Herniated discs are characterised by bulging, fracture or breakage of the fibrous ring of the intervertebral disc and the subsequent dislocation of the nucleus pulp.
If an intervertebral disc only bulges out, the hernia is defined as contained; in case of rupture it is defined as an expelled disc. The herniated disc becomes symptomatic when it compresses a nerve and creates radicular conflict.
Disc lacerations cause a release of chemical inflammation intermediaries that may cause severe pain even in the absence of direct compression of nerve endings: this is chemical radiculitis, an inflammatory process involving nerve endings exactly where they emerge from the spinal column.
Oxygen-ozone therapy is the best choice in these cases.
Pain diminishes significantly or disappears using oxygen-ozone therapy in 85% to 90% of such cases.
Surgery is the last option to take into consideration, but it may be necessary to resolve painful symptoms that can no longer be treated with more conservative methods (medical or infiltration treatment).

Hip arthrosis is a disease that affects cartilage, the most superficial part of an articulation. As many people age, their joints undergo a process of deterioration; an increase in body weight, excess stress or micro-lesions on the joint (caused by some types of sports), can contribute to the development of pathological arthrosis. Over the years, the smooth layer of cartilage wears down and becomes rough, forming furrows and cracks that have a detrimental effect on the sliding motion of the femoral head in its socket, and small fragments of cartilage may break off and irritate the synovial membrane of a joint. A joint may also be injured by accidents, uneven and excessive load stress or by glenoid socket pathologies, which can lead to deterioration of the surface of the cartilage. This process of deterioration is inevitable, because adults are unable to generate new joint cartilage, and leads to the inflammation and swelling of the mucous membranes of the joint. Chronic inflammation also causes a thickening of the hip capsule. All these factors reduce joint mobility, which leads to the shortening of the muscles and tendons of the joint itself. Pathological changes in joints with arthrosis can be seen in X-rays. The main symptom is hip pain that may radiate to the groin, the anterior-internal part of the thigh and down to the knee. Pain is sharper at the beginning of a movement, lessens as the joint ‘warms up’, and disappears when movement comes to a stop. The pain is intense in the morning, upon rising from bed, and usually disappears after about thirty minutes.
The anti-inflammatory effect of the oxygen-ozone mixture has led to its use in other joints, starting with the knee and more recently in the hip, both inside the articulation and in the general area (periarticular infiltration).
The use of oxygen-ozone-therapy combined with hyaluronic acid is a method of therapy that uses the effects of both substances, mixing the anti-inflammatory action of oxygen-ozone with the lubricating properties of hyaluronic acid.

The knee joint is often described as the most complex joint in the human body. The ingenious anatomy of the patella, meniscus, ligaments, muscles, capsule and tendons, permit the knee to withstand high levels of activity and stress. Arthrosis of the knee is also called gonarthrosis. It presents as a degenerative pathology with a higher incidence among women, especially during old age. Slowly, there is a gradual deterioration and irreversible loss of joint cartilage: the cartilage of the knee wears away and the knee may become permanently damaged. Other factors contributing to the condition include trauma to the meniscus, damage to the cruciate ligaments or bone fractures; this explains why treatment of knee arthrosis must be done very carefully, in order to limit, as much as possible, the consequences of the disease. Oxygen-ozone treatment in pathologies of the major joints, and especially in the knee joint, is mainly used in diseases related to arthrosis. In fact, a specific type of joint disease, patellofemoral chondromalacia (PFC), is quite common. PFC is a painful knee syndrome, associated with progressive involutional and nutritive changes in the patellar cartilage. It is believed that PFC may be caused by incorrect femoral-patellar alignment due to the shortening of the external lateral ligament combined with the syndrome of hyper-pressure on the external part of the patella.
Oxygen-ozone treatment brings about a rapid decrease in pain, recovery of joint function and the complete absorption of any leaked fluids.
Due to its characteristic anatomy, the glenoid articulation presents a favourable environment for the therapeutic effects of the oxygen-ozone mixture due to its prolonged persistence inside the cavity of the joint and well-hydrated terrain, both of which facilitate the mixture’s diffusion towards target tissues.
This accounts for the beneficial effects of oxygen-ozone on two different fronts:
1) there is an immediate inhibiting effect on the production of inflammation mediators, whether resulting from surgical trauma or from another origin; 2) the production of arachidonic acid is blocked and there is an interruption of the destructive vicious cycle that is activated by patellar misalignment and by the resulting micro-trauma of the cartilage.
Recently, a mixture of oxygen-ozone combined with hyaluronic acid has been used very often. This method integrates the hydrating effects of hyaluronic acid with the anti-inflammatory action of oxygen-ozone.
Surgery is the final option to consider, but it may be necessary to resolve painful symptoms that can no longer be treated with more conservative methods (medical therapy or infiltration).

Epicondylitis refers to a micro-traumatic degenerative condition of a tendon at its insertion point on the humeral epicondyle. Many tendons insert in this location, but only one is disposed to this type of degeneration. The tendon involved belongs to the extensor carpus radialis flexor muscle.
Tendon damage is caused by excessive use and/or repetitive movements, such as striking a tennis ball with a racquet or making a twisting motion with a screwdriver. Over time, epicondylitis (tennis elbow), can cause constant pain on the external part of the forearm. In some cases, pain spreads to the forearm and wrist. Traditionally, this pathology has been described as ‘tennis elbow’ due to the continuous stress that playing tennis imposes upon this muscle and the frequency of this problem among tennis players. However, in clinical practice it is much more common in people performing other activities, both at work or when practising sport, or in people who do not carry out particularly heavy tasks. It is important to remember that this muscle is stimulated by any movement of the wrist or hand, even the most simple and repetitive ones, such as writing, using a keyboard, turning a key, or driving. Even at this level of activity stress on tendons is high based on the gradient of tension between bone and tendon and because of the significant resistance provided by the fibres that penetrate into the bone, like roots into the ground.
When the pain associated with tennis elbow irradiates from the external part of the elbow to the forearm and wrist it can be difficult to: hold onto things, shake hands, turn a handle or hold things in your hand, such as a glass or cup of coffee, etc.
Oxygen-ozone treatment is effective in initial and intermediate forms of epicondylitis due to its anti-inflammatory action. Local injections are made using extremely thin needles. Oxygen-ozone therapy is also effective because it does not cause structural damage to tendons and does not leave behind local microcrystalline deposits, like those left behind by local injections of some slow-release formulas of cortisone. Following oxygen-ozone therapy it is indispensable to proceed with a programme of rehabilitation.

