Tendonopathies
Low Dose Radiotherapy can decrease Tendonopathy related pain and stiffness. Conditions commonly treated include: Plantar Fasciitis including “Heel Spurs”, Achilles Tendonitis, Tennis Elbow, and Shoulder Pain Syndrome (when not due to rotator cuff tears). Other tendon and ligament inflammatory conditions may also respond.
While Radiation Therapy doses high enough to treat cancer cause inflammation, very low doses do the opposite. In the 0.3 to 0.7 Gy dose per fraction range Radiation Therapy acts as a local anti-inflammatory immunomodulator. The dose is roughly 1/25th of a full cancer treatment course.
Most reports describe 8 out of 10 patients gaining significant benefit, usually with no side effects. The low dose correlates with a less than 1/1000 late skin cancer risk when treating extremities. German centers have extensive experience with this approach, using it for over 40 years, and now select centers in the US are adopting it and finding similar success. Many of our patients experience excellent results. Some relate more modest benefit and about 2 out of 10 patients note minimal change.
This treatment can change the body’s response to ligament and tendon damage and may allow for better healing of the underlying problem. Response may happen quickly but it usually takes a month or two to fully manifest. More than one course may be required for optimal effect. Laboratory, animal, and an ongoing prospective human trial indicate that the effect is due to modulation of pro-inflammatory lymphocytes, vascular adhesion and permeability, macrophage and fibroblast action, and cytokine signaling. Beneficial Physical Therapy stretching and strengthening exercises should continue if not causing more pain.
We favor limiting this treatment to patients over 40 years of age. The optimal patient has tried conservative measures for at least 3 months but still has pain and stiffness. Steroid injections and Nonsteroidal Anti-inflammatories like Ibuprofen and Naproxen Sodium should be held shortly before, during and for a week after the low dose radiation course.
The dose delivered is so low that it has no impact on subsequent surgical procedures should they eventually be required.
Treatment is delivered in 6 quick visits, each given every other day. Treatment may be repeated after a few months if needed for more response.
This treatment is covered by most insurance.
