Prolozone is the injection of ozone to 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. Some mechanisms have been recently reviewed at Curr Med Chem. 2016;23(4):304-14.

 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 not 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. 

Prolozone is an excellent therapy for osteoarthritis in my experience, although it is still considered by mainstream medicine to be experimental or alternative. The basic mechanism of prolozone is simple. Ozone (and numbing agent lidocaine) 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.  Ozone may be injected into the joint spaces and into affected muscles. 

Soft tissue injuries to the joints may 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. Prolozone may help reverse this weakening and relieve the pressure and pain on the joint.  Prolozone, used in the joint space, may also improve deposition of new cartilage.

The use of ozone 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.  Usually the area is pretreated with lidocaine.

In my experience, osteoarthritic knees can often be treated fairly successfully.  It is a very simple injection technique that involves a medial approach into the knee capsule. There is usually a sensation of “full-ness” to the patient, and later in the day there may be some significant pain.  However in my experience, there is usually also significant relief after the first few treatments, and even often the first treatment there is a noticeable change.

Recently, ozone was studied compared to placebo, in which the study can be found online. The summary is pasted below.

PLoS One. 2017 Jul 24;12(7):e0179185. doi: 10.1371/journal.pone.0179185. eCollection 2017.

Comparison between intra-articular ozone and placebo in the treatment of knee osteoarthritis: A randomized, double-blinded, placebo-controlled study.

Lopes de Jesus CC1, Dos Santos FC2, de Jesus LMOB3, Monteiro I2, Sant'Ana MSSC2, Trevisani VFM1.

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The aim of the trial was to determine the effectiveness of oxygen-ozone injections on knee osteoarthritis concerning pain reduction, joint functional improvement, and quality of life.


In this randomized, double-blinded, placebo controlled clinical trial, 98 patients with symptomatic knee osteoarthritis (OA) were randomized into two groups receiving intra-articular 20 μg/ml of ozone (OZ) or placebo (PBO) for 8 weeks. The efficacy outcomes for knee OA were the Visual Analogue Scale (VAS), Lequesne Index, Timed Up and Go Test (TUG Test), SF-36, Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), and Geriatric Pain Measure (GPM).


After 8 weeks of treatment, ozone was more effective than the placebo: VAS [mean difference (MD) = 2.16,

Dr. Eric Chan (ND)