Low-Dose Radiation Therapy for Osteoarthritis: Analysis of Preliminary Outcomes at Scripps Clinic

Osteoarthritis (OA) is a chronic, degenerative joint disease affecting approximately 15% of Americans, resulting in significant pain, functional impairment, and diminished quality of life (QoL). Many patients have symptoms refractory to conventional treatments including lifestyle modification, topical and oral analgesics as well as intra-articular therapy. Low-dose radiation therapy (LDRT) has been used for many decades in Europe to manage OA symptoms, but this treatment remains underutilized in the United States. Since June 2024, LDRT has been routinely used in our clinic to treat OA. This study evaluates early clinical outcomes.

We retrospectively reviewed patients aged 46 to 96 who received LDRT for OA between June 1, 2024, and May 31, 2025. During this period, departmental policy limited treatment to nonpregnant adults and peripheral joints. Demographics, joint site, imaging, prior therapies, radiation dose, and treatment dates were extracted from the medical record. All patients received 3 Gy in 0.5-Gy fractions over ∼10 days. Standardized forms were completed at baseline and at 2-, 6-, and 12-month follow-up, assessing pain (Visual Analog Scale), analgesic use (days/week), and activities of daily living/QoL impact (1-10 scale). Range of motion and treatment-related side effects were also documented.

A total of 167 patients and 184 joints were treated with LDRT for OA. Patients with no follow-up were excluded from the study. Patients had statistically significant improvement in pain scores, reduced analgesic use, and enhanced QoL. Among 184 joints, 88% noted a decrease in pain following treatment at the first follow-up visit. The mean pain scores decreased from 6.31 ± 2.07 pretreatment to 2.51 ± 2.80 at follow-up (paired t test P < .01; Wilcoxon P < .01). In addition, analgesic use (-0.92 d/wk ± 2.00; P < .01), QoL (-2.13 ± 2.20; P < .01), and impact on activities of daily living (-2.05 ± 2.30; P < .01) all showed significant improvements based on mean score reductions. There was no grade 2 or greater treatment-related toxicities.

LDRT is an effective noninvasive treatment for OA with minimal adverse effects. These findings support further study and broader consideration of clinical use in the United States.