Ozone therapy in Rhumatism and arthritis


Arthritis is Inflammation of a joint or a state characterized by inflammation of the joints. , There are more than 100 different types of arthritis, with osteoarthritis being the most common. Osteoarthritis is a degenerative joint disease, due to joint injury, joint infection, or age. Osteoarthritis tends to affect older individuals. Rheumatoid arthritis, psoriatic arthritis, gout, and some other autoimmune diseases are other forms of arthritis.
Patients with arthritis generally experience constant joint pain.
Arthritis can attack neighboring structures, such as the muscles, and even the liver, lungs, kidneys and heart.
Arthritis tends to be a chronic (long-term) disease. Chronic disability due to arthritis is the second most common from of chronic disability, after heart disease.


Rheumatism (or rheumatic disorder)

It is an Indefinite term applied to various conditions with pain or other symptoms of articular origin or related to other elements of the musculoskeletal system.Rheumatic conditions are generally classified as localized, where just a specific location is affected, regional, when a larger region is involved, and generalized, when many parts of the body are painful.

For example:

  • Localized - bursitis, an inflammation of a small sac between the tendon and bone, or between the muscles.
  • Regional - when perhaps there is chest wall pain
  • Generalized - fibromyalgia

Common types of arthritis

Osteoarthritis. This is the most common type of arthritis, also called degenerative arthritis., affecting adults of age group above 40 yrs. Osteoarthritis affects both the cartilage, which is the tissue that cushions the ends of bones within the joint, as well as the underlying bone. In osteoarthritis, there is damage to the cartilage, which begins to fray and may wear away entirely. There is also damage to the bond stock of the joint. Osteoarthritis can cause joint pain and stiffness. Disability results most often when the disease affects the spine and the weight-bearing joints (the knees and hips).

Rheumatoid arthritis. This inflammatory disease of the immune system targets first the synovium, or lining of the joint, resulting in pain, stiffness, swelling, joint damage, and loss of function of the joints. Inflammation most often affects joints of the hands and feet and tends to be symmetrical (occurring equally on both sides of the body). This symmetry helps distinguish rheumatoid arthritis from other forms of the disease. Usually associated with other autoimmune disorders

Juvenile arthritis. This disease is the most common form of arthritis in childhood, causing pain, stiffness, swelling, and loss of function of the joints. This condition may be associated with rashes or fevers and may affect various parts of the body.

Fibromyalgia. Fibromyalgia is a chronic disorder that causes pain throughout the tissues that support and move the bones and joints. Pain, stiffness, and localized tender points occur in the muscles and tendons, particularly those of the neck, spine, shoulders, and hips. Patients also may experience fatigue and sleep disturbances.

Systemic lupus erythematosus. Systemic lupus erythematosus (SLE) is an autoimmune disease in which the immune system harms the body’s own healthy cells and tissues. This can result in inflammation of and damage to the joints, skin, kidneys, heart, lungs, blood vessels, and brain.

Scleroderma. Also known as systemic sclerosis, scleroderma means literally “hard skin.” The disease affects the skin, blood vessels, and joints. It may also affect internal organs, such as the lungs and kidneys. In scleroderma, there is an abnormal and excessive production of collagen (a fiber-like protein) in the skin and internal organs.

Spondyloarthropathies. This group of rheumatic diseases principally affects the spine. One common form—ankylosing spondylitis—also may affect the hips, shoulders, and knees. The tendons and ligaments around the bones and joints become inflamed, resulting in pain and stiffness. Ankylosing spondylitis tends to affect people in late adolescence or early adulthood. Reactive arthritis is another spondyloarthropathy. It develops after an infection involving the lower urinary tract, bowel, or other organ. It is commonly associated with eye problems, skin rashes, and mouth sores.

Infectious arthritis. This is a general term used to describe forms of arthritis that are caused by infectious agents, such as bacteria or viruses. Parvovirus arthritis and gonococcal arthritis are examples of infectious arthritis. Arthritis symptoms also may occur in Lyme disease, which is caused by a bacterial infection following the bite of certain ticks. In those cases of arthritis caused by bacteria, early diagnosis and treatment with antibiotics are crucial to removing the infection and minimizing damage to the joints

Gout. This type of arthritis results from deposits of needle-like crystals of uric acid in the joints. The crystals cause episodic inflammation, swelling, and pain in the affected joint, which is often the big toe

Psoriatic arthritis. This form of arthritis occurs in some patients with psoriasis, a scaling skin disorder. Psoriatic arthritis often affects the joints at the ends of the fingers and toes and is accompanied by changes in the fingernails and toenails. Back pain may occur if the spine is involved.

Bursitis. This condition involves inflammation of the bursae, small, fluid-filled sacs that help reduce friction between bones and other moving structures in the joints. The inflammation may result from arthritis in the joint or injury or infection of the bursae. Bursitis produces pain and tenderness and may limit the movement of nearby joints.

Tendinitis .This condition refers to inflammation of tendons (tough cords of tissue that connect muscle to bone) caused by overuse, injury, or a rheumatic condition. Tendinitis produces pain and tenderness and may restrict movement of nearby joints.


