Vitality Unleashed: The Functional Medicine Podcast

Ozone Therapy Vs. Surgery For Lumbar Disc Disease: Science Explains It Now

• Dr. Kumar from LifeWellMD.com • Season 1 • Episode 188

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Too many people with sciatica and herniated discs feel trapped between living with pain and going under the knife. We bring a different path into focus: intradiscal ozone therapy, a precisely dosed, outpatient procedure that shrinks bulging discs and quiets inflammation—often delivering relief on par with microdiscectomy, without the hospital stay or long recovery.

We start with the science. Ozone cleaves proteoglycans in the nucleus pulposus to reduce disc water content and volume, easing pressure on compressed nerves. At the same time, it downregulates inflammatory drivers like IL‑1β and TNF‑alpha, tackling the chemical storm that makes pain searing and relentless. The result is a two-pronged mechanism—mechanical decompression plus immune modulation—that maps tightly to what patients actually feel: pain fades and function returns.

Then we dig into outcomes. A systematic review of eight prospective studies and 413 patients showed a mean 4.25-point drop in VAS pain scores and a 20.57-point improvement in ODI disability—gains that translate into real life: walking farther, sitting longer, picking up kids, going back to work. A randomized head-to-head trial found ozone therapy non-inferior to microdiscectomy, reframing the risk-benefit calculus when conservative care fails. We also highlight smart combinations: pairing ozone with percutaneous intradiscal radiofrequency thermocoagulation for contained herniations, and adding targeted steroids to calm angry nerve roots.

Dose precision is the unsung hero. Higher concentrations emphasize structural shrinkage, midrange doses regulate inflammation, and low doses improve microcirculation. Choosing the right concentration for the right presentation is where experienced clinicians shine, and it’s one reason safety remains strong. In the reviewed studies, no minor or major complications were reported, with broader literature noting only transient effects like flushing or insomnia—far milder than the risks associated with surgery or chronic opioid use.

If you’re weighing your options after PT, meds, and injections, this conversation offers a clear, evidence-backed middle path that can spare you the scalpel. If it resonates, subscribe, share this episode with someone facing back surgery, and leave a review telling us what you’d like us to explore next.

Disclaimer:
The information provided in this podcast is for educational purposes only and is not intended as medical advice. Always consult with a qualified healthcare professional before making changes to your supplement regimen or health routine. Individual needs and reactions vary, so it’s important to make informed decisions with the guidance of your physician.

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If you enjoyed today’s episode, be sure to subscribe, leave us a review, and share it with someone who might benefit. For more insights and updates, visit our website at Lifewellmd.com.

Stay Informed, Stay Healthy:
Remember, informed choices lead to better health. Until next time, be well and take care of yourself.

SPEAKER_00:

If you're one of the millions of people dealing with chronic lower back pain, you know what I'm talking about. That that searing constant pain from a herniated disc, sciatica.

SPEAKER_01:

It just takes over your life.

SPEAKER_00:

It really does. It affects everything. And you know, it's one of the top reasons people end up in an orthopedic surgeon's office.

SPEAKER_01:

Absolutely. And you start down this path, right? You do the physical therapy, you take the anti-inflammatories, the painkillers. But for so many people, it just doesn't touch the pain.

SPEAKER_00:

Exactly. And that's the scary part. Because when that fails, you start hearing the word surgery. So today we're doing a deep dive into some research that offers a, well, a really compelling alternative.

SPEAKER_01:

A game-changing one, potentially.

SPEAKER_00:

We're looking at a recent systematic review. It was published in Medica, a journal of clinical medicine, and it focuses specifically on the effectiveness of ozone therapy for lumbar disc disease.

SPEAKER_01:

Aaron Powell And this is so critical because there's a huge gap in care right now. The data is, frankly, pretty sobering. Even after all the conservative stuff, even steroid injections, somewhere between 25 and 72% of patients still need surgery within two years.

SPEAKER_00:

Aaron Powell And surgery isn't always the final answer, is it?

