From one neat photo to a whole article about ozone therapy

Over the holidays, I had a lot of fun writing about a poison, inspired by a cool picture. One thing led to another, and a brand new member of the PainScience library of articles was born:

I barely knew that ozone therapy existed before this, let alone that it had anything to do with my job. I was dimly aware of it as a thing that a desperate cancer patient might be offered at a Mexican natural healing clinic, along with their colonics and intravenous shark cartilage.

I have a huge list of topics I want to write about. How can it be 2022, and I still haven’t written an article about arthritis or neuropathy? Glutes not “firing”? And where’s my foam rolling article? My page about joint popping and crepitus? An endometriosis guide, at least? Come on, man!

So I invested in a topic that wasn’t even on my list. Because it got weird and fascinating. In this post, I’ll introduce ozone therapy and tells the story of how I got sucked into the topic.

What is ozone?

Ozone is a pale blue toxic gas, a variant of oxygen, its molecules each made of three oxygen atoms: “trioxygen.” It has a distinctive “fresh” smell and is widely used as a disinfectant — because it murders cells — plus many other industrial applications related to oxidation.

It’s banned by the FDA for medical use. And it has a long and colourful history, literally…

The pictures that piqued my interest

For decades consumers could buy ozone generators for self-treatment, like this bizarre vintage medical device of unknown provenance. It still “works”: it produces a strong ozone odour, and the paddle causes the sensation of little sparks when applied to the skin. Photos by neon collector Jenny Beatty, used with permission. See several more high-res photos.

I got those great photo from Jenny from a post in a Facebook discussion group, Skeptical Revival, which I will take a moment to promote. The group’s intro:

Scientific Skepticism is many things. It’s an approach to evaluating claims (especially extraordinary ones), a worldview, a movement to promote critical thinking, a movement to protect people from the harms of pseudoscience, and a community. Let’s rebuild that community. Share links, post thoughts, discuss ideas.

Rebuild? The skeptical community suffered some schisms over the last decade. Skepticism is not a hive mind. There are factions separated by chasms. There are members I don’t want to be associated with. The group is all about trying to heal, trying to get back on the same page.

And anti-quackery activism is something almost all skeptics can get behind.

More about the photo and the artifact

Jenny is primarily a neon collector, and has some other medical quackery artifacts that light up, like the infamous “violet ray” devices, which were basically zappers, early transcutaneous electrical nerve stimulation (TENS):

Renulife was one of several major manufacturers of “violet ray” devices, which applied a high voltage, high frequency, low current to the human body… for your health. When the violet ray machines became illegal for medical use, some were remarketed as sex toys! 🍆 Photo by neon collector Jenny Beatty, used with permission.

Jenny’s generated its last violet ray long ago. But that ozone generator actually works. And why neon? Neon isn’t needed, so we suspect it’s pure marketing sizzle, there just to make it look more impressive.

Popular but dangerous

At first all I wanted to do was to add ozone air purifiers to my list of popular but dangerous snake oils, which includes historical highlights like voluntary lobotomy for depression and anxiety, and modern horrors like drinking bleach to treat COVID (or anything). Such examples vividly demonstrate the futility of medical anecdotes.

Ozone is another good example, and there was a cool picture I could get the rights to use as well.

I swear, all I was going to do was add one bullet point and a photo.

Okay, maybe one footnote

The journey down the rabbit hole started with a footnote, as it so often does for me. I added one to differentiate between historical and modern ozone quackery: there are modern forms of ozone therapy that are less ridiculous and have nothing to do with inhaling the stuff.

While fact-checking that, I stumbled on this: “Ozone therapy in 65 patients with fibromyalgia: an effective therapy.”

Ozone therapy was on my turf. And this was recent! A 2019 paper by Tirelli et al. (It turns out Italians have written two thirds of all the scientific literature about ozone therapy. Fishy.)

The big three: fibromyalgia, arthritis, back pain

A few PubMed searches later, I knew there was a significant body of modern scientific literature about ozone therapy for many things, including three of concern to me: fibromyalgia, arthritis, back pain.

I shouldn’t have been surprised. Those are three of the most common, difficult pain problems, inevitable targets for every conceivable kind of treatment and therapy. Which is why I probably should have spent the holidays working on, say, an arthritis guide and not an ozone therapy review.

But there was no stopping me after I found the next thing.

One thing led to another which led to Tesla

My ozone review grew like a weed, but was still just a sub-topic for couple other articles, until I learned that ozone therapy was invented by Nikola Tesla. It was the most notorious early electric snake oil! That’s when I knew I was going to have to go all the way with this topic, a whole new article in its own right.

It was still going to be short article, though. Until I got mad.

The first commercial ozone generators were made by Nikola Tesla — the Elon Musk of his day. His legend still powers ozone quackery to some extent well over a century later.

A near perfect example of pseudoscience

Vintage quackery is quaint, but modern quackery is evil, and it was becoming clear that ozone therapy was a •chef’s kiss• example of dangerous pseudoscience:

• Banned by the FDA. Obviously unsafe if used incorrectly.
• Elaborate, superficially plausible biological rationale. Strong “seeds of truth.”
• Powerful links to rank quackery (e.g. alternative cancer clinics), of course …
• … but also vigorous support from superficially credible proponents: doctors, dentists, veterinarians.
• A “growing body of literature,” small but too large to dismiss out of hand, consisting almost exclusively of crappy little clinical trials with off-the-charts risk of bias.

I am outraged by that “literature.” I can’t justify ignoring the available evidence, even terrible evidence. This is the dilemma that the geyser of modern junk science has created: can’t extract much value from it, but can’t ignore it either!

Going all the way

I held my nose and reviewed what there is to review on ozone for fibromyalgia, arthritis, and back pain. From one bullet point and a photo to:

• A 5000-word article with two dozen footnotes and citations.
• A new section of the fibromyalgia article.
• A new section of my patellofemoral syndrome book.
• And still, of course, that new bullet point for the popular-but-dangerous treatments page.
• A new chapter for my back pain book about injecting ozone into intervertebral discs. The same information is in the ozone therapy review, but for members only.