Fibromyalgia and ozone treatment. A comprehensive clinical narrative review

Abstract

Fibromyalgia (FM) is a chronic, multi factorial disorder, predominantly affecting women, characterized by widespread chronic musculoskeletal pain, sleep disturbances, fatigue and psychological symptoms, all of which significantly impair quality of life. Actually, current standard therapeutic strategies remains only partially effective. Ozone therapy (OT), particularly when administered via autohemotherapy (MAHT), has been proposed as a potential complementary treatment targeting underlying mechanisms such as: oxidative stress and inflammation via an induce repeted controlled oxidative stress and the activation of endogenous antioxidant and immunomodulatory pathways.  This clinical narrative review evaluates studies published between 2022 and 2026 on the complementary use of ozone therapy in FM.

Fibromyalgia syndrome (FMS) is a disorder with no cure, characterized by exclusionary criteria from diagnosis, as well as chronic widespread muscle pain, debilitating fatigue, and reduced quality of life. Even though there are numerous pharmacological and non-pharmacological treatment options available to treat FMS, many patients fail to respond to conventional therapies and are therefore classified as being refractory to treatment. In this scenario, complementary modalities such as using ozone as a treatment modality have become a viable therapeutic options, however, Further researches are needed especially, randomized control trials (RCTs) to support and confirm these clinical data to confirm their efficacy. The clinical improvements noted to date with OT are most likely attributable to its antioxidant, anti-inflammatory, and immunomodulatory effects targeting the three central mechanisms of FM (e.g. oxidative stress, central sensitization and immune dysregulation). The recurrent of symptoms in some patients suggest that ongoing clinical benefit may entail optimizing or repeating the ozone treatment protocol. While there is some encouraging evidence, variability among study methodology and design limit the generalization of these results. Additional randomized controlled trials with larger sample sizes that are well-designed are needed to validate these evidences, determine the optimal treatment regimens and define the long-term safety of ozone therapy for FM.

The purpose of this narrative comprehensive review is t1o provide further information of the latest evidences in favor of OT for FM and discuss some aspect of therm.