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cSociedade Brasileira para o Estudo da Dor Rev Dor. São Paulo, 2012 oct-dec;13(4):396 LETTER TO THE EDITOR

Ozone therapy for lumbosciatic pain

Ozonioterapia em lombociatalgia Rev Dor. 2012;13(3):261-70

Dear Editor,

The above-mentioned article1 is a judicious analysis of the therapeutic use of ozone therapy to treat low back pain

and lumbosciatic pain.

However, physicians should not forget that in 07/09/2009 the Federal Council of Medicine (CFM), answering a re-quest of the Brazilian Ozone Therapy Association, has considered ozone therapy an experimental procedure, since in 08/11/04, the Federal Council of Medicine Plenary has approved the Opinion-Consultation CFM 27/043 with the

fol-lowing conclusion: “The literature review shows that ozone therapy has been used in some projects, but there are still

no well justiied, randomized double-blind and placebo-controlled studies showing its eficacy in medicine. In this

sense, the good medical practice does not allow its routine use; however it may be experimentally used after meeting guidelines and standards of Resolution CNS 196/96, which deals with studies involving human beings and includes the approval of the research project and of the free and informed consent term by a research ethics committee”. According to CFM, until 2008, date of the new opinion request, there is no addition or change of previous concepts,

no methodologically acceptable or scientiically proven study which may change previous CFM decision, so CFM

has maintained the terms of the Opinion CFM 27/04, considering ozone therapy as experimental treatment submitted to the standards of Resolution CNS 196/96.

However, the study1 has identiied 2 randomized multicenter studies, 4 systematic reviews being one a meta-analysis

with more than 8 thousand patients in different centers, 1 Italian national consensus and several double blind stud -ies, some with control groups; however the level of evidence to support a more vigorous recommendation is still considered low.

Since ozone therapy is ethically allowed for experimental clinical trials, which comply with the standards of

Resolu-tion CNS 196/96, I see great merit in the study, which is to encourage Brazilian investigators to scientiically evaluate

ozone to treat chronic pain, thus contributing for this minimally invasive method, able to offer analgesia for most patients with very few reports of complications, to be recognized and used in our patients.

Yours Sincerely,

Roberto Awade Physician of the Pain Control Team, Central Institute, Clinicas Hospital of the School of Medicine, University of

São Paulo (USP).

REFERENCES

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