One-off jab of ozone gas to treat foot pain that affects one in 10 UK adults

A single dose of ozone gas could eradicate the difficult-to-treat foot pain that affects almost one in 10 adults in Britain.

Plantar fasciitis – inflammation of the band of tissue that runs along the sole of the foot – can cause debilitating pain that lasts for months or in some cases even years.

The condition is most common in people between the ages of 40 and 60 and can be caused by wearing shoes with little cushioning or support, exercising or walking on hard and uneven surfaces, and being overweight.

Some people get it because they have flat feet, because the tissue is stretched when weight is put on the foot.

Current treatments include taking painkillers, steroid injections to relieve inflammation, wearing special insoles to support the foot, or doing exercises recommended by a physical therapist or podiatrist to relieve discomfort.

But now a trial is underway at Ankara City Hospital in Bilkent, Turkey, to see if a one-time injection of ozone gas can keep pain at bay for longer. The results of this study are expected next year.

Ozone is a form of oxygen gas that occurs naturally in the Earth's atmosphere, where it protects us from the sun's harmful UV rays.

At ground level, airborne ozone is a pollutant that is harmful when inhaled and causes symptoms such as chest pain, coughing and throat irritation. The gas is mainly produced in warm weather, when other pollutants mix with sunlight.

But in recent years, ozone – in small quantities – has also attracted interest because of its potential applications in medicine.

Studies have shown that it can stop tooth decay because it destroys harmful bacteria that rot teeth and gums; while other research suggests it may ease the pain of osteoarthritis – by dampening the release of prostaglandins, chemicals caused by inflammation in a damaged joint that send pain signals to the brain.

It is thought that the ozone shot on painful feet works in the same way as it does on arthritic joints, by counteracting the release of pain-inducing prostaglandins.

But scientists also think that ozone – as a supercharged form of oxygen – can increase oxygen supply to damaged tissue, aiding the healing process. The new study is recruiting 48 people between the ages of 18 and 65 who have foot pain lasting more than three months.

Half will receive a single injection of a liquid form of ozone (where the gas is mixed with saline) into the foot, while the rest will be treated with extracorporeal shockwave therapy – a non-surgical treatment also available on the NHS where energy impulses are administered. are fired through the skin onto damaged tissues to reduce inflammation.

Volunteers are regularly monitored in the weeks and months after treatment to see if the pain has disappeared.

Ultrasounds will also be used to measure the thickness of the plantar fascia before and after treatment. The thicker the tissue, the more likely it is to cause pain.

The results of a similar study in Iran, published in 2018 in the journal Pain Medicine, showed that patients had less pain three months after ozone treatment than those who received steroid injections in the foot.

Matthew Solan, orthopedic surgeon at the Royal Surrey County Hospital, says most cases of plantar fasciitis resolve on their own without specific treatment – ​​and any new medical research should take this natural recovery process into account.

For the previous ozone shot study in Iran, for example, he notes that the patients treated had suffered pain for only two months – and that “almost all would have improved without treatment and with time alone.”

He explains: 'It is wise to have patients spend at least three months on basic exercises: resting, wearing suitable shoes and weight control.

'The evidence for what is good at that stage is poor. Shockwave therapy has the fewest side effects and reasonable evidence.'