Chronic low back pain is often caused by damage to the spinal discs. These discs are located between the vertebral bones of the spine and function as shock absorbers. When they degenerate, multiple parts of the disc can contribute to pain. Two minimally invasive treatments, intradiscal ozone therapy and Discseel, approach this problem in very different ways.

This article explains how each treatment works, what conditions they treat, and how they compare, along with a clear explanation of spinal disc anatomy.

Basic Lumbar Disc Anatomy

Each lumbar disc has three important components:

1. Nucleus Pulposus

• Soft, gel-like center
• High water content
• Distributes pressure evenly across the disc

2. Annulus Fibrosus

• Strong outer ring made of layered collagen fibers
• Contains the nucleus
• Provides structural stability

3. Vertebral Endplates

• Thin layers between the disc and the vertebral bone
• Allow nutrients to diffuse into the disc
• Help anchor the disc

How Disc Degeneration Occurs

Degeneration is a multi-structure process, involving all three components.

Typical Progression

1. Nucleus degeneration begins first
   • Loses hydration
   • Becomes less elastic
2. Annulus develops fissures (tears)
   • Uneven forces stress outer ring
   • Cracks form and may become painful
   • Endplates become inflamed or damaged
   • Reduced nutrient flow worsens disc health

Although this is the most common pattern, all three structures interact and influence each other throughout the disease process.

What Is Intradiscal Ozone Therapy?

Intradiscal ozone therapy is a minimally invasive procedure in which a mixture of oxygen and ozone gas is injected into a spinal disc.

Ozone (O₃) is a highly reactive form of oxygen. In controlled medical doses, it has several biological effects that can help reduce pain.

How Intradiscal Ozone Therapy Works

The treatment works through several mechanisms:

1. Shrinking the Nucleus

Ozone reacts with proteins in the nucleus pulposus, causing it to:

• Dehydrate slightly
• Shrink in volume

This can reduce pressure inside the disc and relieve nerve compression.

2. Anti-Inflammatory Effects

Ozone reduces inflammatory chemicals in and around the disc, which can:

• Decrease pain signals
• Improve the local environment

3. Improved Oxygenation

It may enhance oxygen delivery to tissues, supporting healing processes.

Conditions Treated by Intradiscal Ozone Therapy

Ozone therapy is most commonly used for:

• Lumbar disc herniations
• Contained disc bulges
• Lumbar degenerative disc disease
• Sciatica caused by disc pressure

It is widely used in Europe and other parts of the world as a non-surgical alternative.

Indications for Use

Typical candidates include:

• Patients with back or leg pain lasting several weeks to months
• MRI-confirmed disc bulge or herniation
• Contained discs (not fully ruptured)
• Failure of conservative treatments

It is generally less effective in:

• Severely collapsed discs
• Large annular tears
• Advanced degeneration

Are There Limits on How Many Levels Can Be Treated?

Yes. In most cases:

• One to two disc levels are treated per session
• Occasionally three levels may be treated depending on the physician and patient condition

Treating too many levels at once may increase risk and reduce precision, so careful selection is important.

Treatment Strategy of Intradiscal Ozone Therapy

Ozone therapy primarily targets the nucleus pulposus and the inflammatory environment.

Its goals are to:

• Reduce disc volume and pressure
• Decrease inflammation
• Relieve nerve irritation

However, it does not directly repair structural damage, especially in the annulus.

What Is Discseel?

Discseel is a procedure that focuses on the annulus fibrosus, the outer layer of the disc.

How It Works

It uses fibrin (a natural healing protein) injected into annular fissures to:

• Seal tears
• Prevent leakage of inflammatory chemicals
• Promote healing of the disc wall

Intradiscal Ozone Therapy vs Discseel

Target Structure

• Ozone therapy: Nucleus pulposus
• Discseel: Annulus fibrosus

Mechanism

• Ozone: Shrinks disc and reduces inflammation
• Discseel: Repairs structural tears

Best Candidates

• Ozone: Contained herniations, pressure-related pain
• Discseel: Annular fissures, leakage-related pain

How Each Procedure Treats Pain

Intradiscal Ozone Therapy Strategy

• Reduces internal disc pressure
• Shrinks herniated material
• Lowers inflammation

This can relieve both:

• Mechanical compression
• Chemical irritation

Discseel Strategy

• Seals annular tears
• Stops leakage of inflammatory molecules
• Stabilizes the disc structure

This focuses more on structural integrity.

Does the Annulus Heal After Ozone Therapy?

This is a critical point.

Likelihood of Annulus Improvement

• Low to moderate at best
• Ozone does not directly repair annular fibers
• Any improvement is indirect

If disc pressure decreases:

• Stress on the annulus may lessen
• Small fissures may become less symptomatic

However:

• True structural healing is unlikely without direct treatment because discs lack adequate blood supply for self healing.

Can Annular Fissures Still Cause Pain After Ozone Therapy?

Yes.

Even if ozone therapy is successful:

• Annular tears may still exist
• These fissures can continue to generate pain

However:

• Reduced inflammation and pressure may make them less symptomatic
• Some patients experience significant relief despite persistent structural defects

Key Limitation of Ozone Therapy

Ozone therapy is best understood as:

• A functional treatment (reduces pressure and inflammation)
• Not a structural repair treatment
• Availability may be limited by each country’s regulations

This distinction is important when considering long-term outcomes.

Disc Degeneration: A Whole-System Problem

Disc degeneration affects:

• The nucleus (loss of hydration)
• The annulus (tears and weakness)
• The endplates (reduced nutrient flow and inflammation)

Choosing Between Ozone Therapy and Discseel

The decision depends on the main source of pain.

Choose Intradiscal Ozone Therapy if:

• Pain is driven by disc bulge or herniation
• There is increased pressure inside the disc
• The annulus is relatively intact

Choose Discseel if:

• Pain is driven by annular fissures
• There is leakage of inflammatory chemicals
• Structural damage is the main issue

Final Perspective

Intradiscal ozone therapy and Discseel represent two different philosophies:

• Ozone therapy reduces pressure and inflammation
• Discseel attempts to repair structural damage

Both can be effective, but for different reasons.

Key Takeaway

• Ozone therapy may relieve symptoms without fixing the structure
• Discseel focuses on repairing the disc wall

Because degeneration involves all parts of the disc, understanding which structure is the primary pain generator is essential. Contact the Regenerative Spine & Joint Center to find out if Discseel is right for you.