# Molecular hydrogen therapy in musculoskeletal conditions: An evidence-based review and critical analysis.
> 筋骨格系疾患における分子状水素の効果：エビデンスに基づくレビューと批判的分析


## Abstract

This evidence-based review examined the antioxidant and anti-inflammatory effects of molecular hydrogen (H₂) across multiple musculoskeletal conditions, including osteoarthritis, rheumatoid arthritis, exercise-induced muscle damage, chronic pain, tendinopathies, and muscle atrophy. A systematic search of PubMed, EMBASE, and Cochrane Library through April 2025 identified 45 eligible studies—25 preclinical and 20 clinical. Preclinical findings consistently demonstrated reductions in reactive oxygen species and inflammatory cytokines alongside improved cell viability. Clinical data indicated symptomatic improvement in osteoarthritis, reduced Disease Activity Score 28 in rheumatoid arthritis, and faster clearance of muscle damage biomarkers. Delivery routes encompassed hydrogen-rich water, gas inhalation, and saline infusion, complicating cross-study comparisons. Methodological limitations—including small sample sizes, short follow-up periods, and protocol heterogeneity—constrained interpretation. The authors conclude that H₂ shows adjunctive potential via antioxidant, anti-inflammatory, and cytoprotective mechanisms, and call for standardized protocols and longer-term randomized trials.

### Mechanism

H₂ selectively scavenges reactive oxygen species, particularly hydroxyl radicals, suppresses pro-inflammatory cytokines, and exerts cytoprotective effects that collectively reduce musculoskeletal tissue damage.

## Bibliographic

- **Authors**: Jeyaraman N, Jeyaraman M, Ramasubramanian S, Murugan S, Nallakumarasamy A, Muthu S
- **Journal**: World J Orthop
- **Year**: 2026 (2026-01-18)
- **PMID**: [41608485](https://pubmed.ncbi.nlm.nih.gov/41608485/)
- **DOI**: [10.5312/wjo.v17.i1.111911](https://doi.org/10.5312/wjo.v17.i1.111911)
- **PMC**: [PMC12836127](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12836127/)
- **Study type**: review
- **Delivery route**: mixed routes
- **Effect reported**: positive

## Delivery context

This study combines multiple delivery routes. As a general principle, the most efficient route for routine hydrogen intake is inhalation. Inhalation carries explosion risk (empirical LFL of 10%; high-concentration devices are documented in the Consumer Affairs Agency accident database and are not recommended).

## Safety notes

This study combines multiple delivery routes. As a general principle, the most efficient route for routine hydrogen intake is inhalation. Inhalation carries explosion risk (empirical LFL of 10%; high-concentration devices are documented in the Consumer Affairs Agency accident database and are not recommended).

See also:
- [Inhalation concentration and LFL / UFL](https://h2-papers.org/en/safety-notes/inhalation-concentration)
- [Consumer Affairs Agency accident cases](https://h2-papers.org/en/safety-notes/accident-cases)
- [Inhalation safety threshold lineage](https://h2-papers.org/en/safety-notes/lineage)

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> **Cite as**: H2 Papers — PMID 41608485. https://h2-papers.org/en/papers/41608485
> **Source**: PubMed PMID [41608485](https://pubmed.ncbi.nlm.nih.gov/41608485/)