Low-dose radiotherapy may represent an effective treatment for the relief of pain and the improvement of musculoskeletal function in patients with lateral or medial epicondylitis, finger osteoarthritis, or plantar fasciitis who are resistant to therapy, according to research presented at the European League Against Rheumatism (EULAR) 2019 Congress, held June 12 to 15, 2019, in Madrid, Spain.
In the single-center trial, patients aged ≥40 years (total number of sites treated, 204) with lateral or medial epicondylitis, finger osteoarthritis, or plantar fasciitis were enrolled. Patients received low-dose radiotherapy (ie, 8 × 0.5 Gy, 200 kV X-rays), which was repeated up to a total dose of 8.0 Gy. Changes in pain, function, and quality of life were assessed at baseline and at 2, 6, and 12 months after treatment.
At the 1-year follow-up, patients reported an analgesic effect compared with baseline levels at 39 sites with lateral epicondylitis: at rest (median change in visual analog scale [VAS] score, −2.5; P <.001) and during activity (median change in VAS, −6.0; P <.001). An increase in handgrip strength was also recorded (median change: extension, 16 kg [P <.001]; flexion, 5.2 kg [P =.002]). Patients experienced pain relief after treatment at a total of 10 medial epicondylitis sites, both at rest (median change in VAS, −3.0; P =.041) and during activity (median change in VAS, −0.4; P =.041), as well as increased handgrip strength (6.5 kg; P =.022).
Participants with finger osteoarthritis (n=99 sites) reported significant pain relief during activity (median change in VAS, −3.0; P <.001) and an increase in handgrip strength (2.5 kg; P =.004). Patients with plantar fasciitis reported reductions in pain scores, both at rest (median change in VAS, −4.0; P <.001) and during activity (median change in VAS, −6.0; P <.001), and completed a walking test faster at follow-up compared with baseline (−5.0 seconds; P <.001).
Study limitations include the inclusion of patients from a single center.
“[Low-dose radiotherapy] can achieve significant pain reduction and improved musculoskeletal function in the absence of side effects and should be offered to patients with epicondylitis, plantar fasciitis, and finger osteoarthritis who have not responded to at least 6 months of conservative therapy,” study author Susanne Rogers, MD, from Kantonsspital Aarau, in Switzerland told Clinical Pain Advisor.
Eberle B, Rogers S, Vogt D, Meier E, Moser L, Gomez S, et al. Pain relief and gain of function from low dose radiotherapy for epicondylitis, finger osteoarthritis and plantar fasciitis — results of a prospective clinical trial. Presented at: European League Against Rheumatism (EULAR) 2019 Congress; June 12-15, 2019; Madrid, Spain. Abstract 0498.