There is new hope for those of us who suffer from joint aches & pains related to CIRS & Lyme disease.

As described in the Clinical Review of Medical Ozone.

Ozone can provide relief of chronically inflamed joints, bursae (fluid filled cavities overlying bone where tendon or muscle must pass over the bone–like a pulley), ligaments (connective tissue between bones) & tendons (connective tissue between muscle & bone).

Prolotherapy involves injections of substances that promote healing of the injured area. 

There are a variety of substances that we can use for this.  I’ve personally received ozone treatment for Lyme-related arthritis with good effects.  By this, I mean relief of pain, reduction of excessive fluid in the joint (effusions) that prevented my knees from fully flexing (think of trying to bend a hinge against a tough water balloon in the way).  The effusions lessened or resolved but the best part was the immediate pain relief!  Part of the healing involves fibroblasts laying down more collagen to re-strengthen the involved areas to their pre-damage (or better) state.

Lyme and other tick-borne illnesses can grow in joints, and other tissues causing local pain & destruction of those joints.

Frequently with Lyme, the “migrating pain” presents.  Today perhaps my right knee hurts, tomorrow (or even later today), it may be my left ankle.  Although it’s a difficult process to determine the mechanism of each area, it appears that cytokines–intercellular chemical messengers are actively causing inflammation.

Inflammation can be a double-edged sword.

Short-term inflammation can be good–bringing white blood cells and other immune components to the area of inflammation to help eliminate infection.  Sometimes however-the infection is not easily eliminated.   Inflammation becomes chronic.  Chronic inflammation also damages joints, tendons, bursae–whatever tissue it is present in.

Lyme-related inflammation can wax and wane over time.

This helps us understand why joint aches and pains come and go.  Borrelia burgdorferi, the causative microbe for Lyme is able to “hide” inside the cells of the host, away from it’s immune system ongoing surveillance.  Borrelia and many other tick-borne microbes are “microaerophilic” organisms.   What does that mean?  It only tolerates a little bit of oxygen, to much oxygen is toxic and kills the organism.  Ozone increases the oxygen carrying capacity of hemoglobin ten-fold!  Putting that much oxidation power in the joint or other tissue area inhabited by these germs.  While killing the germs, it also acts as a prolotherapy agent–promoting healing of the damaged tissues–AND providing pain relief!

Pain doesn’t always disappear in the initial session, but improvements are generally noted.

“Ten miles into the woods means ten miles out of the woods”.  The longer somebody has been sick, the more these microbes have been multiplying in their host (you).  The larger the total toxic burden of disease, the more time can be expected before full healing and recovery occurs–but it will–with appropriate therapy!

How often is this done and for how long a period of time?

As with so many things in the practice of medicine, the patient’s response to treatment provides guidance as to how often it needs to be done and for how long.   Typically it can be done as often as a few times per week to an involved area–until that area is doing better.  Some areas will resolve with only one procedure, others will require repetitive treatments, the frequency and amount based on the patient’s response to therapy.

Are there risks, contraindications, potential problems and side effects?

Certainly accidents can happen.  One should always avoid injecting a needle into a joint through infected skin.  The biggest problems with injecting joints are infection of the joint, damage to structures within the joint by the needle–which typically heal uneventfully but may worsen pain in the short-term, inadvertent puncture of a blood vessel causing bleeding, nicking a nerve–which exist in skin, joint capsules, bone and would cause pain and perhaps numbness for awhile until it heals.  An experienced clinician will know how to avoid these pitfalls.  It seems counter-intuitive to inject a gas (ozone is a gas) into a joint–concerns about an air embolism that can migrate in the body are largely unfounded because ozone is so soluble in blood–the gas is absorbed into blood and other cells almost instantaneously as the injection is done–the joint space will briefly billow out a bit then immediately go back to normal size.  For those worried about pain we can add a pain relieving agent like lidocaine or bupivacaine to provide instant relief of any discomfort–with the added bonus of letting us know that we “hit the right spot”.

What parts of the body benefit from ozone?

Autohemotransfusion procedure involves the extraction of 200 ml venous blood into heparin (25 IU/ml) and CaCl2 (5mM). In a sterile single-use 300 ml container, the blood was mixed with 200 ml of the O3/O2 gas mixture at a concentration of 60 μg/ml and then slowly reintroduced into the patient. The blood was extra-corporeal for 15–30 min and there were no adverse reactions except hematoma formation in the area of venous injection.
Rectal insufflation was employed when the performance status was low, or at the preference of patient. This procedure consisted in rectal insufflation of 300 ml of O3/O2 gas mixture at a concentration of 60 μg/ml. The main side effects were transient meteorism and constipation in some patients. Due to its high solubility, the ozone rapidly transits across the colonic mucosa into the portal circulation and through the liver to enter systemic circulation.
Ozone can also be insufflated into the vaginal cavity, nasosinus cavities and external ear canals by allowing the ozone generator to fill a low-pressure reservoir that is then attached to a canula which is inserted into the appropriate body cavity of choice for insufflation. Ozone has been safely instilled into the bladder, pleural & peritoneal cavities as well.
Ozone can be safely injected into tissues as well. These include areas such as the
temporomandibular joint.
Ozone can be used to treat intra-thecal tears of the lumbar spinal discs as well as lumbar disc herniations, some of this effect involves modulation of inflammatory cytokines in the area.  This technique involves imaging equipment that we do not have at this point.
Cervical disc herniations are also amenable to treatment with ozone.
Carpal tunnel syndrome can be improved with injection of 4 cc of ozone and 1 cc of lidocaine directly into the space.
Supraspinatus tendon tears < 1.5 cm in length have been shown to heal with ultrasound-guided injection of ozone into the peri-tendon sheath.
Rheumatoid arthritis treatment with ozone in rats seems optimal at a concentration of 40 µg/mL when injected intra-articularly into the involved joints.
Scleroderma is another systemic connective tissue autoimmune inflammatory disease that shows thermographic improvements after ozone therapy.
Fibromyalgia patients also receive relief from ozone therapy via a variety of mechanisms including antioxidant, immune modulation and mitochondrial effects.
Topically, ozone can be placed directly into an impermeable container such as a bag in which an extremity is encased for topical treatment of wounds and skin. Additionally, it can be bubbled into water (sterilizing it in the process) which can then be topically instilled or applied, or for longer-lasting benefits, into a lipid solution such as olive or other oil and applied directly to the skin or wound.
The benefits listed above are effective in all routes of administration reviewed above.

If you’re having pain problems, please let us know so we can help!

From a variety of IV therapies to local injections–or pretty much any other problem you may be having–we’re terrible mind readers–you need to let us know what’s going on so we can help speed your recovery!

Dr. Raymond Oenbrink