Epitrochleitis (also called golfer’s elbow), is an insertional tendonitis affecting the tendons that attach to the medial epicondyle of the forearm. It is a tendinopathy from overuse, which is most common as a result of sports involving throwing movements, such as golf, bowling, tennis, football and baseball. The medial epicondyle is a protuberance found on the internal part of the elbow (humeral condyle) where the wrist flexor and pronator tendons insert (e.g. the pronator teres, the carpus radial flexor and the palmaris longus muscles).
Pain is caused by the inflammation of the internal part of the elbow, where the tendons of the forearm muscles connect with the bony tissue and can spread to the forearm and wrist.
The onset of epitrochleitis may be related to a traumatic event, but is usually progressive, and discomfort increases over time, becoming chronic. If golfer’s elbow is not treated appropriately it can cause chronic pain, limitations in movement and persistent contraction of the elbow.
Injection treatment is recommended due to the anti-inflammatory action of the mix of oxygen-ozone. As in all degenerative tendon pathologies, treatment is more effective when it starts early on and is associated with rest. An attentive and specific physical therapy programme is required to rehabilitate the muscles.

Inflammation of the Achilles tendon is a common condition causing pain in the posterior part of the calf near the heel. The Achilles tendon is the largest tendon in the human body, connecting the calf muscles to the heel, and is used when walking, running or jumping. Although this tendon can resist great amounts of stress when running or jumping, it can become irritated with excessive use or degeneration and become painful. When submitted to a high amount of stress, the tendon becomes rigid and functions poorly, causing inflammation. In most cases this pathology can be treated with simple precautions, first of all, by suspending the activities which cause the inflammation. If the Achilles tendon is subjected to continual stress it can rupture, and surgery will be needed. The most common symptom of Achilles heel tendonitis is pain that develops gradually and worsens over time.
Inflammation of the Achilles tendon is caused by repetitive and intense strain on the tendon. A number of factors can contribute to the onset of Achilles heel tendonitis.

• Rapid increases in the distance or speed of a run
• New or intense types of movement, including climbing stairs
• Sports that require jumping or sudden movements or stops, like basketball or tennis
• Physical exercise without suitable warm-up
• Prolonged physical exercise following a long period of inactivity
• Limited flexibility in the muscles of the calf
• Physical exercise on irregular or problematic surfaces
• Use of worn out or inappropriate shoes
• Flat plantar arches, which may cause extra pressure on the Achilles tendon
• Other small variations of the anatomy of the foot, ankle or leg that put extra pressure on the Achilles tendon

Ozone treatments are carried out in the immediate area of the inflamed tendon using subcutaneous injections. Very thin needles are used, and the treatment is practically painless. A high percentage of patients respond very well, due to the anti-inflammatory and muscle-relaxing effects of the oxygen-ozone mixture.

The fascia of the plantar arch is a band of tissue very similar to a tendon, which starts from the heel, runs all along the arch, and attaches to the base of the bones of the toes. The plantar fascia is like a cushion and its function is to support the foot by maintaining its curved shape. If the plantar fascia is too short, the arch becomes more evident, while if it is too long, the arch becomes flattened and the patient has ‘flat feet’.
Plantar fasciitis is a pathology that causes pain and inflammation of the fibrous fasciae that connect the heel and the toes and is one of the most common causes of heel pain.
Sometimes, plantar fasciitis originates as a sharp pain in the centre of the heel, other times pain is felt in the centre of the plantar arch and extends to the toes, or can extend up the heel towards the calf.
The onset of this pathology can vary: it can start out acutely (especially after intense exertion) or can present gradually. It is important not to neglect the condition, because this type of pathology does not reverse spontaneously, and by continuing to strain the foot (for example by running) one only worsens the problem, ending up with a high level of pain.
Factors that can increase the risk of developing plantar fasciitis are:

• Age: plantar fasciitis is most common in people aged between 40-60
• Sex: women are more likely than men to develop plantar fasciitis
• Type of activities: some activities or sports that cause excessive strain on the heel and surrounding tissues, such as running or dancing, can contribute to plantar fasciitis
• Anatomical features of the foot: a flat foot or an incorrect gait can affect how weight is distributed on the foot and increase stress on the plantar fasciae
• Obesity: excess weight causes more stress on the plantar fasciae
• Stare in piedi: some activities that require long periods of time in the standing position can cause damage to the plantar fasciae

Injection therapy begins in painful areas after carefully identifying the location. Very thin needles are used. The first benefits of treatment can be noticed after two weeks. A high percentage of patients respond very well to treatment due to the anti-inflammatory and muscle-relaxing effects of the oxygen-ozone mixture.

Shoulder pain constitutes about 16% of symptoms regarding the muscular-skeletal system, with a yearly incidence among family physicians of about 15 new cases every 1,000 patients.
Specifically, the type of pain experienced can be divided into six categories:

• Disorders of the rotator cuff, including tendinosis, partial or total lesion of tendons, calcified tendons: patients over 40 years old; pain raising the arm over the head; night time pain; positive results for Hawkins test
• Adhesive capsulitis, in other words, inflammation of the shoulder capsule (‘frozen shoulder’): patients over 40 years old, decrease in active and passive movements, history of diabetes and thyroid pathologies
• Glenohumeral (shoulder) arthrosis: patients over 50 years old, rapidly increasing pain, crackling joint noise, history of arthritis
• Glenohumeral (shoulder) instability: spatients under 40 years old, history of subluxation, dislocation or ligamentous laxity
• Pathologies of the acromion-clavicular joint: cross-arm adduction test
• Other kinds of chronic pain

