Ozone again…

In today’s Daily Mail, the spurious ‘Good Health’ section features an article entitled, ‘How a shot of ozone can beat backache’. Ozone is something of a buzz word in the alternative therapy/naturopathy circles, where O2 (oxygen) is seen as an amazing cure all (rather than a potential damaging oxidiser), thus O3 (ozone) is king. Ben Goldacre, of the Bad Science blog, has written numerous times about pseudo-scientific ozone treatments.

The difference in this case is that the evidence comes from an 8,000 person meta-study led by Kieran Murphy, MD, at the University of Toronto, analysing results published in similar European treatments, and as such has some degree of validity. Dr Murphy, who performs oxygen/ozone treatments, recently pioneered a medical device for minimally invasion introduction of an oxygen/ozone delivery device to the lumbar discs (the fluid filled spongy spacers between the bones of your spine).

Importantly however, there was a lack of randomised, blinded trials, and there was no control (placebo) group, so it’s difficult to conclude whether any improvements were specifically due to the ozone injections. The placebo effect can be powerful, especially in treatments that involve injections or ‘medical theatre’ (the degree of organisation and preparation before a procedure); Ben Goldacre also writes about such effects.

In January, researchers at the same institution (the University of Toronto) published the results of an 8-week, 3-visit, triple-blinded, randomised controlled clinical trial involving 44 subjects, looking at treatment of hypersensitive teeth with ozone injections. They found that treatment resulted in reduced pain sensation, but that this was indistinguishable from the placebo, demonstrating the patient’s expectation of cure from an invasive practice, or ‘medical theatre’.

Without such controls, it is difficult to conclude whether such therapies are truly effective, though the power of placebo cannot be discounted as having some benefit if it is able to reduce pain.

Fortunately, in the Mail’s article they did offer one paragraph to a Professor of muskuloskeletal medicine at the University of Leeds who welcomed new innovation, but also suggested that the lack of appropriate randomised controlled trials needs to be addressed.

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