Determining if Oxygen Ozone Injection Therapy is Right for You

Determining if Oxygen Ozone Injection Therapy is Right for You

In order to determine if a patient will benefit from oxygen ozone injection therapy, I look at a number of factors. The history is extremely important. That is one of the most important aspects of determining if a patient will benefit. It is important to ask specific questions about the patient’s pain, and when it started, as well as other pertinent questions. During the history, I also observe the patient. I observe how they walk, sit and how they move which are also very important.

Doing a guided physical exam is extremely valuable with palpation techniques. For example, I look for involuntary muscle spasms when I am doing certain maneuvers. It is an additional indication of problems, rather than just relying on the patient saying, “Oh that’s painful,” or not. Sometimes the patient is not aware of these minute pain triggers.

Then, of course, I look at the diagnostic testing reports. I don’t look at the diagnostic tests first. I only look at the diagnostic testing reports after I do my history and physical examination, and formulate an opinion on what is most likely causing the patient’s pain. Then, I look at the diagnostic test report(s), because in a significant number of cases, the issue that is noted on the testing is not necessarily the cause of the patient’s pain.

I have talked about this before in previous podcasts or blogs, but I’ll just briefly mention it again. Studies have been done to demonstrate this, that if you take 1,000 people who are asymptomatic, they have no back pain or pain in general.  They are doing well and they are functioning great; you do an MRIs on each of them, you are going to find herniated discs on 200 or more of those patients. Those herniated discs are not causing pain at all. You can’t just jump to the conclusion that their pain is always caused by herniated discs.

I determine what pathology is causing their symptoms and I treat that pathology appropriately.  This approach enables me to remove the cause of the pain.   I have patient coming with their multiple tests and multiple doctors’ conclusion that they need back surgery but I determined it’s not a disk issue causing the pain but the hip issue. I remove the hip cause, the pain is also removed.

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Podcast Interview Transcript:

RC: Hello, everyone. This is Liz Harvey, coming to you from our studios in New York City, where we are dedicated to bringing you top quality advice from many of the leading expert professionals across the U.S.

In today’s episode, we are speaking with Dr. Warren J. Bleiweiss, a leader in the United States in the emerging medical field of oxygen ozone injection therapy, for the treatment of herniated discs, joint and muscle pain, and injuries. Dr. Bleiweiss pioneered oxygen ozone disc injection therapy in the U.S. He is a graduate of New York University School of Medicine and is board certified in both Anesthesiology and Pain Management. His long list of accomplishments includes leadership experience as a hospital anesthesiology department director, the inventor of a patented medical device, and the founder of one of the first multi-disciplinary pain management centers in New Jersey. He has been successfully treating patients for over 30 years.

Dr. Bleiweiss specializes in minimally invasive alternative treatments that heal patients without surgery or potentially harmful medications. His treatment protocols are specifically designed to activate the body’s innate ability to recover and to regenerate. His practice has been producing excellent results by utilizing these alternative methods.

Today we are sharing some examples of patients who came to see Dr. Bleiweiss specifically for ozone injection therapy, but received different treatments with great results. Dr. Bleiweiss always does a thorough examination and review of a patient’s history and will sometimes recommend an alternative treatment based on the patient’s condition. His goal is to provide pain relief for a patient based on his or her specific needs.

Hello, Dr. Bleiweiss. How are you today?

Dr. Warren Bleiweiss: I’m great. Thank you.

RC: Thanks again for joining me.

When you see a new patient for the first time, what is involved in the initial examination and review of their history?

Dr. Warren Bleiweiss: All right, it’s very important to listen to the patient and observe the patient and ask specific guided questions. Now, when I say observe, I’m not talking about the physical examination portion of the interview, I’m talking about while I’m taking the history. So, for example, even when the patient walks in the room, I’m observing the way their gait is, the way they sit, if they’re favoring one limb, for example, so that’s very important.