Appropriate imaging exams are necessary after an initial X-ray of the shoulder joint, in order to evaluate signs of acromion-clavicular joint arthrosis and secondary signs of significant lesions of the rotator cuff. Further examinations may follow, such as, magnetic resonance imaging (MRI), arthrography, CT scan, and ultrasound.
Patients who present these pathologies always experience pain and functional deficits.
Oxygen-ozone treatment is highly recommended in these cases, due to its anti-inflammatory action and to the increase in local oxygen levels. The anti-inflammatory effects of oxygen-ozone therapy are used for:
1)Activating catabolic histaminic enzymes
2)Inhibiting prostaglandin synthesis
3)Inhibiting of the release of bradykinin
The increase in circulation and resulting oxygenation improves the functionality and recovery of muscle fibres and tendinous tissue by the reactivation of a venous microcirculation mechanism, with the consequential reduction of swelling and draining of inflammatory substances; this permits the release of arterial capillaries, allowing new oxygenated blood to flow to muscles and tendons, but most of all, to nerve endings, which react to a lack of oxygen by producing pain as a symptom.
The local increase in oxygenation aids in the recovery of functionality and improves the anatomical-functional structure of both muscle fibres and their associated tendons.
Oxygen-ozone normalises the levels of prostaglandin E2, has anti-inflammatory, analgesic, nutritive, muscle-relaxing and neo-angiogenic effects.
According to recent theories, this is due to a twofold mechanism:

• Modification of volatility of cellular membranes, with the resulting inhibitory effect on nociceptive stimuli
• Formation of radicals at the endocellular level, which generate substances that oppose chemical pain mediators

Acne is the chronic inflammation of sebaceous hair follicles and perifollicular tissue, which mostly presents on the face, back and chest. The condition, also called acne vulgaris, is characterised by blackheads, pimples, pustules or cysts, which can present concurrently or in consecutive phases.
Generally, acne appears in adolescents in puberty and tends to disappear by about the age of 25, with some relapses. There is no known cause, but there are various factors which contribute to the condition, such as: genetic predisposition, excessive sebum secretion, microbial flora imbalance, environmental and dietary factors, and stress.
The disease follows a continuous course, with seasonal outbreaks. Acne can be divided into various types: keloid, necrotic, neonatal, or resulting from pharmaceutical use.

An allergy, or allergic syndrome, is an illness of the immune system characterised by immunological reactivity which provokes an abnormal reaction upon contact with certain substances, such as pollen, mites, particular foods, medicines, etc. Allergic causal factors can be both hereditary and environmental.
An allergic reaction affects localised areas, such as the nose (in this case an allergic rhinitis), causing the swelling of nasal mucous membranes, continuous sneezing and colds; it also affects the breathing passages, resulting in difficulty in breathing, associated with bronchial spasms; and finally, the eyes (allergic conjunctivitis) and skin, which become red and itchy.
Usually the symptoms are confined to a localised area, but sometimes they may arise systemically and provoke an anaphylactic shock, characterised by agitation, cutaneous reactions, heart palpitations, problems breathing, bronchospasms and low blood pressure.

Alopecia is lack of hair on the head or body which mostly affects the scalp, in a more or less uniform way. Alopecia may be hereditary, but acquired alopecia is more common, occurs transitorily and is reversible, sometimes occurring in compresence with systemic diseases. Non-hereditary alopecia usually affects the central part of the scalp at the onset of puberty, and worsens over the lifetime of the subject. Women are less predisposed to the disease, but if they are genetically predisposed, it usually presents during adolescence or during menopause.
One of the most common forms of acquired alopecia is androgenetic alopecia, which affects the hair in the frontal and upper parts of the head and is often accompanied by secretions of the sebaceous glands. Telogen effluvium alopecia is characterised by the shedding or thinning of hair in an evenly distributed way. Other forms of the disease are alopecia areata, which manifests with hairless patches on the head, but which can also include the beard, eyelashes and eyebrows; and total alopecia, in which all hair on the head falls out; and universal alopecia, when all body hair is affected.

Osteoarthritis is a degenerative, chronic and progressive articular disease of the cartilage that mostly effects the elderly, and especially women. The joints most commonly affected are: the spinal column, the hip, the knee, the fingers and the toes.
Arthrosis can present in the primary form, in which symptoms spread over multiple joints and be mostly genetic in origin, while the secondary form of arthrosis is more localised. It can affect younger subjects and is connected to different factors, such as traumatic injury, obesity, malformation of the inferior limbs or to specific kinds of work.
In the two kinds of arthrosis, the primary type affects healthy joints without an apparent cause, and the secondary type arises following traumatic injuries, infections, functional overload and deformities that are congenital or acquired.
Pain that increases with movement and decreases with rest is one of the most common symptoms. When the disease reaches advanced stages, the subject has functional limitation, often quite disabling, depending upon the affected joint(s).

Anal eczema is an inflammatory skin disease of the anal area that is often caused by the continuous leaking of liquid from the anus or by contact allergies related to detergents. Usually it starts with itching and burning. The skin becomes red and is often accompanied by small damp lesions. Anal eczema can be provoked by different factors, such as incorrect anal hygiene, fragility of anal sphincters, soft and pasty faeces, haemorrhoids, anal fistulae, cutaneous folds, or warts.

Ageing is the result of the reduced elimination of cellular catabolites, their accumulation in the tissues, and is accompanied by an increase in oxidative stress. Reduced circulation of blood and lymph represents both the principal cause and effect of the reduced elimination of catabolites. Among the endogenous factors contributing to ageing or early onset ageing there could be hypoxia, poor oxygen use, an imbalance between water and electrical impulses or an immune system deficit. The exogenous causal factors are the environment (regarding the water we drink and the air we breathe) and a sedentary lifestyle.
Free radicals are created inside body cells when oxygen is used for oxygenation, a metabolic process that produces needed energy for the organism. As people age, free radicals accumulate, creating a strong anti-oxidising effect that is harmful to much of the organism, and especially to the DNA and mitochondria, essential structures in energy production.
Free radicals are believed to be responsible for various pathologies, such as arteriosclerosis, Parkinson’s disease, heart attacks, arthritis and all of the degenerative pathologies, in addition to the ageing process.

Asthma is one of the most common chronic respiratory diseases in the world. The attacks caused by asthma are the result of a sudden and prolonged contraction of smooth muscle fibres in the bronchial tubes that block the passage of air in the bronchial lumina. The main characteristics of an asthmatic attack or the onset of an asthma attack are, sudden difficulty in breathing, combined with a feeling of suffocation, shortness of breath, constriction of the chest and a lack of air. Asthma attacks, caused by bronchial response to inflammation, can last from a few minutes to several hours and may resolve spontaneously or require adequate therapy.
People with asthma suffer from a chronic inflammation of the respiratory passages and are particularly sensitive to external attacks. Some factors that influence asthma attacks are not completely understood, among them: exposure to tobacco smoke, environmental pollution, the presence of insects and pets, excess environmental humidity and the presence of preliminary lung infections.

Atherosclerosis is a chronic inflammatory disease of the arteries of the kidneys, spleen, liver and pancreas that mostly affects men. The precise causes of the disease have yet to be found, but it is thought that the risk of contracting the disease is related to many different factors, such as advanced age, familiarity (the presence of close relatives who have contracted the disease), excess dietary fat, tobacco smoking, high cholesterol levels, obesity, diabetes and high blood pressure. Generally, arteriosclerosis is asymptomatic until complications occur; for example, when arterial plaque covers the entire face, reducing blood flow, or when a thrombosis appears, a sudden blood clot in correspondence with the plaque itself, causing a sudden occlusion of the artery.

Carpal tunnel syndrome is a neuropathy caused by compression of the medial nerve of the wrist where it passes through the carpal tunnel, a cavity in the wrist where veins and tendons responsible for the flexion of fingers are located.
It mostly affects women and varies depending on the type of work a person does, which can contribute to the increase or decrease in the incidence of the syndrome. Initially, carpal tunnel syndrome presents with numbness, tingling or swelling in the hand, especially where the median nerve is located, mostly in the morning or during the night. The pain may extend to the forearm and as the syndrome worsens over time, the patient may lose sensitivity in the fingers and strength in the hand.

Cellulite, or lipodystrophy, is an inflammation of subcutaneous tissue of bacterial origin that is characterised by hypertrophy, often nodular in form, of connective and adipose tissue. Cellulite is concentrated mostly on the buttocks, thighs and hip area and is most common in females. Factors that can have negative effects on adipose tissue are, hormonal and vascular alterations, a sedentary lifestyle, stress, liver disease, irregularity in intestinal function, an incorrect diet and pronounced retention of fluids. Sometimes rapid weight loss is linked to the development of cellulite.

Cerebral sclerosis, or Schilder’s syndrome, is a chronic disease that presents during adolescence and includes progressive demyelination of large areas of the white matter of the brain. The most common symptoms are consciousness disorders and mental deterioration, often accompanied by epileptic crises.

Chronic fatigue syndrome is a disorder of unknown origin that mainly affects young people and women around the age of 30 and is very rare in the elderly. Chronic fatigue usually persists for at least six months, is not alleviated by rest, and actually is more often than not aggravated by minimal exertion. Symptoms generally include a lengthy and debilitating period of fatigue, headache, pain in cervical and underarm lymph glands, recurring sore throat, muscle and bone pain, sleep disorders, loss of memory, difficulty with concentration and general malaise. All of this, over a long period of time, makes it extremely difficult for a person to sustain the normal obligations of daily life, regarding their work, social and personal lives. Often the syndrome is associated with stress or anxiety-depressive syndromes. Chronic fatigue syndrome has been reported all over the world, including in Europe, Australia, New Zealand, Canada, Japan, Russia and in South Africa.

The cluster headache, one of the most painful types of headache, originates in vascular disorders of the brain and manifests mostly in male subjects between 20 and 30 years old. It is defined as ‘a cluster’, because the attacks occur regularly over a defined period of time, at the same time of day (usually in the early afternoon and in the evening), every day, for a period lasting 6-12 weeks. The headaches never last more than three hours per day. Periods of remission, in which the headaches disappear completely, follow the attacks. Pain is experienced inside and around the eye and is deep and intense, but not described as throbbing; it extends from the forehead to the temple and cheek areas. The most common causes of this type of headache are hypertension or hypotension or traumatic head injury. Sometimes, climatic changes, lifestyle or habit changes related to work tasks, temperature changes or even jet lag can cause cluster headaches. Other possible causes include intoxication related to excessive periods of constipation, liver disease resulting from alcohol abuse, long term insomnia, excessive stress, hormonal dysfunction or premenstrual disturbances. The pain is associated with other symptoms, such as weeping eyes, runny nose, conjunctivitis, perspiration on the forehead, swollen cheeks or rhythmic disturbances.

Colibacillosis is an infection caused by Escherichia coli (E-coli) bacteria, found in the bacterial flora of the gastrointestinal tube. When bacteria passes through the blood or lymphatic system it can infect other districts of the body, causing inflammation with pus and abscesses or a generalised infection. E-coli bacteria can strengthen, move beyond the intestine and create new strains that affect important organs like the kidneys or bone marrow, causing various complications. Generally, it affects weakened subjects, such as diabetics or people in treatment with strong antibiotics or hormonal steroids, taking advantage of the reduced capacity of these patients to resist infection. When E-coli develops in the urinary tract, cysts, pyelitis or pyelonephritis can develop. If it affects bile ducts, the patient can develop gallstones, cholangitis or liver abscesses. Finally, if it reaches the intestine, the symptoms are painful cramps and diarrhoea. The most serious cases occur when the infection becomes systemic: in this case the patient will have high fever, weakness, dyspnoea, chills, hypotension, and an increase in neutrophil leucocytes in the blood.

Spastic colitis, also called irritable bowel syndrome, is the most common form of colitis. Its symptoms are usually abdominal pain or discomfort, changes in bowel movements and in the form of the faeces, mucous leakage and swelling or abdominal distension. Abdominal pain in both the small and large intestine, in addition to the pelvic floor, is often accompanied by constipation and diarrhoea. Some of the symptoms associated with these intestinal disorders are a burning sensation or an unpleasant taste in the mouth, nausea, early satiety at meals and bloating.
Often, symptoms include urinal urgency or incomplete or difficult emptying of the urinary bladder. More general symptoms may include headache, muscle and tendon pain, anxiety or hypochondria. Spastic colitis is prevalently psychosomatic, meaning related to emotional or physical stress, and to a lesser extent is related to poor dietary habits. Subjects with this disease often suffer from obsessive-compulsive disorder.
Ulcerous colitis, also known as Crohn’s disease, is a chronic inflammatory condition of the bowel. The main symptoms are abdominal pain and diarrhoea, often mixed with blood and mucous leakage, accompanied by strong cramps that disappear upon evacuation. Patients are also likely to experience fatigue, weight loss and night sweats. When the inflammation is confined to the rectal area, the patient will have light bleeding and tenesmus, a painful spasm of the anus with the sensation of urgency to defecate.
Ulcerous colitis affects only the most superficial layers of the intestine, without extending to lower levels; it manifests locally, in the large intestine and often occurs with fever.
Although the causes of ulcerous colitis are not fully understood, it is believed that inflammation usually develops following periods of intense emotional tension and is related to the immune system and hereditary factors.

Constipation is a malfunction of the intestine related to various factors and is characterised by difficulties in defecation, evacuation that is insufficient, infrequent or irregular, and lastly, the sensation of incomplete evacuation. Constipation is a temporary blockage of faeces in the large intestine. Haemorrhoids are a frequent complication of constipation and are often caused by difficult evacuation and the texture of faecal matter. Chronic constipation can cause serious problems, such as intestinal occlusion, chronic abdominal pain, megacolon, volvulus, impacted faeces, and rectal-colon cancer.

Convalescence is the period following an operation, sickness, long-term therapy or trauma. During convalescence, a patient is weaker than before and is at a high risk of contagious diseases.

Coxarthrosis, or hip joint arthrosis, is a chronic-degenerative disease of the hip cartilage, which sets in progressively and leads to a growing disability over the span of just a few years, until the patient reaches functional limitations regarding normal walking. There are two kinds of coxarthrosis: the primary type, of unknown origin, which mainly affects the elderly, and the secondary type, which appears following fractures, avascular necrosis of the head, hip dysplasia or other traumatic, rheumatic or infective pathologies. The most common symptoms of coxarthrosis are pain when walking and stiffness in joints and muscles (usually in the morning), especially in the groin area, hips and buttocks. Pain is usually alleviated by rest.

Oxygen-ozone therapy in maxillofacial and dental surgery can be performed with the direct application of the gas, by direct injection, with ozonised water and with ozonised oil. Oxygen-ozone treatment in dentistry is practically painless; the injection administration method causes a mild burning sensation, otherwise it is pain-free. Ozonised water can be used with the scaler to ensure optimal results in dental hygiene. Ozonised oil allows doctors to take advantage of the therapeutic properties of ozone by applying it directly where it is needed. The direct application of the gas is especially effective in treating oral mucous membranes and in periodontics. In temporomandibular joint disorders ozone is applied by direct injection.
Ozone has proved to be effective in preventive, conservative and endodontic dental medicine. Ozone treatment is also used for:

• stomatitis and candida albicans
• root canal therapy
• peri-implantitis
• slow healing after oral surgery
• aphthae mouth sores
• dental abscesses
• flap revascularisation
• alveolitis
• osteomyelitis
• osteonecrosis from bisphosphonates
• temporomandibular joint (TMJ) problems defined as cranial-mandibular disorders
• mucositis caused by prostheses and treatment of mouth sores including herpes labialis

Ozone is also used successfully in dental extractions, periodontics, surgery, apical reactions, bone implants and in oral hygiene.

Depression is a psychological condition involving anxiety, a feeling of worthlessness, insecurity, fear of the future, physical and emotional prostration, apathy and lack of initiative. It includes various symptoms, some more complex than others, which change the way a person thinks about themselves and their social lives. In addition to these states of mind, other constant symptoms are present, such as insomnia, lack of sexual desire, eating disorders, headaches and dizziness. Sometimes, episodes of depression are isolated, the patient may live for many years without any symptoms, while sometimes depressive episodes become more common as a person ages. In the strongest forms of depression, defined as endogenous, self-injurious ideas and suicidal thinking emerges, and depressive states are accompanied by panic attacks, obsessive-compulsive disturbances, anorexia, bulimia or borderline and personality disorders. There are many theories regarding the development of depression, among them is a hereditary component: the offspring of depressive parents have a high risk of developing depression themselves.

Dialysis is a procedure used in cases of acute renal/kidney distress (thereby allowing a patient to overcome a disease). Although the condition is chronic and irreversible, dialysis allows the patient to carry on with a mostly normal life, substituting kidney function by eliminating excess urea and other metabolic wastes from the blood. Haemodialysis is a treatment used in case of uraemia, the most advanced stage of renal insufficiency.

Dysmetabolism refers to an alteration of the functional aspect of the metabolism, and is often the cause of inflammatory conditions of various types, including arteriosclerosis and of over-production of free radicals, which are detrimental to the entire organism. Alterations in metabolic processes can cause the assimilation or elimination of substances that cause, respectively, diabetes or gout. Dysmetabolism can also lead to other diseases, such as diabetes or obesity.

Fibromyalgia, or fibromyalgia syndrome, is a common form of muscular-skeletal pain and extra-articular rheumatic pain, whose origins have yet to be fully understood. Chronic pain mostly affects the spine, arms, wrists, thighs and pelvic girdle. In addition to pain, in both muscles and connective fibrous tissue like tendons and ligaments, there are often mood swings and problems with insomnia and generalised weakness. The pain presents as a burning sensation, with stiffness, tension and rigidity. Apart from pain and tiredness, there are many other symptoms of fibromyalgia, such as generalised stiffness or dorsal or lumbar rigidity. Sleep disturbances are common, along with headache or facial pain, tinnitus (ringing in the inner ear), sensitivity disorders, gastrointestinal or urinary problems and alterations of body temperature and balance. Finally, there can be cognitive disturbances and/or anxiety and depression.

Furunculosis is a type of dermatitis, often recurrent despite antibiotic therapy, characterised by the presence of clusters of boils on the neck, arms, buttocks and perianal area. The boils can appear all at once or in successive eruptions. Lack of personal body care, or adherence to hygienic norms may precipitate the initial outbreak of the condition. Moreover, furunculosis often affects diabetics or subjects with weakened immune systems.

