Effects of Oxygen-Ozone Therapy and Physiotherapy on Functioning in Patients with Chronic Non-Specific Neck Pain: A Prospective Double-Arm Pilot Study.

Objectives

This study aimed to evaluate the effects of a combined treatment consisting of O2O3 injections and McKenzie-based physiotherapy exercises, compared to a Control group treated with O2O3 injections and a Back School physiotherapy program, in reducing pain and disability in individuals with chronic non-specific neck pain.

Methods

In this prospective double-arm pilot study, patients with chronic non-specific neck pain and a Numerical Rating Scale (NRS) > 4 were enrolled. All patients received eight weekly sessions of O2O3 injections (10 μg/mL, 10 mL total, and 2 mL bilaterally into the cervical paravertebral muscles). Patients were then randomly assigned (1:1 ratio) to either an experimental group receiving McKenzie physiotherapy or a Control group undergoing Back School techniques, with five sessions per week over two weeks. Outcome measures included the Neck Disability Index (NDI), NRS, EuroQol-5D-3L (EQ5D3L), and EuroQol Visual Analog Scale (EQ-VAS).

Results

A total of 41 patients were included and divided into two groups: Back School (n = 21; mean age: 63.9 ± 13.4 years) and McKenzie (n = 20; mean age: of 57.3 ± 12.9 years). Both groups showed significant improvement in NDI, NRS, EQ5D3L, and EQ-VAS following the O2O3 injection cycle (∆T0-T1 p < 0.001). The subsequent addition of physical therapy led to further improvements across all outcomes in both groups (∆T1-T2 p < 0.001), with the McKenzie group showing slightly greater benefits, despite the lack of significant differences.

Conclusions

This study demonstrated the effects of combining O2O3 injections with either McKenzie or Back School therapy in improving pain, disability, and quality of life in patients with chronic non-specific neck pain.