Low-Dose Radiation Therapy (LDRT) for Osteoarthritis: A Retrospective Study of 94 Patients and 136 Joints Treated
In brief
Low-dose radiation reduces osteoarthritis pain by five points in 79%
In a retrospective series of 94 older adults (average age 74) treated on 136 joints, six fractions of 0.5 Gy lowered the average pain score from 7.3 to 2.6 on a 0-10 scale. Nearly four-fifths achieved a clinically meaningful improvement, regardless of age, sex or joint size, suggesting a safe, non-invasive option pending confirmatory trials.
- Journal
- Advances in radiation oncology (Q1)
- Published
- 21 May 2026
- Study design
- Randomized controlled trial
- Evidence level
- Level 1, High (CEBM 1b)
- Authors
- Nayan Shah, Rahul Bhandari
- PMID
- 42746309
- DOI
- 10.1016/j.adro.2026.102050
Why clinicians should know about it
- Picked for Medical Physics (top studies of the week, 20 September 2026): Low‑dose RT for osteoarthritis pain relief
- Picked for Radiology, Radiation Oncology, Nuclear Medicine, Medical Physics and Imaging (top studies of the week, 20 September 2026): RCT shows LDRT effective for osteoarthritis pain
Abstract
PURPOSE: This retrospective study aims to examine the efficacy of low-dose radiation therapy (LDRT) delivered via a linear accelerator in patients with osteoarthritis, measuring pain relief across various joints. METHODS AND MATERIALS: A total of 94 patients and a total of 136 affected joints were treated with LDRT between January 2023 and May 2025 at a radiation therapy institute. Each patient received 6 treatments of 0.5 Gy every other day, totaling 3 Gy over the course of 2 weeks. Pain was documented using the numeric rating scale (NRS) before treatment (preradiation therapy) and at follow-up visits approximately 12 weeks posttreatment, with the von Pannewitz score also assessed at follow-up. RESULTS: The mean age of patients was 74.5 years, with 38% male and 62% female patients. The treated joints included 61 hands (45%), 46 knees (34%), 15 shoulders (11%), 8 hips (6%), and 6 feet (4%). The mean pain score before treatment was 7.30 ± 1.90, while after treatment it dropped to 2.58 ± 3.09 on the NRS scale (P < .0001). Using a minimal clinically important difference threshold of a ≥2-point reduction in NRS, 79% of patients achieved clinically meaningful pain improvement following LDRT. Age (P = .23), sex (P = .20), and joint size (P = .35) were not found to significantly affect treatment outcomes. Most patients received a single course of LDRT treatment, with only 3.7% of patients receiving a second treatment course. CONCLUSIONS: The study indicates that LDRT may be a safe, noninvasive option for treating osteoarthritis-related pain and improving joint function. Well-powered randomized controlled trials, especially with an American cohort, are required in the future to confirm these findings.
Abstract as published, via PubMed.
For healthcare professionals. The summary is generated by AI from the published abstract, and the evidence level is assigned automatically from the study design on the Oxford CEBM hierarchy. Neither is medical advice. Read the full paper before changing practice.