Osteoarthritis

Osteoarthritis is a common joint condition caused by the gradual breakdown of cartilage and changes within the surrounding bone and soft tissues. It can cause chronic pain, stiffness, swelling, and reduced mobility.

Osteoarthritis most commonly affects the:

• Knees
• Hips
• Hands and fingers
• Shoulders
• Ankles and feet
• Wrists and elbows

Although osteoarthritis cannot be cured, treatment may reduce pain, improve function, and help patients remain active.

Common symptoms include:

• Joint pain that worsens with activity
• Morning stiffness or stiffness after inactivity
• Swelling or tenderness
• Reduced range of motion
• Grinding, clicking, or popping sensations
• Difficulty walking, climbing stairs, exercising, or completing everyday activities

Osteoarthritis is diagnosed through medical history, physical examination, and imaging such as X-rays. Occasionally, MRI or laboratory testing may be used to exclude other causes of joint pain.

Before considering low-dose radiation therapy, patients should have an established diagnosis of osteoarthritis. Rheumatoid arthritis and other inflammatory autoimmune forms of arthritis are not treated with this therapy and should be excluded.

Initial treatment may include:

• Exercise or physical therapy
• Weight management
• Anti-inflammatory or pain medications
• Bracing or assistive devices
• Joint injections
• Surgery or joint replacement for advanced disease

For patients who continue to experience pain despite conservative treatment—or who cannot tolerate medications, injections, or surgery—low-dose radiation therapy may be an option.

Low-dose radiation therapy, or LDRT, is a noninvasive treatment intended to reduce inflammation and pain within an arthritic joint.

LDRT uses only a small fraction of the radiation dose commonly used to treat cancer. It does not restore damaged cartilage or correct structural abnormalities. Instead, it acts on the inflammatory processes contributing to osteoarthritis pain.

In Germany, LDRT has been used for several decades to treat painful osteoarthritis and other degenerative joint conditions. The treatment is now becoming more widely available in the United States and is covered by Medicare. Coverage by commercial insurance plans varies and will be verified before treatment.

LDRT may be considered for patients who:

• Have imaging-confirmed osteoarthritis
• Continue to have pain despite conservative treatment
• Cannot tolerate anti-inflammatory medications or repeated injections
• Are not candidates for surgery
• Wish to postpone surgery
• Have pain that limits walking, exercise, sleep, or daily activities

LDRT is intended to treat the inflammatory component of osteoarthritis. If pain is also caused by tendon or muscle tears, significant changes in the bone, joint deformity, instability, or another structural or functional problem, treatment may feel less effective because radiation does not correct those underlying mechanical changes.

Patients with rheumatoid arthritis or another inflammatory autoimmune arthritis are not candidates for this treatment.

Approximately two-thirds of appropriately selected patients experience meaningful pain relief. Patients who respond commonly report a reduction of approximately three to four points on a 10-point pain scale.

Patients may begin noticing improvement approximately six to eight weeks after treatment. However, the response develops gradually, and the full benefit should not be evaluated until approximately 12 weeks after treatment.

Individual results vary, and LDRT does not reverse the underlying structural changes caused by osteoarthritis.

Treatment begins with a consultation and treatment-planning scan. The affected joint is then treated with a carefully directed, very low dose of radiation.

A typical course consists of six brief treatments administered over approximately two to three weeks. Each visit generally takes only a few minutes, and patients may resume normal activities afterward.

Treatment is painless, requires no anesthesia or recovery period, and has no expected side effects. Some patients begin to experience pain relief after six to eight weeks, with the full response assessed approximately 12 weeks after treatment.

If the initial response is incomplete, a second course may sometimes be considered.

Yes. Receiving LDRT does not prevent a patient from having joint surgery or joint replacement in the future.

For patients who experience meaningful pain relief, LDRT may delay the need for surgery. If surgery later becomes necessary because of progressive arthritis or structural joint damage, previous LDRT does not eliminate that option.

Potential benefits include:

• Reduced joint pain
• Decreased inflammation
• Improved mobility and function
• Reduced reliance on pain medication
• Delaying more invasive treatment or surgery
• No expected side effects
• No interruption of normal daily activities
• Preservation of future surgical options

Not every patient responds, and LDRT does not repair damaged cartilage, tears, deformity, or joint instability.

LDRT is one possible treatment for persistent osteoarthritis pain and does not replace evaluation by an orthopedic physician, rheumatologist, or primary-care clinician. Our radiation oncologists review each patient individually to determine whether the pain pattern, imaging findings, and previous treatments make LDRT appropriate.

If osteoarthritis pain continues to limit your mobility or quality of life despite other treatments, the physicians at Radiant Oncology can evaluate whether low-dose radiation therapy may be an appropriate option.