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Experimental treatment eases knee arthritis pain without surgery or pills
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Researchers are testing low-dose radiation to treat the painful symptoms of osteoarthritis in the knee.
The study, published by researchers in Korea and presented at the American Society for Radiation Oncology (ASTRO) annual meeting in September, suggests that a single course of radiation can be a “safe and effective” treatment option.
Knee osteoarthritis is a degenerative joint disease causing pain, swelling and stiffness in the knees that worsens over time.
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The randomized clinical trial enrolled 114 patients with moderate-to-mild knee osteoarthritis who were each assigned a very low dose of radiation, a low dose or a placebo. The only other pain relief used during the study was acetaminophen.
Knee osteoarthritis is a degenerative joint disease causing pain, swelling and stiffness in the knees that worsens over time. (iStock)
The participants went through six sessions as researchers assessed “meaningful improvement” in at least two of the following markers — pain, physical function and overall assessment of condition.
The patients also completed a questionnaire to report pain, stiffness and function. None of them recorded any treatment-related side effects.
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After four months of treatment, 70% of the low-dose participants met the criteria, compared to 42% in the placebo. Those in the very low-dose group saw a 58.3% improvement.
These findings suggest the low-dose regimen “drove relief beyond placebo effects,” experts noted in a press release.
A researcher suggested that radiation therapy could delay the need for joint replacement. (iStock)
In the low-dose group, 56.8% recorded meaningful improvements in pain, stiffness and physical function scores, compared to 30.6% in placebo.
The study concluded that low-dose radiation led to significant reductions in pain and improved function after four months, a “small fraction” of what is typically used to treat cancer.
“For people with mild to moderate disease, this approach could delay the need for joint replacement.”
Dr. Byoung Hyuck Kim, principal investigator on the trial and an assistant professor of radiation oncology at Seoul National University College of Medicine, Boramae Medical Center, noted that people with painful knee osteoarthritis “often face a difficult choice” between the risk of side effects from pain medications and the risks of joint replacement surgery.
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“There’s a clinical need for moderate interventions between weak pain medications and aggressive surgery, and we think radiation may be a suitable option for those patients, especially when drugs and injections are poorly tolerated,” he said in a statement.
Other lifestyle factors, such as weight loss, should be factored into the consideration of low-dose radiation as treatment, according to the researchers. (iStock)
Radiation therapy may be a better fit for patients with underlying inflammation and preserved joint structure, Kim added.
“For severe osteoarthritis, where the joint is physically destroyed and cartilage is already gone, radiation will not regenerate tissue,” he said. “But for people with mild to moderate disease, this approach could delay the need for joint replacement.”
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This treatment should also be considered alongside other lifestyle factors, including weight loss, physiotherapy and medications because responses could be “even stronger when radiation is properly combined with other treatments,” Kim said.
“And patient satisfaction may be higher than with current options alone.”
The study did have some limitations, the researchers confirmed, including the relatively short follow-up period.
The researchers are planning for larger trials to evaluate the outcomes in specific groups of people, comparing low-dose radiation injections with medication regimens.
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Chronic kidney disease has been named the ninth leading cause of global death.
Record numbers of men and women are currently estimated to have reduced kidney function, according to new research following a study published in the journal The Lancet.
Researchers at NYU Langone Health, the University of Glasgow, and the Institute for Health Metrics and Evaluation (IHME) at the University of Washington analyzed the rise of kidney disease worldwide.
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They examined 2,230 published papers and health datasets from 133 countries, searching for diagnoses, mortality and the toll of disability from the disease.
From 1990 to 2023, cases rose from 378 million to 788 million, landing the disease in the top 10 of most deadly diseases in the world for the first time.
The largest risk factors for kidney disease include high blood sugar, high blood pressure and high body mass index (BMI). (iStock)
The research, conducted as part of the Global Burden of Disease 2023 study, also revealed that about 14% of the world’s adult population has chronic kidney disease. About 1.5 million people died from kidney disease in 2023, an increase of more than 6% since 1993.
Most people in the study were in early stages of the disease, which can be improved with drugs and lifestyle changes before dialysis or surgery becomes necessary, the researchers noted.
The research, which was presented last week at the American Society of Nephrology’s annual Kidney Week conference, marks “the most comprehensive estimate of the condition in nearly a decade,” according to the authors.
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Chronic kidney disease causes the kidneys to lose the ability to filter waste and excess fluid from the blood, NYU Langone detailed.
Mild cases may not show any symptoms, but those in the most advanced stages can require dialysis, kidney replacement therapy or an organ transplant.
Chronic kidney disease causes the kidneys to lose the ability to filter waste and excess fluid from the blood. (iStock)
Impaired kidney function was also identified as a key risk factor for heart disease, contributing to about 12% of global cardiovascular mortality.
The largest risk factors for kidney disease, based on the study findings, include high blood sugar, high blood pressure and high body mass index (BMI).
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Study co-senior author Josef Coresh, M.D., Ph.D., director of NYU Langone’s Optimal Aging Institute, said these results classify chronic kidney disease as “common, deadly and getting worse as a major public health issue.”
“These findings support efforts to recognize the condition alongside cancer, heart disease and mental health concerns as a major priority for policymakers around the world,” he said in a statement.
Kidney disease may show no symptoms, yet can ultimately require dialysis or organ transplantation. (iStock)
Study co-lead author Morgan Grams, M.D., Ph.D., the Susan and Morris Mark Professor of Medicine at the NYU Grossman School of Medicine, also commented that chronic kidney disease is “underdiagnosed and undertreated.”
“Our report underscores the need for more urine testing to catch it early and the need to ensure that patients can afford and access therapy once they are diagnosed,” she wrote.
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New medications have recently become available that can slow disease progression and reduce the risk of heart attack, stroke and heart failure, although it may take time to see the global impact, Grams added.
A doctor urged physicians to be more aware of kidney function and the impact of certain medications. (iStock)
Fox News senior medical analyst Dr. Marc Siegel commented on the “dramatic increase” in an interview with Fox News Digital, agreeing that kidney disease is “vastly underestimated and underdiagnosed,” in part due to lack of symptoms in early stages.
“The kidneys are filters of waste and managers of electrolytes and acid/base balance,” said Siegel, who was not involved in the study. “They are very sensitive to changes in blood pressure and blood flow, and can lead to loss of protein and electrolytes when damaged.”
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“High blood pressure, obesity, heart disease, diabetes and low blood pressure all impact basic kidney function, so there is a high degree of secondary kidney disease and failure in addition to primary damage to the kidneys themselves,” the doctor added.
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Siegel urged physicians to be more aware of kidney function and the impact of certain medications.
This study was funded by the National Institutes of Health, the Gates Foundation and the National Kidney Foundation.
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