The search for effective treatment of lumbar sciatica, prolapsed disk & joint pain is still going on & has along way to go. Main reason of this is; ‘the multi-factorial causation’ of these pathologies. Also this reason is involved in explaining why so many modes of treatment are available.
There is a gamut of therapies available for treatment of prolapsed lumbar disk, this includes noninvasive, minimally invasive & surgical methods. The noninvasive methods (like physiotherapy, diathermy, yoga etc.) are the first line modes of management in most of the cases of lumbar disk prolapsed. But when there is no improvement following these procedures, minimally invasive or surgical interventions are recommended. Majority of specialists propose that the minimally invasive procedures are as effective as surgical interventions in long term prognosis.
These minimally invasive procedures are directed towards providing better clinical results along with an acceptable, cost-effective management of lumbar disk prolapsed. Though surgical interventions were preferred earlier; failure rates & post operative complications following surgeries (like Diskectomy) helped to make favorable environment for minimally invasive procedures.
Oxygen-ozone therapy is one of the most popular & effective minimally invasive procedures nowadays. The principles of Oxygen-ozone therapy are depending upon the action of Ozone.
1. Ozone causes reduction in the size of the herniated part of prolapsed disk, which in turn relieves the compression over the nerve root.
2. As the size of the disk decreases it also reduces the venous congestion by relieving obliteration vessels caused due to compression. This mechanical factor improves local microvascular circulation & increases the oxygen availability. This is one of the beneficial effects of ozone therapy for reducing pain, as the nerve roots are very sensitive to hypoxia & hypoxic nerve roots carry enhanced pain sensation to the brain.
3.Ozone also has immune-modulating action.
4. Ozone acts as an effective analgesic & anti-inflammatory.
When combined with corticosteroid & analgesics at the same time Ozone therapy gives better results.
How Ozone therapy is given?
An intradiscal (within the prolapsed vertebral disk) 4 ml and periganglionic (around the nerve root ganglion) 8 ml injection of ozone-oxygen mixture is given.
What exactly happens inside the disk when injection is given?
At a particular concentration, ozone directly affects phosphorous in the disk nucleus, which in turn causes exudation of water molecules from the disk matrix & therefore the matrix degenerates subsequently. The degenerated matrix is then replaced by the fibrous tissue within a period of 5 to 6 weeks. As fibrous tissue is more compact than the matrix of the disk this makes the disk size smaller.
Who are eligible for Ozone therapy?
A patient showing-
1. Clinical signs & symptoms of lumbar disk nerve root compression.
2. CT (computerized Tomography) &/or MRI (Magnetic Resonance Imaging) showing picture of disk prolapsed.
3. Persistent joint pain & swelling for more than 6 months & not responding to conventional pain management methods like analgesics, anti-inflammatory drugs, physiotherapy etc.
4. Recurrent failure of disk surgeries.
What is the success rate of this therapy?
The success rate of Ozone therapy is around 70-80%, but some specialist have claimed that about 85-90% cure rate can be achieved depending on patient’s compliance.
Who are not eligible?
1. Patients with unusual extent of disk herniation.
2. Severe neurological deficit associated with disk pathologies.
What are the post therapy advices?
When the procedure is complete patient is asked rest in supine position for about 2 hours. Patients can be discharged on the same day. When patient is discharged from the hospital he is instructed to slowly resume his body movements.
Are there any complications?
There are no serious complications of Ozone therapy. Though, some patients may feel abnormal sensations in the lower limb of the same side to the treatment. But this may not be a cause of concern, as the symptom spontaneously vanishes after about 2 hours.