Prolozone Therapy
Prolozone combines the regenerative power of prolotherapy with the healing benefits of medical ozone. This dual-action treatment increases oxygen delivery to damaged tissues while stimulating repair, often providing relief faster than either treatment alone.
What Is Prolozone?
Prolozone therapy is an injection treatment for acute and chronic painful conditions. The name combines "prolo" (from prolotherapy, meaning to proliferate or regenerate) with "ozone" (the therapeutic gas used).
During a prolozone treatment, a mixture of oxygen and ozone gas is injected directly into or around the affected joint, along with nutrients that support tissue repair. This combination increases oxygen delivery to damaged tissues, stimulates healing and often provides rapid pain relief.
Prolozone vs. Prolotherapy
Prolotherapy
- Uses dextrose solution to trigger healing
- Creates controlled inflammation
- Best for ligament laxity and instability
- Typically requires 4-6 treatments
Prolozone
- Uses ozone/oxygen gas plus nutrients
- Increases oxygen to damaged tissue
- Best for degenerative conditions & arthritis
- Often faster relief; ongoing maintenance
Both treatments can be used together or alternated depending on your condition.
How Does Prolozone Work?
The oxygen-ozone gas mixture has a powerful dual effect on target tissues:
- Ozone increases oxygen utilization, damaged tissues often have poor oxygen delivery. Ozone helps cells use oxygen more efficiently, supporting the energy production needed for repair.
- Oxygen increases tissue oxygenation,directly raising oxygen levels in the area, which is essential for healing and new tissue formation.
- Mild proliferative effect,ozone acts as a gentle irritant that stimulates a healing response, similar to prolotherapy but through a different mechanism.
This dual mechanism supports tissue healing and may reduce pain, with some patients noticing improvement relatively quickly after treatment.
The Science of Ozone
Ozone Molecule
Three oxygen atoms bonded together, less stable than O₂, which drives its therapeutic effects
Increased ATP Production
Cells exposed to ozone produce more ATP, the energy currency needed for tissue repair
Enhanced 2,3-DPG
Improves oxygen release from red blood cells to tissues
Conditions Treated with Prolozone
Prolozone is particularly effective for chronic degenerative conditions where improved oxygenation accelerates healing.
Osteoarthritis
Knee, hip, shoulder and hand arthritis respond very well to prolozone. Clinical trials show significant pain reduction and improved function.1-3
The most studied condition for prolozone therapy
Herniated Disc
Clinical research shows excellent results for disc herniations. A meta-analysis found ozone therapy effective for herniated disc pain.4-8
May help some patients avoid surgery
Low Back Pain
Multiple studies demonstrate ozone's effectiveness for chronic low back pain, often outperforming steroid injections.9-11
Learn about our back pain approach →TMJ Dysfunction
Temporomandibular joint pain and dysfunction have shown very good results with intra-articular ozone injections.12
Effective for chronic jaw pain and clicking
Frozen Shoulder
Adhesive capsulitis responds well to prolozone, helping restore range of motion and reduce pain.
Can accelerate recovery significantly
Degenerative Disc Disease
When discs degenerate, prolozone can help improve function and reduce associated pain.
Slows progression and improves comfort
Other Conditions That May Benefit
- Plantar fasciitis
- Tennis/golfer's elbow
- Rotator cuff injuries
- Carpal tunnel syndrome
- Achilles tendinitis
- Neck pain
- Spondylolisthesis
- Bursitis
- Chronic tendinopathies
What to Expect
During Treatment
The injection is slightly more uncomfortable than an acupuncture needle. Dr. Frank Shallenberger, who trained me in this technique, describes it as "like a mosquito with an attitude." A small volume of ozone/oxygen gas mixture is injected into or around the affected joint. The entire treatment takes just a few minutes.
Immediately After
Some patients feel temporary stiffness or pressure at the injection site as the gas disperses; this is normal and short-lived. Most people can return to normal activities immediately.
Within Hours
Typically within a few hours of treatment, people feel an improvement in their pain. Within 24 hours, most cases show decreased pain and often improved range of motion.
