The major efficient mechanisms of ozone therapy are obtained in intradiscal procedures.

Magalhaes et al reported on randomized controlled trials of ozone therapy as a treatment for low back pain secondary to herniated intervertebral discs (HID) (1). We have read their article with interest and want to add important concerns. Ozone therapy has become an alternative treatment for low back pain secondary to a herniated disc. Although the exact mechanism of action of medical ozone is not completely understood, there are a number of characteristics of this molecule that offer some insights into its mode of action in treating HID. The main mechanisms of action are proposed to explain the efficacy of ozone therapy: