Osteoarthritis
Low Dose Radiotherapy can decrease Osteoarthritis (Degenerative Joint Disease or DJD) pain and stiffness. While Radiation Therapy doses high enough to treat cancer cause inflammation, very low doses do the opposite. In the 0.3 to 0.7 Gy dose per fraction range radiation therapy acts as a local anti-inflammatory immunomodulator. The dose is roughly 1/25th of a full cancer treatment course.
Most reports describe 7 out of 10 patients gaining significant benefit, usually with no side effects. The low dose correlates with a less than 1/1000 late skin cancer risk when treating extremities. German centers have extensive experience with this approach, using it for over 40 years, and now select centers in the US are adopting it and finding similar success. Many of our patients experience remarkable results.
Some relate more modest benefit and about 3 out of 10 patients note minimal change.
This treatment does not change the underlying mechanical challenges of degenerative joint damage but can change the body’s response to such problems. Benefit may be transient (a few months) but also may extend out to years. More than one course may be required for optimal effect. Laboratory, animal, and an ongoing prospective human trial indicate that the effect is due to modulation of pro-inflammatory lymphocytes, vascular adhesion and permeability, macrophage and fibroblast action, and cytokine signaling. The synovial capsule appears to be an important part of the response structure.
There may be a favorable response for some patients who have mixed Osteoarthritis and Rheumatoid arthritis, but it is not considered a primary treatment for Rheumatoid arthritis.
We favor limiting this treatment to non-spine sites and patients over 40 years of age. The optimal patient has tried conservative measures for 3 to 6 months but still has pain and stiffness. Steroid injections and Nonsteroidal Anti-inflammatories like Ibuprofen and Naproxen Sodium should be held shortly before, during and for a week after the low dose radiation course.
The dose delivered is so low that it has no impact on subsequent surgical procedures should they eventually be required.
Treatment is delivered in 6 quick visits, each given every other day. Treatment may be repeated after a few months if needed for more response.
This treatment is covered by most insurance.
