Effects of Oxygen-Ozone Therapy and Physiotherapy on Functioning in Patients with Chronic Non-Specific Neck Pain: A...

Objectives: This study aimed to evaluate the effects of a combined treatment consisting of O₂O₃ injections and McKenzie-based physiotherapy exercises, compared to a Control group treated with O₂O₃ injections and a Back School physiotherapy program, in reducing pain and disability in individuals with chronic non-specific neck pain. Methods: In this prospective double-arm pilot study, patients with chronic non-specific neck pain and a Numerical Rating Scale (NRS) > 4 were enrolled. All patients received eight weekly sessions of O₂O₃ injections (10 μg/mL, 10 mL total, and 2 mL bilaterally into the cervical paravertebral muscles). Patients were then randomly assigned (1:1 ratio) to either an experimental group receiving McKenzie physiotherapy or a Control group undergoing Back School techniques, with five sessions per week over two weeks. Outcome measures included the Neck Disability Index (NDI), NRS, EuroQol-5D-3L (EQ5D3L), and EuroQol Visual Analog Scale (EQ-VAS). Results: A total of 41 patients were included and divided into two groups: Back School (n = 21; mean age: 63.9 ± 13.4 years) and McKenzie (n = 20; mean age: of 57.3 ± 12.9 years). Both groups showed significant improvement in NDI, NRS, EQ5D3L, and EQ-VAS following the O₂O₃ injection cycle (∆T0-T1 p < 0.001). The subsequent addition of physical therapy led to further improvements across all outcomes in both groups (∆T1-T2 p < 0.001), with the McKenzie group showing slightly greater benefits, despite the lack of significant differences. Conclusions: This study demonstrated the effects of combining O₂O₃ injections with either McKenzie or Back School therapy in improving pain, disability, and quality of life in patients with chronic non-specific neck pain.