A new way to relieve osteoarthritic pain: Low-dose radiation therapy (LDRT)

Millions of people living with joint stiffness and pain often rely on medications, injections and physical therapy—until they need surgery.

But there’s a reemerging pain relief option for osteoarthritis that could stave off surgery, and its gaining traction in the United States. It’s called low-dose radiation therapy (LDRT).

“When you reduce inflammation in a joint, you reduce pain,” says Joana Emmolo, MD, a radiation oncologist at Atlantic Health, explaining the idea behind the treatment. “Studies show that low-dose radiation therapy can provide significant pain improvement in up to 70% of patients with osteoarthritis.”

An old idea with a modern approach

Elliot Rosenstein, MD, a rheumatologist at Atlantic Health, says treating inflammation with radiation isn’t new. In fact, it was used for a host of illnesses before it evolved into today’s highly targeted, lower-dose format.

“We know cells that cause inflammation are highly sensitive to radiation,” he says. “The return to radiation therapy for osteoarthritic pain is exciting because we are now safely and effectively applying the lowest possible anti-inflammatory doses for pain relief, without any long-term side effects.”

How LDRT treatment works

LDRT is noninvasive, and relief comes quickly. It uses targeted beams of radiation to reduce inflammation in an affected joint. The treatment typically involves six sessions of targeted therapy, twice a week over three weeks. Each visit typically lasts less than 15 minutes.

“We destroy the inflammatory cells and alter their signaling pathways throughout the joint and connective tissue,” says Dr. Emmolo. “With LDRT, there are no side effects because we’re not giving high enough doses to damage healthy tissue.”

Who is a candidate?

LDRT is appropriate for people with moderate osteoarthritis who have already tried more conservative options. It is a safe and effective option for older adults who are not quite ready for surgery — or who hope to delay it.

“Low-dose radiation therapy does not rebuild damaged cartilage, and it is not a substitute for joint replacement surgery,” says Dr. Rosenstein. “But the treatment can give patients up to two years of pain relief, which is much longer than steroid injections, which last about three months.”

Research and real-life results

As interest in LDRT for osteoarthritis grows, doctors are paying attention to the research, and they’re also seeing results first-hand.

For example, Dr. Emmolo recently treated a 70-year-old man with debilitating foot arthritis. For him, anti-inflammatory medications, injections and surgery all either came with risks or were ineffective. Instead, LDRT gave him the ability to walk without pain.

A growing toolkit for arthritis care

The challenge now is to make sure patients know their options.

“Inflammation is at the core of both rheumatoid and osteoarthritis,” says Dr. Rosenstein. He also recommends consideration of two other options for patients—genicular artery embolization, which also reduces inflammation around arthritic joints, and genicular nerve ablation, which interrupts pain signals to the brain.

“Our toolkit to relieve osteoarthritic pain is getting bigger, and that’s good news for patients,” he says. “I think there will be a groundswell of interest in LDRT for people who want to stay active, mobile and independent, but haven’t responded well to other therapies.”