Treatment Course
Most conditions respond well within 6 treatments, given every 2-4 weeks. After the initial course, a maintenance phase begins with treatments every 1-3 months. For advanced osteoarthritis, ongoing treatments every 6-8 weeks help maintain optimal mobility and pain control.
Safety & Training
When administered by a properly trained practitioner, prolozone injections are very safe. Ozone gas is non-toxic at the physiologic doses used in medical applications.
I was trained in ozone therapy and prolozone injections with Dr. Frank Shallenberger MD of Reno, Nevada, recognized as the foremost educator on medical ozone in North America. This training covers clinical indications, safety protocols and proper injection techniques.
Contraindications
- Prosthetic joint replacement,cannot inject into a joint with a prosthesis
- Active infection at the injection site
- Bleeding disorders or anticoagulant therapy (discuss during consultation)
Frequently Asked Questions
Does prolozone hurt?
Prolozone injections are slightly more uncomfortable than an acupuncture needle, but not much more. Most patients tolerate the treatment well. The injection itself is brief, and any discomfort passes quickly.
How many treatments will I need?
Most conditions respond well within 6 treatments given every 1-2 weeks. After the initial treatment course, maintenance treatments every 6 months help sustain results.
How quickly will I feel better?
Many patients feel improvement within hours of treatment. Within 24 hours, most people experience decreased pain and often improved range of motion. Some temporary stiffness immediately after treatment is normal but short-lived.
Can I have prolozone if I've had a joint replacement?
No, prolozone cannot be injected into a joint that has a prosthetic replacement. However, we can treat other joints and areas that are causing pain. Many patients with one joint replacement develop problems in other joints from compensating, and prolozone can help these secondary areas.
Ready to Try Prolozone?
If you're dealing with joint pain, arthritis or a chronic musculoskeletal condition, prolozone may help. Book a consultation to find out if it's right for you.
Book OnlineReferences
- Al-Jaziri AA, Mahmoodi SM. Painkilling effect of ozone-oxygen injection on spine and joint osteoarthritis. Saudi Med J. 2008;29(4):553-7.
- Benvenuti P. Oxygen-Ozone Treatment of the Knee, Shoulder and Hip. Rivista Italiana di Ossigeno-Ozonoterapia. 2006;5:135-144.
- Li JH, et al. Treatment of knee osteoarthritis by ozone combined Chinese materia medica. Zhongguo Zhong Xi Yi Jie He Za Zhi. 2013;33(4):471-5.
- Magalhaes FN, et al. Ozone therapy as a treatment for low back pain secondary to herniated disc: a systematic review and meta-analysis. Pain Physician. 2012;15(2):E115-29.
- Paoloni M, et al. Intramuscular oxygen-ozone therapy in the treatment of acute back pain with lumbar disc herniation. Spine. 2009;34(13):1337-44.
- Bonetti M, et al. Intraforaminal O₂-O₃ versus periradicular steroidal infiltrations in lower back pain: randomized controlled study. AJNR. 2005;26(5):996-1000.
- Wu Z, et al. Percutaneous treatment of lumbar disc herniation by injection of oxygen-ozone. Eur J Radiol. 2009;72(3):499-504.
- Andreula CF, et al. Minimally invasive oxygen-ozone therapy for lumbar disk herniation. AJNR. 2003;24(5):996-1000.
- Melchionda D, et al. Treatment of radiculopathies: efficacy of paravertebral oxygen-ozone injections. J Biol Regul Homeost Agents. 2012;26(3):467-74.
- Yu Z, et al. Targeted injection of ozone for treating lumbar disc herniation. Nan Fang Yi Ke Da Xue Xue Bao. 2012;32(2):243-6.
- de Nêuton F, et al. Effects of ozone in patients with chronic pain related to failed back surgery syndrome. Neuropsychiatr Dis Treat. 2013;9:1759-66.
- Daif ET. Role of intra-articular ozone gas injection in TMJ management. Oral Surg Oral Med Oral Pathol Oral Radiol. 2012;113(6):e10-4.