SPEAKER_01:

Aaron Powell Not at all. Revision surgeries are common. We're talking maybe as high as 25% of people needing another surgery within 10 years. It just highlights this urgent need for something else, something effective but less invasive.

SPEAKER_00:

Aaron Powell Which is our mission for this deep dive. We're going to unpack the evidence that suggests ozone therapy is that middle path, a proven option between conservative care and you know going under the knife. This is the kind of knowledge that's vital if you're focused on your long-term wellness.

SPEAKER_01:

Aaron Powell It is. And it's exactly this kind of evidence-based approach that you see at innovative clinics focused on longevity. I mean, the findings we're about to discuss, they directly support the work being done at places like lifewellmd.com. Right. Dr. Kumar, for instance, has been seeing incredible results with this therapy for over four years. And the science we're looking at today really shows why it works.

SPEAKER_00:

Aaron Powell Okay, so let's start there. The very basic question. Most of us hear ozone, and we think of the atmosphere, maybe pollution. The idea of injecting it into your spine sounds well a little strange.

SPEAKER_01:

It does. It sounds counterintuitive.

SPEAKER_00:

Aaron Powell So, what exactly is intradiscal ozone therapy, and how does it actually fix a physical problem like a herniated disc?

SPEAKER_01:

Aaron Powell That's a great question. And we're not talking about smog, of course. This is medical-grade, highly controlled ozone gas. The therapy itself involves injecting a very precise concentration of it directly into the nucleus pulvisus.

SPEAKER_00:

The jelly-like center of the disc.

SPEAKER_01:

The part that's bulging out and pressing on your nerve, yes.

SPEAKER_00:

Aaron Ross Powell Okay. So the ozone is in the disc. Then what happens? What's the uh the chemical reaction?

SPEAKER_01:

Aaron Powell So the primary action is essentially dehydration. The ozone causes what's called the cleavage of proteoglycans.

SPEAKER_00:

Okay, proteoglycans, can you unpack that for us?

SPEAKER_01:

Of course. Think of your disc like a little sponge. The proteoglycans are the molecules inside that sponge whose entire job is to soak up and hold on to water. They give the disc its volume.

SPEAKER_00:

I see. So they're what makes it pump.

SPEAKER_01:

Exactly. And ozone comes in and it breaks apart those water holding structures. It just diminishes the disc's ability to retain water. It's like wringing out that sponge.

SPEAKER_00:

So less water means a smaller disk. And a smaller disc means less pressure on the nerve. That is incredibly elegant.

SPEAKER_01:

It is, but that's only one part of the story. And this is where it gets really interesting because a herniated disc isn't just a mechanical problem, it creates massive inflammation around that nerve root.

SPEAKER_00:

Right. And that's where most of the pain actually comes from.

SPEAKER_01:

That's the searing pain. And ozone tackles that too through a controlled oxidative effect. It causes the downregulation of major inflammatory mediators.

SPEAKER_00:

What does that mean downregulation?

SPEAKER_01:

It basically tells the body to turn down the volume on inflammation. The review specifically mentions interleukin 1 beta and tumor necrosis factor alpha or TNF alpha. Think of those as the molecules that are screaming pain and swelling in the area. Ozone comes in and just quiets them down.

SPEAKER_00:

Wow. So it's a two-pronged attack. It physically shrinks the disc and it fights the chemical inflammation. That sounds almost too good to be true. Did the clinical results actually back up the theory?

SPEAKER_01:

Aaron Powell They did, emphatically. This systematic review pulled data from eight different perspective studies. So we're talking about a total of 413 patients.

SPEAKER_00:

Aaron Powell And what were they measuring? How do you track success?

SPEAKER_01:

Aaron Powell They focused on two gold standard metrics, the VAS score and the ODI score. Trevor Burrus Right.

SPEAKER_00:

VAS is the visual analog scale. So on a scale of 1 to 10, how bad is your pain?

SPEAKER_01:

Aaron Powell Exactly. And ODI is the Oswestri disability index. That one measures how the pain affects your actual life, your ability to walk, sit, lift things. It's about function.

SPEAKER_00:

Aaron Powell Okay, so what did the numbers show?

