Exercises to Strengthen Back Muscles
(but check with your doctor first)



A minimally invasive interventional radiology treatment—that safely and effectively uses oxygen/ozone to relieve the pain of herniated disks—will become standard in the United States in the next few years, predict researchers at the Society of Interventional Radiology’s 34th Annual Scientific Meeting. In a related study, the interventional radiologists examined just how ozone relieves the pain associated with herniated disks.

Society of Interventional Radiology, April 23, 2009 — Back pain is the most common cause of job-related disability and a leading contributor to missed work. While the pain of herniated disks can be severe, it can ease over time, and many people may no longer feel the need for medical care. However, in some, the pain from herniated (or ruptured or slipped) disks is intolerable or persists. “Having a herniated disk can affect how you perform everyday activities and can cause severe pain that influences almost everything you do; however, you don’t have to undergo invasive surgery,” noted Kieran J. Murphy, M.D., interventional neuroradiologist and vice chair and chief of medical imaging at the University of Toronto in Toronto, Ontario, Canada.

Oxygen/ozone therapy involves injecting a gas mixture of oxygen and ozone into a herniated disk. The treatment can limit pain and inflammation by reducing the disk’s volume. Currently, open diskectomy and microdiskectomy (both involving removal of disk material through an incision) are the standards in surgical treatment for herniated disk.

“Oxygen/ozone treatment of herniated disks is an effective and extremely safe procedure; interventional radiologists use imaging to guide a needle to inject oxygen/ozone into injured disks. The estimated improvement in pain and function is impressive when we looked at patients who ranged in age from 13 to 94 years with all types of disk herniations,” explained Murphy. “Equally important, pain and function outcomes are similar to the outcomes for lumbar disks treated with surgical diskectomy, but the complication rate is much less (less than 0.1 percent),” he added. “In addition, the recovery time is significantly shorter for the oxygen/ozone injection than for the diskectomy,” said Murphy. “The spine is a stunningly beautiful piece of engineering, or, as our engineers say, the spine is like a complex electromechanical system. And the interventional radiology oxygen/ozone treatment takes a minimalist approach. It’s all about being gentle,” said Murphy.

“Ozone shrinks disk volume; this is why it provides pain relief,” said Murphy, whose second study explored the mechanism of why oxygen/ozone treatment works. The bones (vertebrae) that form the spine in the back are cushioned by small, spongy disks. When these disks are healthy, they act as shock absorbers for the spine and keep the spine flexible. But when a disk is damaged, it may bulge or break open. “There are millions of people with back pain who suffer and who can’t work because of their pain. Undergoing invasive surgical diskectomy puts you on a path where you may be left with too little disk. Taking out a protruding disk may lose the shock absorption that naturally resides between them in the spine,” said Murphy, who predicts this procedure will become standard in the United States within the next five years.

Researchers conducted a meta-analysis of various results published for oxygen/ozone treatment in regards to pain relief, reduction of disability and risk of complications. More than 8,000 patients from multiple centers in multiple locations were included in the study. The estimated mean improvement for patients after treatment based on the 10-point visual analog scale (VAS), a standard tool for rating the disabling effects of back pain, was a change of 3.9 (with 0 being no pain and 10 representing worst pain experienced). The estimated mean improvement was 25.7 percent for the Oswestry Disability Index (ODI), which measures one’s ability to manage everyday life-such as washing, dressing or standing (with 61 percent or higher representing back pain that has an impact on all aspects of daily living. The improvement scores for VAS and ODI outcomes are well above both the minimum clinically important difference and the minimum (statistically significant) detectable change, indicating that the improvement in pain and function is a real change that can be felt by the patient.

Much research in oxygen/ozone treatments has been done by interventional radiologists in Italy, said Murphy, indicating that as many as 14,000 individuals have received this treatment abroad over the past five years. The mechanism of action in relieving low back pain is complex; however, the primary effect is a volume reduction due to ozone oxidation. Researchers discovered that a simple incompressible fluid model predicted that reducing disk volume by 0.6 percent results in an intradiscal pressure reduction of 1 psi (pounds per square inch). Thus a very small change in volume creates a large change in disc pressure, which reduces the applied pressure on the nerve and relieves pain. This model confirmed that a minimalistic alternative to a diskectomy, such as oxygen/ozone treatment, is capable of relieving the pain caused by a herniated disk without causing irreparable damage.

How did these clowns see it coming in 2007, when financial reporters did not?

Dr. Jill Bolte Taylor’s website:

Lawrence Grouse, MD, PhD

Medscape J Med. 2008;10(3):59. ©2008 Medscape
Posted 03/10/2008

In another commentary, I advocated the creation of a US health television network,[1] but I didn’t discuss the difficult issues in establishing it or in creating its medical content.

The medical content for a national health network would be crucial in establishing its value. The individuals and organizations with the responsibility for deciding this content cannot be influenced by proprietary interests. A diverse group of health educators who are without commercial bias is needed to make these decisions. Those with conflicts of interest should be excluded.

It is my opinion that medical professional groups are inappropriate judges of what health information to present precisely because of their conflicts of interest. These groups are primarily trade organizations that operate to benefit their members’ and their own financial interests.[2-6]

So, what organization should establish the US health network? Because the good health of the US population is so much in the interest of the US government, it is logical that the government should implement the network. It goes without saying that government policies are also influenced by proprietary interests, but the possibility of achieving the benefits of a health television network should persuade legislators to fund it in a way that would make it less vulnerable to commercial influence and more oriented to effective health education. The US government also has a long arm that can involve state and local governments, schools, public health clinics, and practicing physicians in an integrated program of health improvement. A US health network could be the medium that would link these resources together.

What about the expense of a US health network? In my opinion, commercial advertisements, as long as they are medically appropriate as regulated by the FDA and FTC, could cover these costs. In a business as profitable as television, even the government should be able to break even.[6]

These are just a few of the issues to deal with in establishing a health television network. And like all complex organizations, the devil is in the details, but what is most important is that we work to realize the power for health promotion that exists in television and in new communication technologies. We should not let the “business as usual” attitude prevent the implementation of this life-saving approach to public health.

That’s my opinion. I’m Dr. Larry Grouse, the Executive Director of the ARIA Initiative of the World Health Organization.


  1. Grouse L. Issues in creating a US health television network. Medscape J Med. 2008;10(2):27. Available at: http://www.medscape.com/viewarticle/569156 Accessed March 7, 2008.
  2. Lundberg GD. And then there were none. The demise of national medical television. JAMA. 1995;273:891.
  3. Lundberg GD, Stacey J, Severed Trust: Why American Medicine Hasn’t Been Fixed. New York: Basic Books; 2000.
  4. Angell M. Drug Companies. Oxford: Oxford University Press; 2004.
  5. Kassirer J. On the Take. Oxford: Oxford University Press; 2005.
  6. Grouse LD. For Sale: US Medicine. Physicians For Sale. USHN, Inc. 2008. In press.

Lawrence Grouse, MD, PhD, Clinical Assistant Professor, University of Washington School of Medicine, Seattle, Washington
Author’s email: lgrouse@u.washington.edu

Disclosure: Lawrence Grouse, MD, PhD, has disclosed no relevant financial relationships in addition to his employment.

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