Prolozone is the injection of ozone and homeopathics into joints, trigger points in the muscle and subcutaneously over areas of pain. This increases oxygen delivery to the tissues and improves the antioxidant capacity of the muscles injected. 


Degenerative disease of the joint is also known as osteoarthritis.  It is characterized by pain in joints that are responsible for weight-bearing and joints that are overused. Often times “wear-and-tear” degrades cartilage faster than the joint repair mechanisms.


Osteoarthritis of the hip and knee is now known to no be an inevitable part of aging nor of running. The pathology of osteoarthritis is not confined to the cartilage, but in fact involves loss of cartilage, soft-tissue swelling, and formation of bone spurs.


In order to prevent or to treat osteoarthritis, sometimes we need to slow down the breakdown of the cartilage, but the vast majority of cases require speeding of the joint repair mechanisms.


Conventional treatments include weight loss to reduce pressure on weight-bearing joints, physical therapy to strengthen the muscles that stabilize a joint, and pain relief medications.


Dietary therapy may include antioxidants, vitamin D, and cartilage precursors such as glucosamine sulfate and chondroitin sulfate. Glucosamine and chondroitin sulfate are the “building blocks” of cartilage and increased intake may help with the repair at the joint level. Taking the sulfate form of glucosamine is important. 


Hyaluronic acid is a substance secreted by the cartilage cells of the knee, and help to give the joint fluid a slippery quality. Injections of this fluid into the knee may help with pain and decrease the damage in osteoarthritis.


Prolozone is an excellent therapy for osteoarthritis, although it is still considered by mainstream medicine to be experimental or alternative. The basic mechanism of prolotherapy is simple. A natural medication is injected into the affected tendons, ligaments, or joint spaces, which leads to local inflammation.  Cartilage growth factors are released in the joint space, such as transforming growth factor, with subsequent strengthening of the joint structure.  Usually ozone is injected into the joint spaces and into affected muscles, although occasionally natural medications such as Traumeel and Zeel are used at the tendons and ligaments.


Soft tissue injuries to the joints often start the development of degenerative joint conditions. If the ligaments and tendons that cross a joint are weakened, then the joint itself must sustain more pressure from gravity and joint motion.  Cartilage can then be worn down more quickly than usual, and repair mechanisms may not be able to keep up. Prolotherapy with ozone can reverse this weakening and relieve the pressure and pain on the joint.  Prolotherapy, used in the joint space, can also improve deposition of new cartilage. Since prolotherapy treats the root degenerative causes of joint deterioration, it is extremely useful for a variety of painful conditions.

Orthopedic medicine is one of the most satisfying aspects of a naturopathic practice, as physicians can get excellent permanent results that often save patients from having extensive surgical procedures done.  Traditionally, there have been two ways in which our naturopathic medical skills have contributed to this field: firstly there are natural pharmaceuticals that decrease pain, inflammation, and promote healing, and secondly there are interventional methods that stimulate the body’s own regenerative and healing mechanisms.  Everyone is already well-versed in the familiar uses of bromelain, Wobenzyme, glucosamine sulfate, copper, and such nutrients in the use of injury recovery and slowing of degenerative disease.  There has also recently been an increased interest by both conventional physicians and naturopathic doctors in the use of regenerative therapies such as prolotherapy that, through stimulation of various growth factors, result in permanent improvements in pain through the deposition of collagen and cartilage.  

Traditionally, strong proliferants and sclerosants had been used such as phenol and sodium morrhuate.  Many physicians are leaning towards hypertonic dextrose (>10%) as a proliferant, as this has been shown to be one of the safest.  Recently the use of ozone gas as a proliferant has been used with great ease and success.  This has shown to be an excellent alternative and very versatile tool, as being a gas the rapid diffusion through the tissues somewhat lessens the number of injections per session necessary. It is also usually less painful to the patient.  Ozone used in major autohemotherapy has definite effects on energy production, through the increase of 2,3 DPG and also the stimulation of the citric acid cycle with the increase in delivery of NAD and NADPH to the mitochondria.  2,3 DPG is necessary for the unloading of oxygen at the tissues, and the increased delivery of mitochondrial substrates ensures that sufficient ATP is formed. It is possible that this effect is partly to explain the excellent results of the use of ozone in orthopedic medicine.  With increased stimulation of ATP production, the healing process initiated by prolotherapy with ozone is more likely to be successful in relief of pain.  

The use of ozone in prolotherapy (or Prolozone for short) is extremely versatile. It has been most useful in osteoarthritic knees, chronic low back pain, rotator cuff tears, ankle sprains (especially chronic cases that have progressively become weakened), SI joint dysfunction, and myofascial trigger points.  The general dosage of ozone used is 20-30 ug/ml, at a total volume dependent on the joint or tissue size.  Usually the area is pretreated with a solution consisting of procaine 2%, Traumeel or Zeel, and B12.  The homeopathics and the procaine are usually in a 1:1 ratio, and B12 1-2 mls total is added. Once the solution is injected, the needle is stabilized with a hemostat, the syringe filled with the ozone is loaded, and subsequently the injection is completed.

In general, osteoarthritic knees can be treated very successfully.  It is a very simple injection technique that involves a medial approach into the knee capsule. Generally, 5 cc of the pre-treatment solution is injected, and then 10 cc’s of the ozone gas is injected.  There is usually a sensation of “full-ness” to the patient, and later in the day there may be some significant pain.  However, there is usually also significant relief after the first few treatments, and even patients who have had no relief with NSAIDS and were candidates for surgery respond remarkable well, early. This has made OA of the knees one of the most rewarding conditions to treat.  Dr Shallenberger notes that sometimes he adds growth hormone after the ozone, but I have never found this to be necessary.


Questions and Answers About Prolozone


1. What is Prolozone? 

Prolozone is a method of treatment in which weakened joint structures are strengthened by treating the ligaments and tendons that cross it. Most chronic pain can be very effectively treated this way.


2. I’ve heard of cortisone injections; is this the same thing?

Cortisone injections actually weaken structures. Dr Chan and Dr Ward use ozone, Traumeel, Zeel, and other natural medications  to strengthen and heal structures. Of these, the properties of ozone are remarkable in relieving pain, usually permanently.


3. Will this treatment work for migraines?

Migraines with a significant tension component that precedes the attack can be effectively treated.  Usually, treatment in conjunction with an oxidative modality such as UV irradiation will be most effective.


4. What about "sciatica" pain?

This is effectively treated.  Usually the piriformis muscle belly, its insertions and origins, and the iliolumbar ligaments are treated to have excellent results.


5. How many treatments will I need?

This varies based on the patient but tends to range from between 2 to 6 treatments.  These are usually given at 1 week intervals.


6. Is Prolotherapy safe?

This is an extremely safe treatment. The common effects are a soreness that occurs for 1-3 days after the treatment.  


7. Will my insurance cover this? 

MSP does not cover this treatment, or visits to a naturopathic physician. Extended coverage may cover part of the cost, but varies according to the plan.  Cost of the treatment varies from 80 to 150 dollars depending on the areas treated.