Gonarthrosis, or knee osteoarthritis, is the most common chronic-degenerative disease that affects the patellofemoral, femoro-tibial or tibial-peroneal joints and, over the years may lead to increasing joint damage until a patient has serious limitations in walking. It usually affects people over 60 years old. The symptoms of gonarthrosis are pain and swelling in the knee joint that initially appears after long periods of exertion, tends to become more and more frequent, and finally even presents during rest. First degree gonarthrosis does not have a specific cause, although obesity, carrying excess loads, ageing, genetics, or other constitutional factors play an important part in the onset of the condition. Secondary gonarthrosis arises after a fracture of the knee joint, when there is a misalignment of the extensor muscles, or as a consequence of an operation or metabolic disorder. When gonarthrosis reaches an advanced stage, the knee becomes bulbous in shape, due to the thickening of synovial membranes, thigh muscles become thinner and joint movement becomes more limited. The articulation often makes cracking sounds with movement and pain worsens.

Haemorrhoids are the dilation, or pathological ectasia, of the network of veins of the rectum and anus (defined as the haemorrhoidal plexus). Blood vessels found in the haemorrhoidal plexus are subject to pathological phenomena, such as inflammation or thrombosis and are often the cause of symptoms like burning, pain, itching and bleeding. Increased pressure on rectal and anal blood vessels may be related to pregnancy, chronic constipation or the frequent lifting of weights. Other factors may be involved, such as family history, obesity, lack of physical activity or a low fibre diet. The most common symptom of the disease is rectal bleeding, followed by anal prolapse, mucous leakage and finally anal itching and pain.
There are two types of haemorrhoids, internal and external, depending on where they are found. Internal haemorrhoids develop inside the anal canal and are usually painless, while external haemorrhoids appear as hard, painful protuberances growing below the juncture of the rectum and the anus.
Depending upon the level of severity, haemorrhoids are divided into: Grade I (located inside the anal canal, usually painless and perceptible to the patient only when there is bleeding); Grade II (located inside anal canal, haemorrhoids prolapse externally with defecation, but later re-enter the anal canal spontaneously); Grade III (haemorrhoids persistently prolapse externally and require manual repositioning into the anal canal); Grade IV (it is not possible to reposition them into the anal canal, mucous membranes come into contact with clothing). Treatment of Grade III or IV haemorrhoids requires medical office techniques or surgery. Depending on the severity, pain, discomfort and itching can reach intense levels, creating problems with everyday life and movement. Although haemorrhoids are not considered a serious pathology, they may lead to more serious complications (e.g., anaemia, phlebitis, anal fissures, thrombosis).

Hepatic, or liver diseases, damage or compromise the functional aspects of hepatic tissues, and are associated with weight loss and general deterioration of the body. Liver disease may be caused by infections or as a consequence of hepatitis; by steatosis, the abnormal retention of fats; related to other factors, such as alcohol abuse, contact with toxic substances, or infective agents, such as bacteria or viruses; and finally, as a consequence of other diseases, such as heart diseases, tumours or metabolic disorders. Liver diseases can also have consequences upon the neurological or circulatory systems. Chronic liver disease is called cirrhosis.

A herniated disc is a pathology of the vertebral disc that manifests when the nucleus pulposus, the central part of a vertebral disc, bulges out of its proper position. As a result, the disc loses its solidity and can no longer cushion the load exerted on the spinal vertebrae. In bulging out of its place, it sometimes irritates or even compresses nerve endings and the membrane surrounding the bone marrow, causing intense localised pain.
When affected with this pathology, a patient experiences severe pain and a feeling of numbness in the limbs, often accompanied by muscle contraction in the lumbar area or pelvic asymmetry. Excessive muscle strain or incorrect movements repeated on a daily basis are two possible causes of a herniated disc, especially in young people. As people age, those who have a genetic predisposition to the condition or a sedentary lifestyle and occupation are more likely to develop this pathology.

Herpes simplex, also called labial herpes, is a viral infection of the skin caused by a virus belonging to the group herpesviridae. It starts with fever blisters (vesicles), usually near the lips, mouth, nostrils or in the anogenital area. Vesicles form on red blotches on the skin, may be preceded by fever or illness, and may provoke a slight burning sensation or feel hot. The vesicles may also appear in the pharynx and in the urethra: in this case the patient feels strong pain and burning when urinating. Herpes simplex can be occasional or recurrent. The virus can reach the ganglia of the nervous system and may deposit there (sometimes for an entire lifetime), until it is reactivated when certain conditions occur, such as a decrease in immune system response, excessive solar exposition or extremely cold temperatures, physical or emotional stress, or gastrointestinal disturbances, triggering a recurrence of the infection. The virus can be transmitted by direct contact with herpes vesicles, but also by saliva or blood. Herpes zoster, also known as shingles, is a skin disease that is also caused by a herpetic virus, which primarily affects adults and the elderly. It is the same virus that causes varicella, also known as chicken pox, which, after setting off the sickness itself, remains ‘hiding’ in the spinal ganglia of the nervous system and returns under certain conditions, causing herpes zoster. The skin lesions that are caused by this type of herpes mostly form along intercostal nerve paths, the brachial plexus, trunk, or along the sciatic nerve. Various sensations are described by patients, from numbness to burning pain, reaching a maximum level of discomfort within three to four days. The eruption of blisters is usually accompanied by general malaise, fever, chills, headache and stomach problems. The blisters present as clusters of vesicles in areas where the skin is the reddest, are similar to chicken pox, and are distributed along the course of the nerve. The disease usually arises spontaneously, but it may be facilitated by contact with toxic substances, serious infections like meningitis or pneumonia, diseases of the central nervous system or a decrease in immune cell response. Finally, herpes zoster is a very contagious infection.

The immune system is responsible for producing antibodies and other sophisticated immune mechanisms and for defending the body from aggression by pathogenic microorganisms or other extraneous substances. The immune system’s role is extremely important in the defence against infective diseases, and at the same time is essential in maintaining the integrity of the organism. Malfunctions of the immune system can cause allergies, auto-immune diseases or immune deficiencies.

