Radiation therapy targets arthritis swelling, pain
If the aches and pains of ongoing osteoarthritis are getting to be too much for you to bear, there may be a new way to find relief.
More than 32 million Americans suffer from osteoarthritis, a degenerative joint disease caused by the gradual breakdown of cartilage. It can impact nearly any joint including knees, hips, spine, fingers, shoulders, and ankles.
“Osteoarthritis is a chronic and often debilitating condition that causes pain, stiffness, and swelling in the joints,” says Dr. Chirag Shah, chair of Radiation Oncology at AHN Cancer Institute. “Arthritis can severely impact mobility and quality of life, and many patients struggle with limited options once medications, injections, or even surgery fail to provide relief.”
You or someone you know may be struggling with osteoarthritis or even considering potential joint replacement surgery. But there may be another surprising option to explore before going down that road: low-dose radiation therapy (LDRT), an innovative new therapy being offered at several AHN locations including the Peters Township Health + Wellness Pavilion in McMurray.
Low-dose radiation therapy (LDRT) delivers precise, low doses of radiation to affected joints. Studies have shown it can provide significant and lasting relief for up to 75% of patients without the side effects commonly associated with other arthritis treatments such as stomach ulcer risk from chronic use of NSAIDs or others from overusing corticosteroids.
How does radiation help with arthritis?
“The mechanism is not completely known, but the feeling is that low doses of radiation are anti-inflammatory by modulating inflammatory pathways,” says Shah. “Radiation therapy has long been used safely and effectively to treat cancer. But at very low doses, it also has an anti-inflammatory effect that benefits patients with arthritis.”
Research suggests LDRT may provide joint relief by reducing the production of inflammatory proteins known as cytokines. That anti-inflammatory effect has prompted doctors to use LDRT for decades to treat benign inflammatory and degenerative disorders such as epicondylitis and plantar fasciitis. In recent years, researchers have resumed exploring its wider application as a potential therapy for osteoarthritis using significantly lower levels of radiation than those used to treat cancer.
“Low-dose radiation therapy gives us an innovative, safe, and noninvasive way to help patients regain function and improve their day-to-day lives,” Shah adds. “We are excited to bring this therapy to our communities, where many people live with chronic arthritis pain.”
The use of radiation to battle arthritis is surprisingly not a new approach, with the first case report dating all the way back to 1898 and more in the early 1900s. It fell out of favor in the United States back in the 1980s but is still being commonly used in Europe.
Shah points out an older survey that found only 10% of U.S. doctors offered the therapy but up to 85% did in central Europe. Now, LDRT is increasingly being used in the U.S., with AHN and Shah being recognized as a leader in the practice.
Shah recently co-authored clinical guidelines for its use in treating osteoarthritis that were published in the journal Practical Radiation Oncology and are helping to pave the way for its broader adoption across the country.
The LDRT protocol typically consists of six treatments delivered over two to three weeks with minimal side effects such as redness of the skin or mild tiredness.
Shah says all kinds of patients are seeing benefits from the treatment in different parts of the body and varying levels of severity of their arthritis. “While response rates are not 100%, we do see success in a large number of patients with some studies/articles quoting 60 to 90%,” he said. “We don’t treat spines and most commonly offer treatment for hands, elbow, shoulders, feet, knees, hips, and SI joints in the pelvis.”
For patients who have tried all sorts of other therapies such as injections and medications, this may be something to consider before weighing the possibility of joint replacement surgery.
“We do have patients that have long-term benefits,” Shah said. “We don’t have studies that I am aware of that show permanent relief. I have had patients have relief for months to years. If the discomfort returns, we can also re-treat.”