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Research &
Efficacy of LDRT

Low-Dose Radiotherapy (LDRT) is an established, noninvasive treatment option for managing pain and inflammation associated with various benign conditions, particularly osteoarthritis (OA) and other musculoskeletal ailments. For patients who have not found relief through standard therapies, LDRT offers a cost-effective, evidence-based alternative focused on improving quality of life, reducing pain, and restoring function.

Below is a collection of resources detailing the clinical evidence, mechanisms, and efficacy of LDRT.

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Key Research & Clinical Findings

“Low-Dose Radiotherapy Offers Pain Relief for Patients with Osteoarthritis”

Link to Article PDF

Summary of Key Points:

  • Evidence of Efficacy: The strongest support is highlighted by a randomized trial (Makarova et al., 2023) which found that LDRT significantly reduced disability risk and provided sustained improvements in pain and function for knee OA patients over a decade.
  • Clinical Outcomes: Systematic reviews and clinical studies confirm that LDRT provides moderate to long-term pain relief and improved mobility with minimal side effects.
  • Mechanism of Action: LDRT provides relief through its anti-inflammatory effects, which involve modulating immune cells and cytokine profiles to reduce pro-inflammatory mediators in joint tissues.
  • Typical Regimen: A common, effective, and well-tolerated regimen involves fractionated doses, such as 10 fractions of 0.5–1 Gy each.
  • Results: The authors conclude that given the significant burden of OA, LDRT is a medically justified intervention for select patients with refractory osteoarthritis.

Presentation: “Low Dose Radiation Therapy for Musculoskeletal Ailments”

Link to Article PDF

This presentation by Evan Thomas, MD PhD DABR, provides a comprehensive overview of LDRT for a wide range of painful inflammatory musculoskeletal conditions, drawing heavily on decades of clinical experience, particularly from Germany.

Summary of Key Points:

  • Conditions Addressed: LDRT is used for OA as well as other conditions including tendinitis (e.g., rotator cuff, Achilles), bursitis, plantar fasciitis, and Dupuytren’s Contracture.
  • Mechanism of Action: LDRT is described as “sterilizing inflammation.” It works by reducing pro-inflammatory cytokines, increasing anti-inflammatory cytokines, and polarizing immune cells (macrophages) toward an anti-inflammatory state.
  • Treatment & Safety: Treatment typically involves a small number of low-dose fractions (e.g., 3-6 Gy total) delivered over 2-3 weeks. It has minimal acute side effects, with one review of over 1000 patients reporting only a single case of mild skin redness.
  • Historical Context: First used for arthritis in 1898, LDRT is now widely used in Germany (estimated 400,000-600,000 U.S. patient equivalent annually) for benign inflammatory diseases.

Clinical Outcomes: Summaries of 18 modern studies (5,992 patients) show high response rates. Case studies for hand OA, plantar fasciitis, and knee OA show good pain response rates ranging from 68% to over 80%.

Study: “Low-Dose Radiation Therapy for Osteoarthritis: A Retrospective Single-Institution Analysis”

Link to Article PDF

This 2025 retrospective study from a single American institution analyzes the real-world analgesic effects of LDRT on 69 patients (treating 168 joints) for painful osteoarthritis.

Summary of Key Points:

  • Methodology: Patients were treated with a typical LDRT course of 3 Gy delivered in 6 fractions (0.5 Gy per fraction) over 2 to 3 weeks. Pain was assessed before treatment (pre-RT), at the end of treatment (EOT), and at a 10-week follow-up (FU).
  • Results: Patients experienced a significant reduction in pain scores. Mean relevant pain (on a 0-10 scale) dropped from 6.3 pre-RT to 4.0 at the end of treatment. This significant pain relief was sustained at the 10-week follow-up.
  • Patient Improvement: At the 10-week follow-up, 72% of joints maintained significant pain improvement as assessed by the patient (von Pannewitz score).

Findings: The study demonstrates that LDRT provides significant and sustained pain relief for osteoarthritis across various joint types, supporting it as a promising noninvasive treatment option. It also notes the potential benefit of a repeated course for select patients.

Study: “Low‑dose radiation therapy for hand osteoarthritis: shaking hands again?”

