Experimental treatment relieves knee arthritis pain without surgery or pills

Researchers are testing low-dose radiation to treat the painful symptoms of osteoarthritis in the knee.

The study, published by researchers in Korea and presented at the American Society for Radiation Oncology (ASTRO) annual meeting in September, suggests that a single course of radiation may be a “safe and effective” treatment option.

Knee osteoarthritis is a degenerative joint disease that causes pain, swelling and stiffness in the knees that worsens over time.

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The randomized clinical trial enrolled 114 patients with moderate to mild knee osteoarthritis, each of whom were assigned a very low dose of radiation, a low dose, or a placebo. The only other pain reliever used during the study was paracetamol.

Participants went through six sessions while researchers assessed “significant improvement” in at least two of the following markers: pain, physical function, and overall assessment of the condition.

Patients also completed a questionnaire to report pain, stiffness, and function. None of them reported side effects related to the treatment.

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After four months of treatment, 70% of participants receiving low doses met the criteria, compared to 42% of those receiving placebo. Those in the very low dose group experienced a 58.3% improvement.

These findings suggest that the low-dose regimen “boosted relief beyond placebo effects,” the experts said in a news release.

In the low-dose group, 56.8% reported significant improvements in pain, stiffness, and physical function scores, compared to 30.6% in the placebo group.

The study concluded that low-dose radiation produced significant reductions in pain and improved function after four months, a “small fraction” of what is typically used to treat cancer.

“For people with mild to moderate disease, this approach could delay the need for joint replacement.”

Dr. Byoung Hyuck Kim, principal investigator of the trial and assistant professor of radiation oncology at Seoul National University College of Medicine, Boramae Medical Center, said people with painful knee osteoarthritis “often face a difficult choice” between the risk of side effects from painkillers and the risks of joint replacement surgery.

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“There is a clinical need for moderate interventions between weak analgesics and aggressive surgery, and we believe radiation may be an appropriate option for such patients, especially when medications and injections are not well tolerated,” he said in a statement.

Radiation therapy may be more suitable for patients with underlying inflammation and preserved joint structure, Kim added.

“In the case of severe osteoarthritis, where the joint is physically destroyed and the cartilage is already gone, radiation will not regenerate the tissue,” he said. “But for people with mild to moderate disease, this approach could delay the need for joint replacement.”

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This treatment should also be considered along with other lifestyle factors, including weight loss, physical therapy and medications, because responses could be “even stronger when radiation is appropriately combined with other treatments,” Kim said.

“And patient satisfaction may be higher than with current options alone.”

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The study had some limitations, the researchers confirmed, including the relatively short follow-up period.

Researchers are planning larger trials to evaluate outcomes in specific groups of people, comparing low-dose radiation injections with medication regimens.