Ozone Therapy Simply Explained

1. What It Is About

Ozone therapy uses a mixture of oxygen and ozone. Ozone is a gas that occurs in nature through sunlight or lightning. In therapy it is produced from pure oxygen using special devices. The mixture can be applied in various ways: locally, for example as an injection into a joint or onto the skin, or systemically, for example via treatment with the patient’s own blood. The underlying idea is that ozone can trigger reactions in the body that reduce inflammation and promote healing. Historically the procedure originates from water treatment, where ozone was used for disinfection. First medical applications date back to the early twentieth century, with systematic studies following from the 1990s onwards. Today ozone therapy is used for various complaints, most commonly for problems with joints, intervertebral discs and wounds.

2. What Studies Show

Ozone therapy is best studied for musculoskeletal complaints. In a large multicentre study from 2009, people with acute back pain and a herniated disc received either an ozone injection or a sham treatment. The study was double-blind, meaning neither the participants nor the practitioners knew who received which treatment. Ozone therapy performed better than the sham treatment 1. For knee osteoarthritis, ozone was compared with hyaluronic acid, a substance frequently injected into joints. In several randomised studies from 2017, 2018, 2020 and 2023, ozone performed similarly well or in some cases better for pain and joint function than hyaluronic acid 3 5 6 7. There are also indications for chronic wounds: a randomised study from 2014 examined people with diabetic foot ulcers. Non-invasive ozone therapy promoted healing by stimulating the growth of factors important for tissue repair 2. In dentistry, ozonated gels were compared with chlorhexidine, a disinfectant. Randomised studies from 2021 to 2024 showed that ozonated gels were similarly effective to chlorhexidine in chronic periodontitis and peri-implantitis and had anti-inflammatory effects 4 8 9 10. Robust data exist on safety, especially for local applications. Side effects such as pain at the injection site are, however, rarely recorded systematically.

3. What Remains Unclear

Many studies involve only a small number of participants and observe patients for only a short period, often only weeks to months. This makes general statements difficult. In addition, a uniform dosage and application method is often lacking, which complicates comparisons. For subjective complaints such as pain or fatigue the placebo effect is hard to control, meaning that the expectation of improvement alone can produce an effect. For applications outside the musculoskeletal system, for example in viral infections or as an adjunct to cancer therapy, controlled human studies are missing. Existing work often consists only of cell or animal studies or small observational reports that do not permit reliable conclusions. How ozone acts in the body in detail is also not yet fully understood. Open questions concern the optimal dosage, the mode of action at cellular level and possible combinations with other treatments.

4. What This Means in Everyday Life

Ozone therapy is already being investigated in studies for some complaints, especially joint and back pain. The results are partly encouraging, yet not equally well supported in all areas. Anyone interested in ozone therapy should be aware that research still leaves many questions open. There is no general recommendation, and treatment should be carried out by experienced professionals. It is important to obtain information about the individual situation and possible risks. Science is working to clarify the open questions, for example through larger studies with uniform methods. Until then ozone therapy remains a procedure that shows promise in certain cases but is not regarded as established everywhere.

All Details with Study Numbers and Sources: detailed page on ozone therapy. For children: ozone therapy for children.