Every few years, my wife, Terri Su, MD, and I take a spiritual journey to India. Part of our time is spent doing sewa (volunteer work) at a charitable hospital. There, no money exchanges hands, and patients are served to the best ability of the hospital. Terri and I endeavor to bring a healing modality that is both inexpensive and effective.
As one can imagine, the variety of disorders seen brings thoughts back to what American doctors were seeing 100 years ago. Indians are hard-working people on the farms. They subject themselves to a lot of physical trauma and overuse. The result is joint trauma, degenerative joint disease, lumbar problems, osteomyelitis, and more.
This trip (December 2010), we brought an ozone generator graciously donated by Longevity Resources of Canada. All we needed was to attach oxygen to it to be able to draw ozone at variable concentrations. Our goal was to introduce, teach, and have the hospital staff master ozone therapy, especially Prolozone.
Prolozone is a term coined to honor a marriage of traditional prolotherapy enhanced by the use of ozone. Medical ozone is a weak mixture (up to 2%) of ozone (O3) gas in oxygen (O2) gas. O2 gets run through an electrical discharge, which splits it so that it can reform as O3. O3 is relatively unstable, so it must be generated on site.
The hospital was blessed in that its medical director is quite open-minded and welcomed the new technology, both on his medical units and in assigning us to the orthopedic unit as well.
Our first patient was an older man who limped in with advanced DJD (degenerative joint disease) of the knees. After Prolozone therapy, he exited the orthopedic clinic virtually pain free. After seeing several cases like this, the orthopedic surgeon was in a state of pleasant shock, and wanted to run with the therapy. After we demonstrated 3 to 4 treatments on any particular joint, he took the baton.
After 4 to 5 incredible successes, he asked us to see a young man, about 25, with a herniated disc from heavy farm labor. The man was an inpatient and brought to the outpatient department in a wheelchair and could not arise from the seat without assistance. He was hunched over about 20º and couldn't straighten up. Disc surgery was planned. The surgeon asked for my assistance in an Italian method of intradiscal ozone injection that is extraordinarily popular in Italy.1 However, it must be done under fluoroscopy. Based on lots of experience, I suggested nonfluoroscopic ozone injections to the L4-5 facet joints and the SI joints. I told the doctor not to expect an immediate result in this case like the knees, since the gas had to gradually move around the skeletal structures. (Additional medical research indicates that guided needle into the disc might not be necessary. Simple injection of ozone into the paravertebral muscles is quite effective as well.)2
This injection was not comfortable due to the patient's inability to straighten his spine and lie flat. Nevertheless, we got it done and he returned to the ward, still in pain. When we visited him 3 hours later, he could get out of bed on his own and stand up straight By the end of the day, he could bend over and touch his toes, a very happy camper (Photo 1).
News of this spread like fire around the hospital. In the ensuing days, hospital staff quietly came in and/or brought their parents and children to us in effort to get a treatment in the midst of a revolving door of patients in the orthopedic unit. These cases weren't just limited to joints. The ophthalmologist brought in a member of his staff with a pigmented retinal disorder. We treated her blood, almost daily. The following week, a retinal specialist documented, in pictures, a regression of the abnormal pigmentation.
On Thursday, our next to our last hospital day, the hospital director arranged for a good friend to travel 7 hours by train from Delhi to our location to see us for a terribly deranged shoulder. She had three failed surgeries for rotator cuff problems. Her joint was arthritic. Her range of motion was nearly frozen. She was eating NSAIDs, which were tearing up her stomach and giving no relief for 24/7 high-level pain.
We had very little time to try to help her. We did Prolozone on her shoulder. No help. The following day (our last), we added neural therapy to her shoulder scars, in addition to the Prolozone. On Sunday evening, we saw the director at a function and were told her pain was 50% reduced.
That was heartwarming, considering the last regular patient we saw in the hospital that Friday, only 15 minutes before we were whisked away. Another frozen shoulder. Only one minute after injection of ozone into her shoulder joint, she had nearly full range of motion (Photo 2).
The reasonable person would ask how can you get results so fast that last? I know that I would have asked the same 20 years ago.
Instant relief of pain is a good indicator of the accuracy of the injection. A local anesthetic is instilled first to reduce any discomfort of the ozone gas. We use 1% preservative-free procaine. Instant pain relief is most likely due to the immediate action of the procaine. However, in very many cases, pain relief is lasting, significant, and sometimes permanent. Why?
