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Medical ozonated water is a therapeutic solution consisting of ozone (O3) dissolved in sterile water or saline. It is utilized in clinical practice for its potent anti-inflammatory, analgesic, and antimicrobial properties, particularly in the management of chronic pain. The mechanism of action involves the induction of controlled oxidative stress, which activates the Nuclear factor erythroid 2-related factor 2 (Nrf2) antioxidant pathway and inhibits the production of pro-inflammatory cytokines such as Tumor Necrosis Factor (TNF) and various interleukins. In the context of patients with type 2 diabetes mellitus, medical ozonated water is being evaluated as a non-steroidal alternative to glucocorticoids for minimally invasive pain procedures to avoid the adverse systemic hyperglycemic effects typically associated with corticosteroid administration.
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