SPEAKER_01:

The results were highly significant across the board. For pain, they saw a mean improvement of 4.25 points on the VAS scale.

SPEAKER_00:

Aaron Powell 4.25. So if you walk in with an eight out of 10 pain, you could be walking out with something closer to a four. For someone in chronic pain, that's that's life-changing.

SPEAKER_01:

It's the difference between being disabled by pain and being able to live your life. And the disability scores reflected that. They saw a mean improvement of 20.57 points on the ODI. Wow. So people aren't just saying they feel less pain, they are actually getting their function back. And both results were statistically significant. This wasn't a fluke.

SPEAKER_00:

That's incredible data. But you always have to ask, who does it work for? Did they find it worked better for, say, younger patients, or only at a certain level in the spine?

SPEAKER_01:

Aaron Powell And that's one of our most powerful findings in the whole review. They ran a meta-regression to check for exactly that. They found no significant association. The improvement in pain wasn't linked to the patient's age, their gender, or the specific lumbar level, even though L4, L5, and L5S1 were the most common.

SPEAKER_00:

So it seems to work broadly. That makes it an incredibly versatile tool.

SPEAKER_01:

It really does. Which brings us to the next logical question. We know it works, but how does it compare to the current gold standard?

SPEAKER_00:

Aaron Powell, which for many people, after conservative care fails, is microdisectomy surgery.

SPEAKER_01:

Major operation. You've got general anesthesia, hospital time, a long recovery.

SPEAKER_00:

So how did this injection stack up against that?

SPEAKER_01:

Well, the review highlighted a randomized control trial that did a direct head-to-head comparison, ozone therapy versus microdisectomy. And the conclusion was stunning. They found that ozone treatment was non-inferior to the surgery.

SPEAKER_00:

Non-inferior. Let's really unpack that. That means you get a statistically similar result, a similar reduction in pain and disability as you would from major surgery. Trevor Burrus, Jr.

SPEAKER_01:

Exactly. But with a procedure that's, you know, a simple outpatient injection, it just completely changes the risk-benefit calculation for the patient.

SPEAKER_00:

Aaron Powell It creates a true middle path. You don't have to choose between constant pain and the risks of surgery anymore.

SPEAKER_01:

Trevor Burrus, it's a paradigm shift. You get a similar clinical outcome without the anesthesia, without the recovery time, without the risk of scar tissue that can happen after surgery.

SPEAKER_00:

Aaron Powell And researchers are always looking to improve, right? Did they look at combining ozone with other treatments?

SPEAKER_01:

Aaron Powell They did, and they found some interesting synergies. For patients with a contained herniation, where the disc is bulging but hasn't fully ruptured. Okay. Combining ozone with something called percutaneous intradiscal radiofrequency thermocoagulation, or PIRFT, was even more effective at reducing pain.

SPEAKER_00:

Aaron Powell PIRFT, what is that adding to the mix?

SPEAKER_01:

It's basically using targeted heat to shrink tissue and sometimes to deactivate the tiny nerve endings that are sending pain signals. So you get that effect on top of the ozone's action.

SPEAKER_00:

A powerful combination.

SPEAKER_01:

Very. They also found that adding a beta-methazone injection, that's a steroid around the nerve root, boosted the benefits compared to just ozone alone. It shows how a tailored approach is really key.

SPEAKER_00:

And that idea of precision brings us to what I think is the most fascinating detail in the whole study: the dosage, the concentration of the ozone itself.

SPEAKER_01:

Yes, this is absolutely critical. It's not a one-size-fits-all treatment. The dose you use completely changes what the ozone actually does in the body.

SPEAKER_00:

Okay, so walk us through the different levels.

SPEAKER_01:

So if a clinician uses a high concentration, let's say between 40 and 70 micrograms, the primary goal is tissue destruction. You're using the ozone to literally dissolve and shrink that bulging disc material as much as possible.

SPEAKER_00:

Okay, that's the brute force structural fix.

SPEAKER_01:

Aaron Powell Right. But if you dial the concentration back to the 20 to 30 microgram range, the effect changes completely. Now it's primarily an immunoregulatory dose.

