<p>Interesting effectiveness of ozone injection for carpal tunnel syndrome treatment: a randomized controlled trial</p>

Abstract

Purpose: Carpal tunnel syndrome (CTS) is the most common entrapment neuropathy in the upper limb. Local injection of different substances has been increasingly used as an acceptable conservative treatment in non-severe cases. This study aimed to evaluate the efficacy and safety of local ozone injection in the management of non-severe CTS. Methods: In the current randomized controlled trial (RCT), 40 patients with mild or moderate CTS were included in two parallel groups. Both of them used the resting volar wrist splint for 8 weeks; while the intervention group received a single dose of local ozone injection, except for the same splinting protocol. The main outcome measures including visual analog scale (VAS) for pain; symptom severity or functional status, based on Boston questionnaire (BQ); and median nerve conduction study, were reassessed 10 weeks after the treatment. Results: All of the measures including VAS, symptom severity, functional status and EDX improved significantly in both groups with the maximal changes in VAS. The VAS reduction was more remarkable in the ozone group than the control group [64% versus 45.3%, respectively]. Moreover, both of the BQ subscales showed significantly higher improvement in the ozone group compared to the control group ( P =0.01 and 0.02, respectively). Although the improvement of EDX parameters was slightly better in the ozone group, the difference was not significant. Neither minor nor major side effects were reported. Conclusion: Ozone therapy as a safe and low-cost method, could provide promising results among women with mild to moderate CTS, at least for short-term treatment. Clinical trial registration: IRCT2016040913442N9.

Oxygen-Ozone Therapy for Reducing Pro-Inflammatory Cytokines Serum Levels in Musculoskeletal and Temporomandibular Disorders: A Comprehensive Review

“…Elawamy et al demonstrated that both intracarpal ozone or methylprednisolone reported advantageous impacts upon CTS in people with SSC; nonetheless, ozone relieves pain, enhances the hand functioning, decreases the duration and frequency of Raynaud’s attacks, declines the size of ulceration, and improves median nerve conduction study over the 6-month follow-up [ 132 ]. Rascaroli et al found slight improvements in sensory and motor parameters after ozone therapy, and Bahrami et al showed improvement of median sensory nerve action potential latency, compared to the pre-treatment level in both groups (one group treated with wrist volar splint alone, the other group treated with ozone injection and splint) [ 133 , 134 , 135 , 136 ]. The nature of the fibrotic expression in SSc people with CTS seemed to be significantly associated with gene upstream for Col1 and Col3, TGF-β, and SMAD3 in CTS fibroblasts [ 137 , 138 ].…”

“…Moreover, the pressure pain threshold of the temporal muscle, masseter muscle, and TMJ lateral pole were significantly higher in the ozone group ( p = 0.035; p = 0.007; p = 0.012, respectively). The same authors also compared the bio-oxidative ozone therapy to occlusal splints therapy in patients affected by both muscle and articular TMD disorders [ 135 , 175 , 179 ], showing that both therapies were effective in the improvement of mandibular movements and VAS scores. However, evaluating the effects in terms of PPT measurement of the temporal and masseter, their results indicated that occlusal splint treatment produced better results than ozone application ( p = 0.046; p = 0.024, respectively).…”

Non-Surgical Management and Post-Surgical Rehabilitation of Carpal Tunnel Syndrome: An Algorithmic Approach and Practical Guideline

“…Recent studies have recommended local ozone therapy in some musculoskeletal conditions (70,71). Rascaroli et al showed that neurophysiological and functional parameters after O2-O3 treatment were improved significantly more than the motor and sensory nerve conduction parameters (72).…”

Effect of Persian manual therapy (Fateh technique) on patients with mild and moderate carpal tunnel syndrome: a clinical trial

“…8 Therapies include surgical and non-surgical treatments. The non-surgical treatments used for this condition include a variety of options, including changing habits such as restricting the movement of the wrist joint and reducing strenuous occupational activity; using ergonomic devices, using splints or a variety of oral medications such as oral steroid medications as well as ultrasound therapy, 9 injection of steroid medications, 10 taking nonsteroidal anti-inflammatory drugs (NSAIDs), Diuretics, Vitamin B6, Job change, 11,12 topical injection of progesterone, 13,14 Botulinum toxin injection, Use of magnets, 15 Iontophoresis, Low-level laser, 16 Median nerve mobilization, 17 Scaphoid and Hamate Mobilization, 18 Static magnetic field (SMF), Bioptron, 19 specific exercise, 20 Plateletrich plasma (PRP) 21 and ozone therapy 22 are other suggested non-surgical treatments.…”