Low-Dose Proton Therapy for the Treatment of Osteoarthritis and Other Benign Conditions

Do you have patients who haven’t responded to or can’t afford traditional courses of treatment for inflammatory conditions? Are they ineligible, unwilling or do they need to defer surgery? Low-dose Radiation Therapy (LDRT) offers a low-risk option that can reduce or eliminate symptoms of pain, decreased mobility, and joint stiffness in as little as six treatments with minimal side effects and good therapeutic results.

Musculoskeletal patients with conditions such as osteoarthritis, planter fasciitis, tendonitis and more, now have a safe, drug-free, Medicare/Medicaid covered and effective treatment for their pain. For decades, low-dose radiation therapy has successfully been used in Europe to treat joint pain and inflammation. More recently, large series confirming good outcomes have been reported from the United States. Now the Maryland Proton Treatment Center is bringing this effective use of radiation to you and your patients.

What Is LDRT?

LDRT or low-dose radiation therapy uses a very low dose compared to standard radiation therapy used to treat cancer. This radiation targets inflammatory cells, which are very sensitive to the treatment.  Reducing these cells calms down pain and joint stiffness, and essentially no side effects during treatment are possible due to the very low doses used.

Dr. Matthew Ferris
Medical Director, Maryland Proton Treatment Center
Assistant Professor of Radiation Oncology, University of Maryland School of Medicine

Very small doses of proton radiation (0.5 Gy) are administered in six sessions (3 Gy total), 2-3 times per week, at 30 minutes per session. Patients would feel like their normal selves during and after treatment. For context, cancer treatments are typically ~20x more dose than this.

Protons, unlike traditional photons, can be precisely controlled to deliver radiation to the targeted area while minimizing damage to surrounding healthy tissue.  This is especially important when offering treatment to patients with “benign” or non-cancerous conditions, since we want to minimize risk of secondary cancer development from radiation exposure as much as possible. The risk of secondary cancer development following protons at these low doses should be negligible.

Study Results

In 2025, a study was reported of 69 LDRT osteoarthritis patients with a total of 168 joints treated with a mean pre-RT score of 40.4 and a relevant pain score of 6.3 resulted in the following: At the end of treatment, scores decreased significantly to 26.0 and 4.0 respectively. Eighty percent of patients showed a significant pain improvement at the end of treatment with 72% maintaining at follow-up. Thirty-three percent of joints received a second LDRT phase of another 6 treatments.

How Does It Work?

LDRT helps to regulate inflammatory processes. It…

– Modulates cytokine production to reduce inflammation.
– Alters immune cell activity, decreasing inflammatory responses.
– Reduces synovial membrane inflammation (synovitis).

What Conditions Can It Treat?

– Osteoarthritis
– Epicondylitis/Tennis Elbow
– Plantar Fasciitis
– Ledderhose Disease (Plantar Fibromatosis)
– Dupuytren’s Contracture
– Tendinitis (Achilles, etc.)

For a more detailed critical review, please read:

1) International Journal of Radiation Oncology*Biology*Physics, Volume 114, Issue 2, 1 October 2022, Pages 203-220, The Use of Low-Dose Radiation Therapy in Osteoarthritis: A Review.