Low-Dose Radiation Therapy for Hand and Thumb Osteoarthritis

Low-dose radiation therapy (LDRT) is an outpatient treatment that directs a very small amount of radiation at an arthritic joint to calm inflammation in the joint lining. Hand osteoarthritis, including the small joints of the fingers and thumb base, is one of the conditions programs discuss LDRT for.

What the Evidence Covers

Be aware: the published sham-controlled trial evidence for LDRT, including the 2025 Korean randomized trial^[1] and the 2019 Dutch trial^[6], specifically studied knee osteoarthritis. Direct trial evidence for the hand specifically is thinner than for the knee. A radiation oncologist can explain how the overall evidence and dosing approach apply to hand joints in particular.

For comparison, topical anti-inflammatory medicines, applied directly to the skin over a painful joint, are commonly discussed for hand osteoarthritis specifically, since they can be effective for accessible joints like the hand and may have fewer whole-body effects than oral medicines. LDRT is generally discussed after conservative options like these, along with physical therapy and other measures, have not provided enough relief.

Typical Schedule

• Total dose of about 3.0 Gy, split into 6 treatments of 0.5 Gy each
• Treatments given 2 to 3 times per week, over about 2 to 3 weeks
• Outpatient visits of roughly 10 to 15 minutes each

Who May Be a Candidate

Programs generally consider adults with hand osteoarthritis who have not gotten enough relief from medications (including topical anti-inflammatories), injections, or other conservative treatments. As with other joints, candidacy also depends on age, the extent of structural joint damage, and overall health. A radiation oncologist weighs these together.

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
6. Mahler EAM, et al. Effectiveness of low-dose radiation therapy on symptoms in patients with knee osteoarthritis: a randomised, double-blinded, sham-controlled trial. 2019. PubMed