title: The usefulness of ozone treatment in spinal pain.
abstract: OBJECTIVE
  The aim of this review is to elucidate the biochemical, molecular, immunological, and pharmaceutical mechanisms of action of ozone dissolved in biological fluids. Studies performed during the last two decades allow the drawing of a comprehensive framework for understanding and recommending the integration of ozone therapy for spinal pain.
  
  
  METHODS
  An in-depth screening of primary sources of information online - via SciFinder Scholar, Google Scholar, and Scopus databases as well as Embase, PubMed, and the Cochrane Database of Systemic Reviews - was performed. In this review, the most significant papers of the last 25 years are presented and their proposals critically evaluated, regardless of the bibliometric impact of the journals.
  
  
  RESULTS
  The efficacy of standard treatments combined with the unique capacity of ozone therapy to reactivate the innate antioxidant system is the key to correcting the oxidative stress typical of chronic inflammatory diseases. Pain pathways and control systems of algesic signals after ozone administration are described.
  
  
  CONCLUSIONS
  This paper finds favors the full insertion of ozone therapy into pharmaceutical sciences, rather than as either an alternative or an esoteric approach.
authors.affiliation: Department of Biotechnology, Chemistry and Pharmacy, Università degli Studi di Siena, Italy.
authors.forename: Velio
authors.initials: V
authors.lastname: Bocci
authors.affiliation: Department of Medical Biotechnologies, University of Siena, Siena, Italy.
authors.forename: Emma
authors.initials: E
authors.lastname: Borrelli
authors.affiliation: Department of Biotechnology, Chemistry and Pharmacy, Università degli Studi di Siena, Italy.
authors.forename: Iacopo
authors.initials: I
authors.lastname: Zanardi
authors.affiliation: Department of Biotechnology, Chemistry and Pharmacy, Università degli Studi di Siena, Italy.
authors.forename: Valter
authors.initials: V
authors.lastname: Travagli
mesh_terms: D000975:Antioxidants / Q000378:metabolism*; D001416:Back Pain / Q000628:therapy*; D006801:Humans; D018384:Oxidative Stress / Q000187:drug effects; D010126:Ozone / Q000627:therapeutic use*
chemical_list: D000975:Antioxidants; D010126:Ozone
keywords: antioxidants; oxidants; oxidative stress