{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,13]],"date-time":"2026-07-13T10:19:31Z","timestamp":1783937971028,"version":"3.55.0"},"reference-count":29,"publisher":"MDPI AG","issue":"6","license":[{"start":{"date-parts":[[2026,3,17]],"date-time":"2026-03-17T00:00:00Z","timestamp":1773705600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>Background\/Objectives: Sacroiliac joint (SIJ) dysfunction is a common yet frequently underdiagnosed cause of chronic low back pain. This study aimed to compare the clinical effectiveness of ultrasound-guided corticosteroid and ozone injections in patients with chronic low back pain due to SIJ dysfunction. Methods: This comparative clinical study included 64 patients with chronic sacroiliac joint (SIJ) dysfunction who received ultrasound-guided SIJ injections with either corticosteroid (n = 31) or ozone (n = 33). Participants had a mean age of 45.0 \u00b1 7.7 years, and the sex distribution was 42\/22 (female\/male). Pain intensity was assessed using the Numeric Rating Scale (NRS), disability using the Oswestry Disability Index (ODI), and quality of life using the Short Form-12 Physical (PCS) and Mental (MCS) Component Summary scores. Outcomes were evaluated at baseline, 3 months, and 6 months. Longitudinal changes were analyzed using two-way repeated-measures ANOVA (group \u00d7 time) with Bonferroni-adjusted post hoc comparisons. Effect sizes were calculated using Cohen\u2019s d. Normality and homoscedasticity were assessed (Shapiro\u2013Wilk and Levene tests), and baseline comparisons were performed using appropriate parametric or non-parametric tests. Results: Both treatments significantly improved pain, disability, and quality of life at 3 months (p &lt; 0.01). However, improvements were significantly greater and more durable in the ozone group across all outcomes at both 3 and 6 months (p &lt; 0.01). At 6 months, between-group differences favored ozone for NRS (mean difference \u22122.81; Cohen\u2019s d = \u22122.36), ODI (\u22126.05; d = \u22121.46), SF-12 PCS (+4.24; d = 1.24), and SF-12 MCS (+4.22; d = 0.83). A \u226550% pain reduction was achieved at 3 months in 97.0% of ozone-treated patients versus 45.2% of corticosteroid-treated patients (p &lt; 0.01) and persisted at 6 months in 18.2% and 0% of patients, respectively (p &lt; 0.05). The magnitude of improvement in the ozone group exceeded commonly reported Minimal Clinically Important Difference (MCID) thresholds for chronic low back pain outcomes, supporting clinical relevance. Conclusions: Ultrasound-guided ozone injection provided greater and more durable improvements in pain relief, functional status, and quality of life compared with corticosteroid injection in patients with SIJ dysfunction.<\/jats:p>","DOI":"10.3390\/jcm15062285","type":"journal-article","created":{"date-parts":[[2026,3,17]],"date-time":"2026-03-17T10:21:41Z","timestamp":1773742901000},"page":"2285","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Comparative Effectiveness of Ultrasound Guided Ozone (O2\u2013O3) and Corticosteroid Injections for Sacroiliac Joint Dysfunction: A Multicenter Clinical Trial"],"prefix":"10.3390","volume":"15","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-5715-2844","authenticated-orcid":false,"given":"Ridvan","family":"Isik","sequence":"first","affiliation":[{"name":"Department of Physical Medicine and Rehabilitation, Division of Pain Medicine, Sakarya Training and Research Hospital, 54290 Sakarya, Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0004-8639-2742","authenticated-orcid":false,"given":"Muhammed Zahid","family":"Sahin","sequence":"additional","affiliation":[{"name":"Department of Physical Medicine and Rehabilitation, Faculty of Medicine, Sakarya University, 54290 Sakarya, Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Emre","family":"Uzun","sequence":"additional","affiliation":[{"name":"Department of Physical Medicine and Rehabilitation, Sakarya Training and Research Hospital, 54290 Sakarya, Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5187-1856","authenticated-orcid":false,"given":"Ferhat","family":"Ege","sequence":"additional","affiliation":[{"name":"Department of Physical Medicine and Rehabilitation, Division of Pain Medicine, Diyarbak\u0131r Gazi Ya\u015fargil Training and Research Hospital, 21010 Diyarbak\u0131r, Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kemal","family":"Nas","sequence":"additional","affiliation":[{"name":"Department of Physical Medicine and Rehabilitation, Division of Pain Medicine, Faculty of Medicine, Sakarya University, 54290 Sakarya, Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2026,3,17]]},"reference":[{"key":"ref_1","first-page":"58","article-title":"Burden of Chronic Low Back Pain in the Turkish Population","volume":"61","author":"Icagasioglu","year":"2015","journal-title":"T\u00fcrkiye Fiz. 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