  • Rheumatic diseases are generally believed to be caused by a combination of genetic and environmental factors. In other words, you may be born with a susceptibility to a disease, but it may take something in your environment to get the disease started.
  • In osteoarthritis, inherited cartilage weakness or excessive stress on the joint from repeated injury may play a role.
  • In rheumatoid arthritis, juvenile arthritis, and lupus, patients may have a variation in a gene that codes for an enzyme called protein tyrosine phosphatase nonreceptor 22 (PTPN22).
  • Certain viruses may trigger disease in genetically susceptible people. For example, scientists have found a connection between Epstein-Barr virus and lupus. There are likely many genes and combinations of genes that predispose people to rheumatic diseases, and many different environmental factors that trigger them.
  • Gender is another factor in some rheumatic diseases. Lupus, rheumatoid arthritis, scleroderma, and fibromyalgia are more common among women. This indicates that hormones or other male-female differences may play a role in the development of these conditions.
  • One of the key factors explaining today's high rates of chronic disease including arthritis, besides poor diet and sedentary lifestyle, is an epidemic of vitamin D deficiency

Common Signs and Symptoms of Arthritis

  • swelling in one or more joints
  • stiffness around the joints that lasts for at least 1 hour in the early morning
  • constant or recurring pain or tenderness in a joint
  • difficulty using or moving a joint normally
  • warmth and redness in a joint

Common laboratory tests

Antinuclear antibody (ANA). This test checks blood levels of antibodies that are often present in people who have connective tissue diseases or other autoimmune disorders, such as lupus.

CCP (or anti-CCP). This test checks blood levels of antibodies to citrulline, a protein that can be detected in up to 70 percent of people in the early stages of rheumatoid arthritis

C-reactive protein test. This nonspecific test is used to detect generalized inflammation.

Rheumatoid factor. This test detects the presence of rheumatoid factor, an antibody found in the blood of most (but not all) people who have rheumatoid arthritis.

Other tests, Complete blood count (CBC). Creatinine. Erythrocyte sedimentation rate (ESR). Hematocrit (PCV or packed cell volume). Synovial fluid examination. Urinalysis.

Imaging Procedures, X rays provide an image of the bones, but they do not show cartilage, muscles, and ligaments. Other noninvasive imaging methods such as computed tomography (CT or CAT scan), magnetic resonance imaging (MRI), and arthrography show the whole joint.


The goal of treatment is to reduce pain, improve function, and prevent further joint damage.

  • Rest and relaxation-- People who have a rheumatic disease should develop a comfortable balance between rest and activity. Over use of the joint may aggravate degeneration in osteoarthritis
  • Exercise-- People with a rheumatic disease such as arthritis can participate in a variety of sports and exercise programs. Physical exercise can reduce joint pain and stiffness and increase flexibility, muscle strength, and endurance. Exercise also can result in weight loss, which in turn reduces stress on painful joints.
  • Diet-- a well-balanced diet helps people manage their body weight and stay healthy. Diet is especially important for people who have gout. People with gout should avoid alcohol and foods that are high in purines, such as organ meats (liver, kidney), sardines, anchovies, and.foods rich in b,c,d and k vitamins and minerals (Ca, Mg) are advised.
  • Medication-- The medications used to treat most rheumatic diseases do not provide a cure, but rather limit the symptoms of the disease. types of medications commonly used in the treatment of rheumatic diseases are Oral analgesics, Topical analgesics, NSAIDS, Disease-modifying antirheumatic drugs, Corticosteroids, Hyaluronic acid substitutes etc..
  • Assistive Devices-- Splints and braces are used to support weakened joints or allow them to rest. Some prevent the joint from moving; others allow some movement.
  • Surgery-- In severe cases, surgery may be necessary to repair damage to a joint
  • Nutritional Supplements--. These include products such dehydroepiandrosterone (DHEA) for lupus, and glucosamine and chondroitin sulfate for osteoarthritis.
  • Alternative therapies—These are treatments other than Allopathy. It is a fact that conventional treatments can be ineffective and carry with them significant side effects, and it's not surprising that many arthritis sufferers turn to alternative treatments now a days.Well known Alternative therapies in arthritis are; ozone therapy(prolozone injections), Acupuncture, , Homoeopathy, magnet therapy etc..

Ozone Therapy in Arthritis:

Mechanism of action of Ozone

  • Proteolytic enzymes and endogenous ROS are inhibited
  • Bradykinin and inflammatory PG release is inhibited
  • Release of immunosuppressive cytokines TGF-beta and IL-10 may inhibit inflammation
  • Disappearance of edema leads to improved circulation, washing away of lactic acid and relief in pain
  • Ozone injections act as an analgesic
  • Algic stimulation of skin can reduce pain through mechanism of Diffuse Noxious Inhibitory Control
  • H2O2 may cause irreversible damage and death of nociceptors; consequently activation threshold
  • Simultaneous release of endorphins and blocked release of algic stimuli


Mode of administration

  • Ozone therapy is given in the form of Injections under aseptic precautions around the knee (Peri articular Injections) and inside the knee joint (Intra articular)
  • Peri articular injections are given for 10 to 15 sittings or intra articular injections are done for 3-5 sittings depending upon the age of the patient and severity of the disease