How Low-Dose Radiation Might Ease Your Osteoarthritis Pain

If you’ve been living with osteoarthritis, you know it can wear you down. And while pain medications and joint replacement surgery work well for some people, they’re not for everyone. Fortunately, a once-popular treatment option is gaining traction again: low-dose radiation therapy.

Radiation therapy is often thought of as a treatment for cancer. But it’s been used for decades to treat arthritis and other benign (noncancerous) conditions. And experts are now returning their attention to it.

We talked with radiation oncologist Rahul Tendulkar, MD, to learn how low-dose radiation is being used for osteoarthritis symptoms and who might benefit most.

What is low-dose radiation therapy?

High doses of radiation can be used to kill cancer cells. But for people with arthritis, lower doses of radiation can help lower inflammation and relieve pain without damaging healthy tissue.

“This approach fell out of favor for a while in the United States several decades ago, as other treatments became widely available, like anti-inflammatory medications,” Dr. Tendulkar explains. “Now, there’s growing interest again.”

Low-dose radiation has been used more commonly in Europe for arthritis relief. Doctors in Germany developed the treatment protocols that serve as the basis for the practice in the U.S.

“It’s not a cure for arthritis,” he continues, “but it can manage the inflammatory process and lead to meaningful pain relief.”

Who can benefit from radiation for arthritis?

Low-dose radiation therapy isn’t for everyone — and it’s not a first-line treatment. It’s mainly being explored for people who fall into what Dr. Tendulkar calls the “middle ground”— people with osteoarthritis who haven’t responded to medications but aren’t quite ready or able to have joint replacement surgery.

“It’s a great option for patients who can’t take anti-inflammatory drugs due to ulcers, kidney problems or other conditions,” he adds. “It may also help people who want to avoid surgery or delay it for as long as possible.”

Right now, the treatment is typically reserved for people with arthritis in their joints, including their:

• Shoulders
• Hands
• Knees
• Feet

Why? Joints are easier to target with radiation without risk of affecting nearby organs. Older adults with osteoarthritis in other areas, like their hips or spine, may be candidates in select cases.

It’s not used for rheumatoid arthritis or psoriatic arthritis.

Is it safe?

Understandably, some people feel nervous when they hear the word “radiation.” That’s because exposure to radiation can be a risk factor for developing cancer later on. That’s especially true in younger people, as secondary cancer from radiation is slow to develop, typically emerging 10 years or more after treatment.

But because the dose of radiation used for arthritis is so small, the risk of developing cancer from low-dose radiation is understood to be extremely low.

Consider this: If you’re getting radiation for breast cancer, a typical dosage is 40 to 50 units (these units are called “Gray”). Prostate cancer uses 70 to 80 units. A typical dose of radiation for arthritis? Just 3 units.

“We always weigh the risks and benefits, especially in younger patients. But for older adults, the safety profile is very reassuring,” Dr. Tendulkar says.

What kind of results are people seeing?

Low-dose radiation therapy has shown a lot of promise.

“In one recent trial, about 70% of patients who received radiation saw a drop in their knee pain, compared to about 40% in the placebo group,” Dr. Tendulkar reports. “That’s a meaningful difference.”

People are typically reassessed about three months after treatment. If they don’t see results, a second round of radiation may help. And if pain returns years later, some may be eligible for re-treatment.

What’s the treatment like?

The process is fast and painless. Here’s what to expect:

• Planning scan: First, you’ll have a CT scan to map the treatment area.
• Regular visits: Treatment plans usually call for six sessions over two to three weeks.
• Short sessions: Each session takes 10 minutes or less.
• No downtime: You can drive yourself to appointments, and side effects are minimal. Dr. Tendulkar says some people might have minor skin irritation, no more than a very mild sunburn. But that’s rare.

“You’re not radioactive, and you won’t feel anything during treatment,” he clarifies. “It’s a lot like getting an X-ray.”

The bottom line

Low-dose radiation therapy isn’t a replacement for traditional arthritis treatments — but it may offer relief for people stuck between medications that don’t work and surgery they’re not ready for.

“It’s a promising tool,” Dr. Tendulkar says. “And for the right people, it could make a big difference in quality of life.”

Radiation is becoming increasingly popular for treating arthritis, but it hasn’t caught on everywhere. Talk with your healthcare provider about whether it’s an option for you.