Comparison of the Effects of Paravertebral Ozone, Local Anesthetic, and Normal Saline Injection on Pain, Disability, and Quality of Life in Chronic Low Back Pain: A Retrospective Clinical Study
Selda Çiftçi Inceoğlu1, Aylin Ayyıldız2, Alperen İnceoğlu2, Figen Yılmaz31Department of Physical Medicine and Rehabilitation, University of Health Sciences, Şişli Hamidiye Etfal Training and Research Hospital, İstanbul, Türkiye2Department of Physical Medicine and Rehabilitation, Başakşehir Çam and Sakura City Hospital, İstanbul, Türkiye
3Department of Physical Medicine and Rehabilitation, Private Clinic, İstanbul, Türkiye
INTRODUCTION: The aim of this study is to compare the effects of paravertebral ozone, local anesthetic (LA), and normal saline (NS) injections on pain, disability, and quality of life (QoL) in patients with chronic low back pain (CLBP).
METHODS: Patients who underwent lumbar paravertebral ozone (Group 1), LA (Group 2), and NS (Group 3) injections due to CLBP between March and September 2023 were retrospectively screened. Patients with a history of surgery, injection, or physical therapy for the lumbar region in the last 6 months, as well as those with radicular spread or neurological deficits, were excluded from the study. Pain levels were assessed with the Numeric Rating Scale (NRS) for rest, movement, and night pain, disability levels with the Istanbul Low Back Pain Disability Index (ILBPDI), and QoL with the Nottingham Health Profile (NHP). Pre-treatment and post-treatment 3rd-month results were compared.
RESULTS: In Group 1 (n=15), significant improvement was observed in NRS, ILBPDI, and NHP scores before and after treatment compared to baseline. In Group 2 (n=15), significant improvement was observed in NRS and ILBPDI, and in Group 3 (n=15), significant improvement was observed only in rest NRS scores (p<0.05). Group 1 showed significant improvement compared to Group 3 in all evaluation parameters (p<0.05). In Group 2, a more significant improvement was observed only in ILBPDI scores compared to Group 3 (p<0.05). Significant improvement was found in night NRS and NHP evaluations in Group 1 compared to Group 2 (p<0.05). No significant difference was observed in other pairwise comparisons (p>0.05).
DISCUSSION AND CONCLUSION: Lumbar paravertebral ozone is an effective treatment for pain, QoL, and disability in CLBP. Paravertebral ozone injection is a preferable treatment due to its advantages over LA and NS.
Keywords: Chronic low back pain, intramuscular injection, local anesthesia, normal saline, ozone, paravertebral.
Manuscript Language: English