Pain is really our friend, not the enemy. It's an indicator that something is wrong, and is produced by inflammation. Inflammation can have many causes, including but not limited to infection, injury, allergy, interference fields, and more. Where there's inflammation, there's lack of oxygen, which sustains the problem. I am an oxygen man. I believe that oxygen delivery and consumption is absolutely the most important factor in healing. Instillation of the gas mixture provides instant oxygen, which can begin repair processes immediately. Ozone has been shown to stimulate healing interferons, cytokines, and growth factors. In particular, it can stimulate TGF-beta (transforming growth factor beta), which activates cartilage repair and growth.
So why the immediate and long-term effects? The local anesthetic, placed in the right location, immediately kills the pain. The gas mixture quickly goes to work, attenuating inflammation and providing oxygen for repair.
Office results with Prolozone. Admittedly this is anecdotal, however, other Prolozone therapists have mirrored my results. I see about 80% resolution of knee OA. For low backs, it's about the same. Hips are a bit less, 50/50. Then there are shoulders. I've seen immediate results like those in the Indian hospital, and there have been failures as well. For routine rotator cuff incomplete tears, like supraspinatus, results are about 80%. Ankle problems are usually more complex. However, I've seen some respond up to 80% or more, and of course there are failures. Plantar fasciitis responds 60% to 80%. Cervical and whiplash injuries – like lumbar spine problems, about 80%.
Comparison with conventional prolotherapy? I was taught prolotherapy in 1989 by Bill Faber, DO, whom I consider a master. I marveled at the results, repeatedly writing about them in my Second Opinion Newsletter. However, prolotherapy involves a myriad of needle sticks and injection of fluids. These promote inflammation that can be quite uncomfortable for the patient over several days. I know. I've had it. I find Prolozone at least as effective, far easier to do for the physician (far fewer needle sticks) as well as the patient. There is virtually no discomfort within seconds after the injection, unlike prolotherapy. The gas spreads out, covering a much broader area than prolotherapy solutions. It is much more forgiving, considering that it is 100% oxygen (ozone is oxygen). I've never seen a bad reaction to it.
I encourage prolotherapy doctors to learn Prolozone, since they already are masters at needling. I believe that you'll find the results superior, quicker, and with far less trauma to your patients, as well as to yourself.
The hospital orthopedic surgeon e-mailed me a few weeks after we left. He reported continuing good results at his own hands. The very significant savings to the hospital with fewer surgeries and less drug dispensing can be put to very good use in this developing country. Unlike in the US, the doctors there yearn for inexpensive highly effective treatments, regardless of political correctness. Aside from the cost of the machine, the out-of-pocket expense for one knee treatment is the cost of a syringe, a few pennies for the procaine, and a few pennies for the oxygen. (We do add a pinch of vitamin B12 and folic acid to the local anesthetic to potentiate healing effects.) Not bad for a charitable Indian hospital where the locals simply have no money.
The knee technique? About 2 to 2.5 cc of 1% procaine with a "pinch" of B12 and folic acid added is injected into the joint with a 27-gauge needle. The needle is left in place. The local anesthetic syringe is removed and a 20 to 25cc syringe prefilled with ozone at about 25 gamma (micrograms/cc) is attached. The gas is slowly administered over ½ to 2 minutes, and needle withdrawn (Photo 3). The joint is then flexed and extended to ensure gas distribution. Other joints mirror this technique with volumes adjusted for size of joint, tendon, ligament, or other specific location. Patients have no problems driving home, but consideration must be made for the total amount of local anesthetic if multiple locations are treated.
I teach an intense hands-on workshop 2 or 3 times a year on all aspects of oxidation therapy administration, including Prolozone demonstrations, as well as other ozone and ultraviolet blood irradiation demonstrations. For those interested, please e-mail me at firstname.lastname@example.org.
Our heartfelt thanks to Longevity Resources Inc. and its CEO, Roger Chown, for graciously donating an ozone generator to the charitable hospital for its ongoing use.
Robert Rowen, MD
P.O. Box 6187
Santa Rosa, California 95406
1. Muto M, Ambrosanio G, Guarnieri G, et al. Low back pain and sciatica: treatment with intradiscal-intraforaminal O(2)-O (3) injection. Our experience. Radiol Med. 2008 Aug;113(5):695–706. Epub 2008 Jul 1.
2. Paoloni M, Di Sante L, Cacchio A, et al. Intramuscular oxygen-ozone therapy in the treatment of acute back pain with lumbar disc herniation: a multicenter, randomized, double-blind, clinical trial of active and simulated lumbar paravertebral injection. Spine (Phila Pa 1976). 2009 Jun 1;34(13):1337–1344.