Evaluation of the usefulness of ozone - O3 in the treatment of low back pain. Is it really something more than an empirical concept? Systematic review of the literature.

Low back pain (LBP) is a common pathology, and its high prevalence has led to the emergence of alternative options that have gained popularity without objective epidemiological evaluations. This work seeks to clarify the utility of ozone in the treatment of LBP.A systematic literature search was conducted following the principles by PRISMA. The search included articles published up to June 2023. Each of the authors reviewed the abstract of the articles and applied the inclusion and exclusion criteria.A total of 28 articles were selected: 18 prospective randomized clinical studies, 3 systematic reviews plus meta-analysis, and 6 retrospective case series studies.The treatment of LBP is complex. Advancements have been made in recent years from biomechanical and pathophysiological perspectives, but ozone therapy is not considered a treatment option. Techniques that involve the use of ozone fall into the category of empirical options. International guidelines for LBP exclude ozone therapy. It is advisable to conduct further studies under strict parameters to better evaluate its outcomes.