What's reported in the research, and the questions worth asking your radiation oncologist
Low-dose radiation therapy (LDRT) uses a small fraction of the dose used in cancer treatment, but it's still radiation, so it's worth understanding what's actually been reported.
Many patients report few immediate side effects and can return to usual activity right after treatment. Temporary skin irritation, fatigue, or other local effects are possible, depending on the body area treated. Serious short-term side effects appear uncommon in published studies, but a radiation oncologist should review both short- and long-term risks before treatment.
A 2025 systematic review and meta-analysis that pooled 12 studies involving about 1,750 patients found that most adverse events were similar between the LDRT and comparison groups, although mild nail reactions were reported more frequently with LDRT.[5]
Hair loss is not a side effect reported with LDRT for osteoarthritis. It's generally associated with radiation passing through hair-bearing skin at meaningfully higher doses, most familiar from whole-brain radiation therapy for brain tumors. LDRT targets joints such as the knee, hip, hand, shoulder, elbow, ankle, or foot at a small fraction of that dose, so it isn't expected to affect hair anywhere on the body, including at the treatment site.
Patients are not radioactive during or after treatment. LDRT for osteoarthritis is delivered by external beam, the same basic type of machine used for diagnostic X-rays and most cancer radiation therapy. The machine produces radiation only while it's switched on and aimed at the treatment area; it doesn't linger in or on the body afterward. Patients don't need to limit contact with family, including children or someone who is pregnant. This is different from treatments like radioactive iodine or some brachytherapy implants, where the patient does carry radioactive material for a period and does need to follow specific precautions. LDRT for osteoarthritis is not one of those treatments.
A typical LDRT course uses about 3 Gy divided over six treatments, substantially lower than the total dose commonly used in cancer treatment (often 40 to 80 Gy, depending on the cancer type), though dose alone does not determine risk. Age, treatment location, the amount of normal tissue exposed, and individual health history also matter.
Long-term clinical experience has not identified a clear signal of increased radiation-induced cancer after LDRT for osteoarthritis. However, available studies are not large enough to rule out a very small risk completely. No dose of ionizing radiation is considered entirely risk-free, and a radiation oncologist should discuss how the expected benefit and potential risk apply to the individual patient.
For education only. LDRT is not right for every patient. Talk with your doctor about whether it makes sense for your situation.
References:
5. Hammadeh BM, et al. Efficacy, safety, and pain management of low-dose radiation therapy in osteoarthritis: a comprehensive systematic review and meta-analysis. 2025. PubMed