During the history, it’s important to ask specific guided questions. For example, if someone has low back pain that goes down the leg obviously every physician is going to ask about numbness and weakness and other questions but I find it very important to ask very specific questions about the pain like, for example, how far does it go down the leg? Does it go below the knee? If it goes below the knee, what percentage of time does it go below the knee? Does it often go below the knee? Does it rarely go below the knee? Is there any component of groin pain? There are specific questions that will key me into the cause of their pathology.

After that, I perform a guided physical examination based on their condition. Like, for example, if their condition is in their back and going down their leg, I’m not going to spend a huge amount of time examining the shoulders or the eyes or the ears or other things. That would be a waste of time. I want to focus my energies on the problem at hand. Then after that, I look at the tests. I do not look at the tests, the results and the films before I do my history and physical examination because I don’t want to have any predetermined ideas of what’s causing their problem.

The reason why I do this is we know that there are a lot of things that show up on MRIs and X-rays that aren’t causing a patient’s problem. For example, if you take a thousand patients, I’m not going to use the exact numbers, but there have been multiple studies that have been performed related to this issue, so if you take a thousand patients who have zero pain, they have no back pain, they have no leg pain, if you ask them if they have pain, they say no, they’re healthy, they do everything they want, they’re young, and you do MRIs on those thousand people, you’re going to find disc herniations on approximately 200 of them, and they didn’t even know they had that.

What if one of those patients gets back pain and they had a disc herniation for five years and didn’t even know, and then you do an MRI and you see the disc herniation? Is that disc herniation really causing their back pain or is it something else? This is what I figure out while I’m doing the history and physical examination.

We also know that a lot of herniated disc aren’t painful from discography studies, which I don’t want to go into too detail on discography, but it’s basically pressurizing the disc with contrast and determining whether it’s causing a patient’s pain, so we know that many of the herniated discs in patients with back pain aren’t the source of the pain.

Then, once I do my history, my physical exam and look at all the studies, I analyze in my mind in a logical and succinct manner what is a likely cause of their pain. Sometimes it’s very obvious, It’s really obvious. Sometimes it’s not obvious, in which case, I might come up with what we call differential diagnosis and assign a probability to what may be causing the pain. I might be, for example, 80% sure that the disc is causing them pain, but I might think that there’s a probability that it’s a facet, which is a joint of the spine issue, and if that’s the case, then I’ll investigate the facet, which is very easy to determine if it’s causing the pain. You can just block the nerve to the facet until I’m 100% sure or 99% sure that the disc is the cause of the pain and then treat that.

Besides oxygen ozone injection therapy, what other alternative treatment modality do you practice?

Dr. Warren Bleiweiss: I also practice regenerative medicine such as stem cells. Everybody’s heard of stem cells. There are placental growth factors. There are things called exosomes, which are small vacuoles that carry pieces of messenger RNA, for example.

I also practice something called A2M, which is alpha-2-macroglobulin. Alpha-2-macroglobulin is a large protein that’s made in the liver, and it’s our body’s natural defense against proteases, which are enzymes that can destroy cartilage or discs. When those proteases, which are found in the body, are out of balance in a joint or a disc, they could actually cause destruction of that joint or disc over time. A2M completely stops the destructive activity of those proteases.

What’s great about A2M is that there’s a test that you could perform. It’s called the FAC test, and it’s sent out to an independent laboratory, and what I do is lavage the joint or the disc with saline and send it out. If that’s positive, there’s a very, very high chance that the A2M will solve the problem. The real importance of A2M in my mind, is that it prepares the structure, whether it’s a disc or a joint, for other regenerative treatments and makes it more likely for them to work.

Now, A2M has regenerative properties on its own. It does have binding sites for molecules that result in regeneration, but one thing that a lot of people don’t think of is that the process that has led to the degeneration, whether it’s a disc or a joint, may still be active at the time of a regenerative procedure.

Let’s say you have degenerative disc or someone has degenerative disc or a degenerative joint and they’re going to have a stem cell treatment. If they have an out of control, destructive protease problem in the joint or the disc that led to the destruction in the first place and it’s still present, then injecting the cells into that disc or joint is not going to be good at that time because they’re going to have less of a chance of surviving and thriving. So, it’s very important to put out the fire before you do the treatment.

