Clinical predictors of response to ozone therapy for treatment of discogenic and non-discogenic low back pain.

The ozone administration has emerged as a well-established treatment for disc herniation causing acute spinal pain. However, no study thus far has investigated its effectiveness for the treatment of non-discogenic low back pain. Aims of this study were to investigate the response of different groups of low back pain patients to ozone administration and to identify clinical predictors of this response. Forty-nine patients underwent 10 paravertebral ozone injections. Pre-post-intervention assessments of clinical characteristics and pain intensity were performed. Fifty-nine percent of patients were identified as responders to treatment: they showed median reductions of pain intensity of 4.0, 4.0, and 5.0 numeric rating scale points at the end of the intervention and after 2 months and 6 months, respectively. The pre-post-intervention decrease in pain intensity was the only significant predictor of the medium-term (i.e., 6 month follow-up) response. The paravertebral ozone administration is an effective procedure for the low back pain treatment. The early reduction in pain intensity is a response endophenotype that allows the identification of patients who are likely to respond to treatment. The present findings support the incorporation both of the procedure and of this clinical biomarker in protocols for rehabilitation of low back pain.