Who Is a Good Candidate for Low-Dose Radiation Therapy (LDRT)?

Is LDRT Right for You?

What the National Guideline Says

In 2026 the American Radium Society published the first U.S. consensus guideline on LDRT for osteoarthritis, written by a panel of radiation oncologists, rheumatologists, orthopedic surgeons, and a patient advocate. It describes LDRT as an appropriate option for people with symptomatic osteoarthritis who:^[2]

• Have persistent pain and trouble using the joint
• Have not gotten enough relief from conservative treatments such as exercise, physical therapy, weight management, anti-inflammatory medicines, topical medicines, braces, or injections
• Are not good candidates for surgery, or would rather delay or avoid it
• Understand both the possible benefits and the current limits of the evidence

The guideline does not recommend LDRT as a first treatment. It also notes that people with mild to moderate osteoarthritis are the most likely to benefit, and that the decision should be made together with your doctors. Our guideline summary covers it in more detail.

A Quick Self-Check

If most of these sound like you, it is reasonable to ask about a consultation with a radiation oncologist.

• A doctor has diagnosed osteoarthritis in the joint, usually with an exam and an X-ray
• The pain has lasted for months and gets in the way of walking, sleep, work, or daily tasks
• You have already tried other treatments and they did not help enough, or the relief did not last
• You want to avoid or delay surgery, or surgery is not a good option for you
• You can get to six short appointments over about two to three weeks

Situations That Need a Closer Look

None of these automatically rules you out, but tell the radiation oncology team about them early.

• Pregnancy. Radiation treatment is generally avoided during pregnancy. Tell the team if you are or could be pregnant.
• Past radiation to the same area. Earlier radiation treatment, for cancer or anything else, is factored into the plan.
• Connective tissue disease. Some conditions, such as scleroderma or lupus, can make tissues more sensitive to radiation, so the team will review them carefully.
• Pain that may start somewhere else. Hip or leg pain can come from the lower back, and shoulder pain can come from the neck. Confirming the source comes first.

What to Bring to Your Consultation

• Recent X-ray or MRI reports for the painful joint
• A list of treatments you have tried, and how long each one helped
• A list of your current medicines and any past radiation treatment
• Your insurance card, and a referral if your plan requires one
• Your questions. Our guide on how to talk to your doctor about LDRT can help.

References:
1. Kim BH, et al. Clinical Effectiveness of Single Course Low-Dose Radiation Therapy in Knee Osteoarthritis: Short-term Results from the Randomized, Sham-Controlled Trial. ASTRO 67th Annual Meeting Late-Breaking Abstract LBA 06. 2025. Abstract
2. American Radium Society (ARS) Appropriate Use Criteria for Low-Dose Radiotherapy for Osteoarthritis. American Journal of Clinical Oncology. 2026 (ahead of print). PubMed