OZONE AS AN ADJUVANT THERAPY IN TREATMENT OF FIBROMYALGIA SYNDROME

Background: Fibromyalgia syndrome (FMS) is characterized by an increase in pain perception in the central nervous system, whose main symptom is chronic widespread pain at muscles, tendons and ligaments but not in joints, accompanied by symptoms that disrupt the daily living activities of the patients. Objective of this study was to assess the effectiveness of ozone therapy either by local intra-muscular injection or combined local intra-muscular injection and rectal insufflation as an adjuvant therapy in FMS. Patients & Methods: Fifty patients with FMS were recruited for this study and classified into three treatment groups .Group (A),20 patients treated with local intra-muscular ozone injection 2 sessions /week for 5 weeks. Group (B),20 patients treated with local IM injection in tender points and rectal ozone therapy /twice weekly for 5 weeks and the third group (C),include10 patients were the control group not receiving ozone therapy .Assessment were done by visual analogue scale (VAS) for pain , fibromyalgia impact questionnaire (FIQ), Hamilton depression rating scale (HDRS) and Short form 12 – Items health survey (SF-12)for depression , sleep disturbance and daily living activity assessment at baseline and 5weeks later after ozone treatment . Results: signi?cant decrease in FIQ total scores after 5 weeks of treatment in groups (A&B) with percentage of change 33.4 % in group (A) and 47.7% in group ( B) more than in control group (C)17.3 %. The improvement was mainly in physical symptoms, such as work impairment, stiffness, pain, fatigue, and morning tiredness. There were significant differences in scores of HDRS and SF – 12 items between the baseline and after 5 weeks of ozone treatment in both groups (A & B) than in control group(C). Significant reduction in VAS by 35.3 % in group A and 45.3 % in group B after treatment while in group C 17.7 %. Conclusion: ozone therapy given by rectal insuf?ation together with local tender point's injection seems to be bene?cial than local tender point's injection alone, mainly for the physical symptoms of FMS, though anxiety and depression also improved. The ozone therapy can be considered as an interesting adjuvant therapy in treating symptoms of FMS.