![Title and abstract of [Effectiveness of ozone therapy compared to other therapies for low back pain: a systematic review with meta-analysis of randomized clinical trials].](/assets/studies/andrade-2020-ozone-back-pain-meta/title.png)
Key Takeaway
Ozone therapy was more effective than steroids and placebo for lumbar pain relief at 6 months (RR 2.2, p < 0.00001), though results are limited by moderate to high risk of bias in the included studies.
Summary
This systematic review and meta-analysis compared ozone therapy to steroids and placebo for low back pain in adults, searching four databases (Medline, Scopus, Lilacs, EMBASE) covering 1966-2018.
From 779 identified articles, six randomized clinical trials with 717 participants were selected. At 3 months, no significant difference was found between ozone and comparison groups. However, at 6 months, ozone therapy demonstrated significantly greater effectiveness than other therapies (RR 2.2, 95% CI: 1.87-2.60, p < 0.00001).
The authors cautioned that these results are not definitive, as the included studies carried moderate to high risk of bias, limiting the strength of the evidence.
Methods
- Systematic review and meta-analysis of RCTs
- Searched Medline, Scopus, Lilacs, EMBASE (1966-2018)
- 6 clinical trials selected from 779 identified articles (717 participants)
- Outcomes: pain relief, complications, satisfaction, quality of life, recurrence
Key Results
- 3-month outcomes: no significant difference (RR 1.98, 95% CI: 0.46-8.42)
- 6-month outcomes: ozone superior to steroids and placebo (RR 2.2, 95% CI: 1.87-2.60, p < 0.00001)
- 717 participants across 6 RCTs
Figures
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Limitations
- Moderate to high risk of bias in included studies
- Small number of eligible RCTs (6 out of 779 screened)
- Heterogeneity in ozone administration protocols
- No significant benefit at 3-month timepoint