Link to Article PDF

This 6-year study concluded in 2021 from Madrid, Spain evaluated how LDRT affected pain and function of hand osteoarthritis.

Summary of Key Points:

  • Methodology: The LDRT treatment course included a total dose of 3-6 Gy delivered in 6 fractions (0.5 – 1.0 Gy per fraction) every other day over 2 to 3 weeks. Clinical response was evaluated using the visual analog scale (VAS) to evaluate pain level and joint functionality was evaluated by using the von Pannewitz score (VPS). Patients who had not sustained adequate pain relief and functional improvement after 8 weeks were offered a second course of treatment.
  • Results: The average VAS score for pain was 8/10 before treatment. At the end of treatment, at the 3-, 6-, and 12-month follow-ups average VAS scores for pain were 4/10, 3/10, and 3.5/10, respectively.
  • Patient Improvement: With a median follow-up of 10.5 months, 94% of participants reported an improvement in pain. 70% of participants removed functionality improvement according to the von Pannewitz score.

Literature Review: “The Use of Low-Dose Radiation Therapy in Osteoarthritis: A Review”

Link to Article PDF

Summary of Key Points:

This 2022 literature review examined the most recent literature published in several individual studies on the use of LDRT for osteoarthritis.

  • A 2021 study of 970 participants with a total of 1,185 joints treated by LDRT found that 66% of patients reported significantly decreased pain intensity when surveyed 8 weeks post treatment. Of the 34% of participants who did not initially receive adequate relief, 61% found adequate relief after a second course of LDRT.
  • A 2020 study of 483 participants with finger and thumb osteoarthritis found that 70% of participants reported a reduction in pain.
  • A 2022 study of 196 participants with foot and ankle osteoarthritis found that 75% of participants reported a reduction in pain, with 37% of those participants reporting an 80-100% reduction in pain.
  • Review Conclusion: Numerous recent studies published outside the US have suggested moderate to long-term pain relief and improvement in mobility after treatment with LDRT for joints affected by osteoarthritis. LDRT has been shown to be a cost-effective, noninvasive treatment with minimal side effects.

Clinical Cases of LDRT

“Low-Dose Radiotherapy Offers Pain Relief for Patients with Osteoarthritis”

Link to Article PDF

This presentation details the practical application, treatment protocols, and supporting evidence for LDRT through specific clinical cases and a review of established practices, particularly from the extensive German experience.

Summary of Key Points:

  • The Care Gap: LDRT is positioned as a critical option for patients with moderate-to-late stage symptoms who have not found relief with conservative treatments and wish to avoid or delay surgery.
  • Schedule & Outcomes: A typical schedule involves six treatments (total dose of 3-6 Gy) over 2-3 weeks. Data shows approximately 80% of patients experience pain relief at 2 months, and 60% maintain pain relief at 1 year.
  • Safety Profile: The treatment has minimal to no acute side effects. A study of over 1,000 patients reported only one instance of mild skin redness (Grade 1 erythema).
  • Clinical Case Evidence: The presentation provides specific examples of LDRT success:
    • Hand OA: Studies show a 68% good pain response, with one study finding 94% of patients reported improvement.
    • Plantar Fasciitis: RT studies demonstrate an 80-85% pain response rate.
    • Knee OA: Data shows a 79% good pain response for patients.

Corticosteroid Concerns: The presentation contrasts LDRT with corticosteroid injections, highlighting studies that suggest steroid injections may accelerate OA progression and cartilage loss.

Try Non-Surgical
Pain Relief with LDRT

At JointGlow, your care is guided by nationally recognized specialists in radiotherapy, regenerative medicine, and integrative wellness. Our multidisciplinary team—including expert physicians, clinical coordinators, and compassionate support staff—delivers advanced therapies tailored to your unique needs. We’re here to help you move better, live fully, and feel your best—sooner.

Our physicians are among the select few in the U.S. specifically trained in Low-Dose Radiotherapy (LDRT)—ensuring exceptional care every step of the way.

Evan Thomas, MD, PhD

Specialist in Precision Therapies for Joint & Tendon Conditions

Bobby Koneru, MD, FASTRO

Leader in Low-Dose Radiotherapy & Non-Invasive Pain Relief
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