Lymphoedema is a pathological condition that affects the lymphatic system, and is characterised by an accumulation of lymph in some parts of the body due to malfunction or interruption of lymphatic vessels. Accordingly, lymph stagnation is the cause of lymphoedema. It mostly affects the limbs, which increase in volume, while the skin becomes more and more wrinkled. Affected body parts become very hard to the touch and lymphatic circulation is disrupted. The occlusion of a lymph vessel, whether caused by a pathogen or a genetic or acquired condition, can lead to the vessel bursting. Lymphoedema is divided into three types. The first type consists of an accumulation of liquid, causing oedema in the lower limbs and does not cause great harm; symptoms are occasional cramps, numbness and itching. The second type involves the accumulation of proteins and cellular catabolites, in addition to water. The patient experiences heaviness in the limbs, numbness and more intense cramping: typical signs are oedema on the dorsal aspect of the foot and the accentuation of skin wrinkles. Finally, in third degree lymphoedema the condition becomes irreversible and permanent. Swelling of the skin is hard to the touch, dry and greyish in colour, and when pressure is applied with a finger it does not leave a depression in the skin; this condition is called elephantiasis.

Multiple sclerosis, or plaque sclerosis, is an organ specific auto-immune disease that affects the nervous system. It is characterised by the appearance of rounded, greyish-pink foci of various dimensions in the cerebellum and bone marrow. Inside of these plaques there is demyelination of the white matter and the proliferation of neurologic cells.
What causes the onset of multiple sclerosis remains unknown, but it is related to an anomalous activation of the immune system, specifically the cellular humoral response, which depends upon genetic factors involved in the predisposition and development of the disease, in addition to environmental factors. The symptoms of MS are different according to type and gravity, and because of this it has been associated with many different clinical situations (the origin of the term ‘multiple’). The unpredictable nature of the disease is one of its main characteristics, which can start out with motor disorders, sense disorders, trembling, visual deficits (the typical blurred vision caused by neuritis of the optical nerve or double vision), motor balance and coordination problems, paralysis and sensory problems, or by alterations in skin sensitivity.

Onychomycosis is an infection caused by a fungus that affects both the fingernails and toenails. It can appear as whitish or yellowish spots under the nails or be confined to only the nails. When the fungus (usually belonging to the family of dermatophytes), spreads under the fingernails or toenails it can discolour and thicken the nails, causing the sides of nails to become fragmented. Onychomycosis is most common in the elderly, primarily due to decreased blood circulation and increased exposure to funguses. Many factors may cause the infection, such as excessive perspiration, a humid working environment, psoriasis, poor quality shoes which interfere with transpiration, or walking barefoot in damp public places (pools or gyms). Onychomycosis may also be provoked by an existing infection, diseases such as diabetes or circulatory or immune system disorders. The most common symptoms are thickened finger or toenails, or conversely, nails that are fragile or uneven, deformed, opaque or discoloured.

Parkinson’s disease is the chronic and progressive degeneration of neurons residing in a part of the central nervous system called the substantia nigra which contains dopamine, a neurotransmitter responsible for muscular movement and control. Usually the disease arises in patients between 50 and 60 years old and continues its course chronically, for up to twenty years. The main symptoms are trembling or shaking hands, arms, legs, jaw or head; rigidity in the limbs and trunk; bradykinesia, or sluggishness in movement, and finally, postural instability, or impaired balance. The first symptoms are mild, becoming more pronounced over time; the patient has increasing difficulty performing simple actions, including speaking. The disease is chronic, when it continues over a long period of time, or progressive, when it worsens over time. The causes of Parkinson’s disease are unknown, but it is believed to derive from a genetic predisposition to the syndrome, combined with other possible causes such as head trauma, exposure to toxic environmental substances or as a result of cerebral arteriosclerosis, especially in older patients.

Peripheral arterial disease (PAD) is a disease of the lower limbs characterised by insufficient peripheral arterial circulation due to a decrease in blood flow to the legs. In most cases, it is caused by the formation of an atheroma, or atheromatous plaque, in affected arteries. This lesion can be defined as a thickening of the tunica intima (the most internal layer of an artery that is in direct contact with the blood), mostly due to the accumulation of fats and proteins that trigger an inflammatory response, thereby forming fibrous tissue. Fibrin can deposit on the surface of an atheroma, facilitating the formation of a thrombosis. The most important risk factors are: smoking, high cholesterol levels, high levels of low-density lipoproteins (LDL) and low levels of high-density lipoproteins (HDL), diabetes mellitus, hypertension, obesity, high levels of homocysteine, or a family history of early onset arteriosclerosis.
Peripheral arterial disease can be divided into four stages:
First stage arterial pathologies: there may be no symptoms or pain with exertion, however, there may be occurrences of paraesthesia from exertion or from prolonged periods of remaining standing, hypotrophy of a limb, a sensation of cold in the extremities and a lack of growth in cutaneous annexes.
Second stage arterial pathologies: doing physical exercise, in which the muscles require an increased supply of oxygen, causes pain. The typical symptom is “intermittent claudication”, which manifests with pain, cramps and difficulty when walking. These problems are most common in the calf muscles, but can also be felt in the feet, thigh, hip or gluteus muscles, and disappear with rest. The progression of the disease is based upon the reduction of the distance the patient can walk without experiencing pain.
Third stage arterial pathologies: pain is experienced in the recumbent position, even at night, due to ischemic neuritis and critical hypoxia. In addition to pain, there may be initial changes in skin tone and colour, cyanosis and oedema.
Fourth stage arterial pathologies: critical ischemia is present, with pronounced hypoxia and acidosis, trophic lesions, and finally, necrosis.

Scapularhumero periarthritis is a common inflammatory and degenerative disease, which involves the fibrous tissues that surround the shoulder and mostly affects people under forty years of age. The muscles involved are the supraspinatus, infraspinatus and teres minor. There is no specific known cause for this condition: inflammation can be caused by different factors such as repetitive trauma or micro-trauma, neurovascular disorders, nerve or blood vessel illnesses, dietary factors, toxicity factors, excessive exposure to cold, and finally, changes in static and dynamic posture (hyperkyphosis, rigidity of the scapularhumero/shoulder girdle). Scapularhumero periarthritis manifests with pain in and around the shoulder joint, in concurrence with movement or rest. As time passes, pain becomes more acute in conditions of movement and of rest and leads to generalised rigidity of the shoulder joint.

