After LDRT: Recovery, Restrictions, and What to Expect

Our what to expect page covers the visits themselves. This one covers what comes after the last visit: the quiet weeks, the follow-up visit, and what to do if the pain comes back. The numbers on how fast relief builds and how long it lasts are on our how long LDRT takes to work page.

The Timeline After Your Last Session

Not much happens at first, and that is normal. The German DEGRO guideline, the reference many programs work from, says the effect of a course should be judged after 2 to 3 months, because the response is delayed^[1]. So the first days after your last session do not tell you whether the course worked.

That timing shows up in how trials are run. In the ArthroRad trial, patients were checked at 3 months and again at 1 year after the end of treatment^[2]. In a United States series of 69 patients and 168 joints, pain was recorded at the end of treatment and again at a 10-week follow-up, and the average pain score was the same at both points, 4.0 out of 10, down from 6.3 before treatment^[3]. Your own program may check you sooner or later than this, but a course is judged over months.

What does that mean for daily life in the meantime? There is no published general rule that keeps you off your feet after a course, and no recovery period is built into the treatment the way it is after surgery. If your program gave you a specific limit for your joint, follow that, because it was set for you. Otherwise, you can go about your normal routine.

Activity, Work, and Travel

No guideline we found sets a general ban on work, exercise, lifting, or travel after LDRT. Many patients expect radiation treatment to come with a rest period, but the published guidance does not set one. Some programs give their own advice for a particular joint. If yours did, follow it.

Travel needs no special planning after a course. LDRT does not make you radioactive, so there is no isolation period and no need to keep away from family or other travelers. If you traveled for treatment, plan the trip home around your own comfort. Our traveling for LDRT page covers planning the course itself.

Medications, Exercise, and Other Treatments

Keep taking your normal medications unless your own doctor tells you otherwise. Our what to expect page gives the same advice for the treatment weeks. LDRT does not replace the rest of your arthritis care, and it does not add any new medication.

The same goes for exercise and physical therapy. We found nothing in the LDRT guidance that tells patients to stop them, and your own doctor's plan for your joint still stands. If you were in a therapy program before the course, ask your program whether to keep the same schedule in the first weeks, since they know which joint they treated and how sore it was to start with.

A common question is how long to wait before a cortisone or gel shot into the same joint. We found no published standard for spacing an injection after an LDRT course. If you have an injection booked, tell the program that treated you and ask them about timing. Do the same for any procedure planned on that joint.

Skin and the Treated Area

Temporary skin irritation over the treated joint is possible. A 2025 review that pooled 12 studies found more adverse events overall with LDRT than with the comparison treatments, mostly nail reactions^[4]. In two recent trials, though, no side effects were reported: the German ArthroRad trial found none in either dose group^[2], and the Korean LoRD-KNeA trial of 114 knee patients reported no treatment-related toxicities^[5]. Those are group results, not a promise for any one person.

If the skin over the treated joint looks irritated, or a nail changes, tell your program and ask how to care for it. The full list of reported effects is on our side effects page.

The Follow-Up Visit

Expect the real check to come at about 2 to 3 months, following the DEGRO timing^[1]. Some programs will see you sooner for a quick check, and trials have used 10 weeks, 3 months, 4 months, and 1 year, so the exact date varies.

At that visit, expect questions about your pain and how well the joint works, such as whether walking, stairs, or gripping have gotten easier. Trials measured the same things: a pain score, a function score for the joint, and a general quality of life score^[2]. It helps to keep a short note of your own in the weeks before the visit: a pain score on a good day and a bad day, and one task that got easier or did not. It is easier than trying to remember three months at once.

When to Call Sooner

Most of the wait is uneventful. Call your program sooner, rather than waiting for the follow-up, if you notice any of these:

• New swelling in the treated joint that keeps growing, rather than settling.
• Skin that breaks open, blisters, or looks infected in the treated area.
• Pain that is clearly worse than before treatment and does not settle over a few days.
• A new problem in the joint that was not there before, like locking, giving way, or a sudden loss of movement.

This list is general information, not medical advice for your situation. If you are worried, call your program.

If Relief Fades

If relief fades, a second course may still be an option. Some programs offer one, and policies vary, as our FAQ notes. In the United States series of 69 patients, 33 percent of joints went on to receive a second phase of the same 3 Gy in 6 visits, and those joints saw further pain reduction^[3]. That series had no control group, so it cannot prove the second course caused the extra improvement, but it shows a second course is a real option some programs use.

Wait for the 2 to 3 month check before deciding, bring your notes, and talk through the options then. Our what if LDRT does not work page covers repeat treatment and the alternatives in full.

References:
1. Ott OJ, Niewald M, Weitmann HD, et al; German Cooperative Group on Radiotherapy for Benign Diseases (GCG-BD). DEGRO guidelines for the radiotherapy of non-malignant disorders. Part II: Painful degenerative skeletal disorders. Strahlentherapie und Onkologie. 2015;191(1):1-6 (evaluation of the treatment effect after 2 to 3 months; single doses of 0.5 to 1.0 Gy and total doses of 3.0 to 6.0 Gy per series). PubMed
2. Niewald M, Moumeniahangar S, Müller LN, et al. ArthroRad trial: randomized multicenter single-blinded trial on the effect of low-dose radiotherapy for painful osteoarthritis, final results after 12-month follow-up. Strahlentherapie und Onkologie. 2024 (follow-up examinations at 3 months and 1 year; side effects did not occur; favorable pain relief in both arms with no significant difference between arms). PMC
3. Koneru BN, Sick J, Shaikh HA, Spengler H, Small W Jr, Shaffer R. Low-dose radiation therapy for osteoarthritis: a retrospective single-institution analysis of 69 patients and 168 joints. International Journal of Radiation Oncology, Biology, Physics. 2025;123(2):352-360 (mean pain score 6.3 before treatment, 4.0 at the end of treatment, 4.0 at the 10 week follow-up; 33% of joints received a second phase, with further pain reduction; retrospective, no control group). PubMed
4. Hammadeh BM, et al. Efficacy, safety, and pain management of low-dose radiation therapy in osteoarthritis: a comprehensive systematic review and meta-analysis. Rheumatology International. 2025;45:210 (12 studies, about 1,750 patients; more adverse events overall with LDRT than with comparison treatments, particularly nail reactions). PubMed
5. Kim BH, Ro DH, Wang JH, et al. Single course low-dose radiation therapy in knee osteoarthritis (LoRD-KNeA): a randomized controlled trial. BMC Medicine. 2026 (114 patients; responder rate at 4 months 70.3% at 3 Gy vs 41.7% sham; advantage present at 8 months, no longer statistically significant at 12 months; no treatment-related toxicities reported). BMC Medicine