The 2026 American Radium Society Appropriate Use Criteria states plainly: with regard to LDRT for spine osteoarthritis, limited or no data is available and caution is recommended.
Spinal treatment fields involve proximity to radiosensitive structures (spinal cord, nerve roots, kidneys, gonads depending on level) and greater bone marrow irradiation than peripheral joint treatment. The risk calculus is qualitatively different from treating a peripheral joint.
Physical therapy, core strengthening, oral/topical NSAIDs, epidural steroid injections (for radiculopathy), facet joint injections, and surgical evaluation for structural compression are the established options for spinal OA — managed by primary care, rheumatology, pain management, and spine specialists.
If you also have peripheral joint OA (knee, hip, shoulder), LDRT may still be relevant for those joints. See knee OA, hip OA, shoulder OA, candidacy criteria.
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.