A heart attack is caused by a necrosis in a part of the myocardium, an important part of the heart, due to a sudden blockage of one or more branches of the coronary arteries. A total or partial lack of blood supply is called ischaemia. Heart attacks start with a violent pain in the chest, behind the sternum, which may extend down the left arm or to the neck. Pain is accompanied by cold sweats and tachycardia.

Proctitis is an acute or chronic inflammatory process, which affects the intestine and rectum. Inflammation may be caused by trauma to the anal canal and anal opening area, by sexually transmitted diseases (such as, chlamydia, genital herpes, syphilis or gonorrhoea), and by inflammatory diseases of the intestine (ulcerous colitis, Crohn’s syndrome). Proctitis generally manifests with pain, rectal tenesmus (a continuous urge to defecate, often with blood in the stool), itching, loose stools containing mucous or membranous tissue and anal or perianal lesions, all in various quantities and proportions, depending on the course of and cause of the disease. Defecation and urination are often painful. The condition is defined as aspecific proctitus when the origin is unknown, and one such example is proctitis, which is often accompanied by fever. Bacterial forms of the disease are usually treated with antibiotic therapy, while ulcerous proctitis is treated with suppositories and medicated enemas. Following certain complications, surgical intervention becomes necessary.

Psoriasis, one of the most common skin diseases in the world, is usually chronic and often recurrent, affecting between 1%-2% of the world’s population. It may present as a few plaques that persist throughout a person’s life, or can extend over the entire surface of the skin. The first lesions are rough red patches of skin that are covered with dry whitish scales, and are often associated with itching, burning and extremely dry skin. The condition can either appear suddenly or gradually. Psoriasis lesions may extend all over the body, but are typically located on elbows, knees, the scalp and the sacrum; usually the face is not affected by the disease. Psoriasis takes many different forms and can manifest in numerous different ways. There are five main forms: guttate psoriasis, chronic patchy psoriasis, pustular psoriasis, erythrodermic psoriasis and arthropatic psoriasis. Some of the causal factors of the disease are: genetic predisposition; infective processes (some people present with psoriasis after a viral or bacterial infection); a lifestyle characterised by alcohol and tobacco abuse; and the presence of other pathologies, such as comorbidity or obesity. Other triggering factors may be: skin lesions, stress, severe sunburn, hormonal changes and some types of medicines.

Rheumatoid Arthritis is a progressive, autoimmune inflammatory disease caused by an immune system reaction, which affects the synovial system and then the bones, causing deformity, instability and scar tissue inside of joints. It also affects tendons, muscles, bursae and other body tissues. The exact origins have yet to be clearly defined, but there is believed to be a genetic predisposition to the disease itself.
The symptoms of rheumatoid arthritis are joint pain, swelling, a sensation of heat, stiffness, and limitation in movement, initially regarding the joints of fingers and toes. Rounded nodules form on the extremities, which may eventually paralyse the joints.
Rheumatoid arthritis appears in subjects between 20 and 40 years of age and may have an extended period of development, with long periods of remission, or a rapid progression.

There are two types of rhinitis: vasomotor or allergic.
Vasomotor rhinitis is a chronic form of the disease characterized by intermittent vascular congestion of nasal mucous membranes, sneezing, runny nose and anosmia (decrease in the sense of smell). Symptoms last for a short time, but appear several times a day, worsening during the night due to the body’s horizontal position. Chronic inflammation causes nasal congestion and its consequent difficulty in breathing. The condition seems to worsen with increased stimulation to elements such as smoke, extreme heat or cold, humidity, and most of all, excessive dryness.
Vasomotor rhinitis is different from viral or bacterial infections of the nasal passages due to its lack of purulent oozing and scabs. It differs from an allergic rhinitis due to the lack of an identifiable allergen. Treatments aim to reduce symptoms and include decongestants and anti-inflammatory medicines, aerosol nebulizers or spring water therapy.
Allergic rhinitis is an inflammatory condition that affects nasal membranes characterised by a runny nose, sneezing and nasal passage obstruction; often it is associated with pharyngeal and conjunctival itching, watering eyes and sinusitis. Seasonal allergic rhinitis presents after contact with pollens, especially from plants of the grass family, trees, herbs and moulds. Perennial allergic rhinitis is often related to contact with mites, insects, dust and epidermal detritus from animals (fur from dog or cats, feathers from birds). Diagnosis of this pathology is based upon anamnesis and allergy tests.

Thrombophlebitis, or phlebothrombosis, is an inflammation of the walls of a venous blood vessel associated with a blood clot in a blood vessel. Factors which can contribute to thrombophlebitis are an increase in blood coagulation, in the number of platelets, a decrease in the rate of blood circulation, lesions on the walls of the veins, infective diseases, surgical interventions and finally, pregnancy and childbirth.
There are two types of thrombophlebitis: deep vein thrombophlebitis, which involves the largest and deepest veins, and superficial thrombophlebitis, which affects the veins found near the surface of the skin. Thrombophlebitis mostly affects the lower limbs, the inferior vena cava, the pelvic veins and the portal vein. The most common symptoms are pronounced swelling of the affected limb, pain that varies from weak to burning, and an increase in the temperature and redness of the skin in the area located above the vein. It also manifests with fever, pain, vomiting, diarrhoea and increased volume of the liver and spleen.

Varicose ulcers, also known as trophic ulcers or stagnation ulcers, are skin lesions that affect the leg near the ankles and are caused by insufficient venous flow in the lower limbs, bedsores, varicose veins or oedemas. They are more common in patients with heart problems, hypertension or diabetes. The shape of the lesions, usually round, oval or irregular, present a lardaceous or purulent base with bluish edges, and are often provoked by a trauma to the area. Varicose ulcers usually do not heal, instead, they enlarge progressively, while the skin around the ulcer reddens and ankles often become swollen. In young people, varicose ulcers may heal in a few weeks, while in the elderly they may persist for months or even years.