Low-dose radiation therapy has been used for multiple joints, but the strength of evidence varies considerably. The 2026 American Radium Society Appropriate Use Criteria (ARS AUC) rates the knee as the highest-evidence joint, followed by the hip and shoulder. Smaller joints (hand, thumb, foot, ankle) have strong European practice data but fewer randomized trials. The spine requires particular caution due to limited published data for osteoarthritis specifically.
The knee has the strongest evidence base for LDRT of any joint. Multiple randomized controlled trials — including two double-blind sham-controlled studies — and large U.S. retrospective series show roughly 80% of treated joints meeting the responder criterion (Koneru et al., 2025). The 2026 ARS AUC rates knee osteoarthritis as the highest-evidence indication for LDRT. See the knee osteoarthritis page.
Hip OA is the second-strongest LDRT indication per the 2026 ARS AUC, with strong representation in European clinical series including large German and Dutch practice-based datasets. See the hip osteoarthritis page.
The shoulder is among the top three joints for LDRT evidence per the 2026 ARS AUC. Overall treatment response rates across published series range from 60–90%. See the shoulder osteoarthritis page.
Donaubauer et al. reported 70% pain response at three months in 483 treated patients — one of the largest single-joint LDRT datasets published. See the hand osteoarthritis page.
First carpometacarpal OA is a well-established LDRT target in European practice. See the thumb arthritis page.
Weissmann et al. reported 84% three-month pain response in 196 patients — among the highest joint-specific response rates in the LDRT literature. See the foot and ankle osteoarthritis page.
Plantar fasciitis is an established LDRT indication with decades of European use. The German DEGRO guideline endorses low-dose radiotherapy for plantar fasciitis as standard of care. See the plantar fasciitis page.
The 2026 ARS AUC explicitly recommends caution for spinal osteoarthritis, citing limited published data. See the spine page.
The elbow and other peripheral joints have been treated in European series, but the published evidence base is more limited. See the other joints page.
Related: Am I a candidate for LDRT? | Full evidence review | Find a provider
Medically reviewed by: Robert Warren Floyd, M.D., Ph.D. — Resident Physician, Radiation Oncology, The University of Texas MD Anderson Cancer Center. Last reviewed: August 2, 2026. Independent personal project — not affiliated with or endorsed by MD Anderson Cancer Center. Funding & independence disclosure.