Ozone Therapy as a Redox-Modulating Strategy in Degenerative Musculoskeletal Diseases: A Clinical-Mechanistic Review

Area of Science:

• Musculoskeletal Medicine
• Redox Biology
• Pain Management

Background:

• Degenerative musculoskeletal diseases cause significant pain and disability globally.
• Oxidative stress and impaired redox signaling are implicated in these conditions.
• Medical ozone therapy is explored as a redox-modulating intervention.

Purpose of the Study:

• To review the literature on oxidative stress, redox signaling, and medical ozone therapy in degenerative musculoskeletal disorders.
• To evaluate preclinical and clinical evidence regarding ozone therapy's efficacy and mechanisms.
• To assess the potential of ozone therapy as an adjunctive treatment.

Main Methods:

• Narrative clinical-mechanistic literature review.
• Searched PubMed/MEDLINE, Scopus, and Google Scholar.
• Critically evaluated preclinical (2000-2025) and clinical (2020-2025) studies.

Main Results:

• Preclinical data suggest controlled oxidative stimuli activate adaptive cellular defenses.
• Clinical studies show short- to mid-term improvements in pain and function for conditions like osteoarthritis and disc disease.
• Significant heterogeneity, lack of MCID achievement, and unvalidated mechanisms limit current findings.

Conclusions:

• Ozone therapy shows plausible biological effects via hormetic redox modulation and may offer symptomatic benefits.
• Lack of standardized protocols, high-quality long-term data, and mechanistic validation necessitate cautious interpretation.
• Considered an investigational adjunct, not a standard of care; further rigorous trials are needed.