SPEAKER_00:

Meaning it's focused on the inflammation.

SPEAKER_01:

Exactly. At that level, its main job is to quiet down those inflammatory messengers like TNF alpha.

SPEAKER_00:

And what if you go even lower?

SPEAKER_01:

Below 20 micrograms, the main effect is improving microcirculation. It helps bring blood flow, nutrients, and healing factors into that damaged area. And one study they cited found a direct link.

SPEAKER_00:

What was that?

SPEAKER_01:

A highly significant negative correlation. The more the disc height was physically reduced, the lower the patient's pain score was at six months.

SPEAKER_00:

So the dose you choose and the mechanical effect it creates directly predicts a long-term pain relief. That's the very definition of precision medicine.

SPEAKER_01:

It is. And it shows why experience matters so much. Knowing whether to use the destructive dose or the immunoregulatory dose, that's the art of it. It's what Dr. Kumar's team at LifeWellMD.com does. They leverage that four years of experience for each patient.

SPEAKER_00:

Aaron Powell Right. It's not just a simple injection protocol.

SPEAKER_01:

Okay, so we have high efficacy similar to surgery. We have a sophisticated, precise mechanism. We have to talk about safety. What are the risks?

SPEAKER_00:

This might be the most remarkable finding of all. The authors looked at safety across all eight studies, all 413 patients. And the conclusion was that none of the eight studies reported any minor or major complication.

SPEAKER_01:

Hold on. Zero complications.

SPEAKER_00:

You zero.

SPEAKER_01:

In over 400 interventional spine procedures, that's almost unheard of.

SPEAKER_00:

It really is. It's a powerful statement about the safety profile of this therapy when it's done correctly.

SPEAKER_01:

Now, to be fair, that's just in the studies included in this review. What about the wider body of research? Have any side effects ever been reported? Yes, and the authors are transparent about that. The wider literature has noted some subtle and usually temporary adverse effects, things like insomnia, some itching, gastritis, a rapid heartbeat, or hot flushes.

SPEAKER_00:

So minor things.

SPEAKER_01:

Generally minor, yes. And it's still considered a very, very safe procedure, especially when you compare it to the risks of major surgery or long-term use of opioid painkillers.

SPEAKER_00:

So when you put it all together, the efficacy, the mechanism, the safety. What was the final word from the researchers? What's the big takeaway?

SPEAKER_01:

Aaron Powell Their conclusion was direct and unambiguous. They state that ozone treatment is an effective therapy for this kind of low back pain and quote, can be considered a standard treatment for patients in whom conservative treatment failed.

SPEAKER_00:

Aaron Powell A standard treatment. Yeah. It's not experimental anymore, it's proven.

SPEAKER_01:

It's a proven frontline option.

SPEAKER_00:

Aaron Powell Which leaves us with a final provocative thought. If ozone therapy gives you results that are non-inferior to microdisectomy, but with a tiny fraction of the risk, how much sooner should you be exploring this path before you agree to surgery?

SPEAKER_01:

That's the question you should be asking your doctor. You have a proven, safe, effective middle path.

SPEAKER_00:

So if you or someone you love is struggling with this kind of chronic back pain, if you've done the PT, you've tried the medications, and you're now facing the prospect of surgery, this research gives you a clear, science-backed alternative.

SPEAKER_01:

Don't feel like you're out of options.

SPEAKER_00:

Dr. Kumar and the team at LifeWellmd.com specialize in this exact cutting edge therapy. They understand the nuances of the dosage, how to tailor it to your specific condition, as part of their larger focus on health and longevity. If you're ready to start your wellness journey, give them a call.

SPEAKER_01:

It's so important to go to someone with that level of specific expertise.

SPEAKER_00:

Call 561-210-9999. You can learn more about how Dr. Kumar uses his four plus years of experience with ozone therapy to help people get their lives back. Again, that number is 561 210 9999.

SPEAKER_01:

Please share this deep dive. Let people know there's another powerful option before they commit to the operating room.