If a patient came to you specifically for ozone injection therapy, what are some reasons why you would determine not to perform it?

Dr. Warren Bleiweiss: Okay, so there are two main reasons. The first is if I don’t think that there’s a significant chance that it will help. That’s the first thing.

Now, I did mention in a previous interview that I had patients early on in treatment that came to me, if someone wants to read the story of Dr. Mike M., where they had severe degeneration, and I didn’t think the procedure was likely to work, and it did. I’m not talking about a patient like that. After that experience and after other positive experiences, I don’t see a downside to inject a joint that’s very degenerative because there’s a chance that it could work and work for a long time and have really dramatic results.

I’m talking about, for example, a patient who comes to me for ozone injection of a disc and I examined the disc, and the MRI, for example, shows severe degeneration and there’s spinal stenosis and other things that have developed over the years. If spinal stenosis has a significant bony encroachment problem, I know for a fact that ozone is not going to solve that issue because, once the bone grows around and narrows the canal, the ozone is not going to take the bone away. That’s a good example of why I would not do the ozone. I may recommend something else, but I’m not going to do the ozone for that.

Now, the other reason is that if I discover that there’s pain coming from another issue, another source of the pain other than what the patient thought or the referring doctor thought the problem was.  The goal is to help the patient with whatever is best for their specific condition. So, one of the things that I do is I determine what their pain source is.

I’m going to use the example of another patient story, which is Susanna B., and she came to me for an ozone disc injection. Now, I had treated her son approximately five years earlier for an ozone disc injection, and he did extremely well with only one treatment. Susanna was in a car accident and she had severe back pain and she tried everything. It didn’t help, and I don’t have her chart in front of me, but I remember most of the details, and she went to two orthopedic spine surgeons, and they both recommended spine surgery. She didn’t want spine surgery, and she came to me specifically for ozone disc injection. I did my due diligence. We talked about the history and the physical exam. I determined that her problem was mostly likely from her hip. I talked about the history, and I talked about it’s very important to ask questions about the pain pattern.

This is a very good example. This is somebody who had low back pain and the pain was going down her leg, and she did have disc issues, but the pain was clearly coming from her hip. Various things just in the history, aside from the fact that I observed the way she walked when she came in because there’s a specific gait that is coming in patient with hip issues, but I asked her my guided questions, and she had a lot of groin pain, which is very typical with hip pain because the ball and socket joint of the hip is in the groin area and the pain didn’t radiate below her knee. It never radiated below her knee. Then when I examined her, my physical exam was most consistent with hip issues, so her hip was never looked at with any X-rays or MRIs.

Also, I just have to take a step back, the mechanism of the injury. She saw the accident coming. It was an accident from behind, and she saw it in her rearview mirror, I believe, and she had her foot on the brake. Now, that creates a lot of shock going up to the hip, so there were many things that cued me into looking at the hip, so we did an X-ray. There was a lot of degeneration. We did an MRI, and she had really, really bad hip issues. To confirm what was the source of her problem, I did a diagnostic block, so I did under fluoroscopic guidance, I injected a very long-acting local anesthetic and a steroid. She had significant temporary improvement, and it came back, so I sent her for a hip replacement, and she did great.

Someone might think, “Well, why not try ozone on the hip?” This is an example of really bad pathology. It wasn’t just degeneration. Like I said, I don’t have her chart in front of me, but there were things going on inside her hip on the MRI that I knew were not going to be solved by ozone. So, this is a good example of somebody that was diagnosed by two other physicians that she needed back surgery, and it turns out that it was her hip, and she did very well, and if she had the back surgery, she would have been very unhappy.

RC: Thank you so much, Dr. Bleiweiss. We know you’re busy, so I just want to thank you for all of your time and your help today.

Dr. Warren Bleiweiss: You’re welcome.

RC: For our listeners across the country, if you are interested in speaking with the doctor, please visit or call 973-403-3334 to schedule an appointment.

And on behalf of our team, we want to thank you for listening, and we look forward to bringing you more top-quality content from our country’s leading experts.


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