathione peroxidase and superoxide dismutase. 5,7 Ozone is known to exert a mild, transient and controlled oxidative stress that promotes upregulation of antioxidant systems and modulation of the immune system. 8 In accordance with this its mechanism of action is suggested as an effective therapeutic indication in the treatment of FM.…”