Peter Attia MD - Radiation for Arthritis, Tendonitis, and Injuries: The Unexpected Benefits | Sanjay Mehta, M.D.
The discussion focuses on using low-dose radiation therapy to treat conditions like tendonitis, osteoarthritis, and plantar fasciitis. This method, prevalent in Germany, involves administering a very low dose of radiation, similar to the anti-inflammatory effects of cortisone shots but potentially longer-lasting. The treatment involves six sessions over two weeks, with a success rate of 60-80% in pain reduction, and up to 90% after a second course. The therapy is non-invasive, allowing patients to continue their daily activities without interruption. Practical applications include treating chronic conditions that have not responded well to traditional therapies, offering a new avenue for pain management without the side effects of medications.
Key Points:
- Low-dose radiation therapy offers anti-inflammatory effects similar to cortisone shots.
- Treatment involves six sessions over two weeks, with a high success rate in pain reduction.
- The therapy is non-invasive and allows patients to maintain their daily activities.
- Particularly effective for conditions like plantar fasciitis and tendonitis.
- Widely used in Germany, with potential for broader application in the US.
Details:
1. 🩺 Personal Insights and Therapy Choices
- The discussion around using radiation to enhance tissue began approximately two years ago, highlighting a longer-term exploration of therapy options.
- The speaker experienced mild tendonitis in the Achilles tendon, sparking a search for alternative therapies to alleviate the condition.
- Despite initial skepticism, the possibility of using radiation as a therapeutic option was considered, reflecting a willingness to explore unconventional treatments.
- Frequent travel to Houston for therapy was deemed impractical, indicating a preference for more accessible and locally available treatment options.
2. 🌎 Radiation Therapy: Global Use and History
- Radiation therapy was widely used in the U.S. until around 1970-1980, marking a significant era of medical treatment evolution.
- In Germany, approximately 20,000 to 50,000 patients annually receive low-dose radiation therapy for musculoskeletal conditions such as tendinitis and osteoarthritis.
- In addition to Germany, several other European countries continue to employ radiation therapy, reflecting its sustained relevance in certain medical practices.
- The research landscape is predominantly observational, with few randomized trials, highlighting a gap in controlled scientific validation but indicating a reliance on empirical evidence.
3. 🌟 Radiation Therapy Mechanism and Protocol
- Low-dose radiation therapy can have an anti-inflammatory effect similar to a corticosteroid dose.
- The protocol involves administering a very low dose of 50 CentiGray (cGy) or 50 RADS, given six times over two weeks.
- The cumulative dose is 3 Gray (Gy) to the affected joint.
- A low energy machine, such as Electron Beam radiation, is used, especially for small areas like the hand.
- The total dose for this therapy is significantly lower than typical cancer radiation doses, which can involve 40 Gy, such as in breast cancer treatments.
- The treatment is delivered in a superficial manner, effective for conditions affecting areas like the hand.
4. 📊 Effectiveness and Application Protocols
- Electron Beam Therapy is effectively used for treating superficial skin cancers by adjusting electron energy to target specific areas like knuckles or temples, avoiding deeper tissue impact.
- Historically, Ortho voltage machines utilized kilovoltage x-rays for superficial treatments, whereas modern technology employs megavoltage x-rays for deeper penetration, marking a significant advancement.
- The German protocol for treating affected joints involves administering half a gray of radiation thrice a week (Monday, Wednesday, Friday) for two weeks, focusing solely on affected areas.
- This approach is noted for its anti-inflammatory effects, similar to cortisone or NSAIDs, with a 60-80% success rate in pain reduction after 12 weeks.
- Retreatment after 12 weeks, as per the German protocol, boosts success rates to over 90% in terms of pain reduction.
5. 👣 Plantar Fasciitis: Treatment and Personal Experience
- Approximately 70 plantar fasciitis cases treated, showing extensive experience in handling the condition.
- Patients often endure symptoms for years before treatment, highlighting the importance of early diagnosis and intervention.
- Successful treatment has enabled surgeons who previously struggled with standing to return to their duties after six sessions, showcasing the treatment's effectiveness.
- Patients experienced almost immediate relief within a week of their final treatment, demonstrating rapid recovery and effectiveness.
- Utilized a combination of physical therapy, orthotic support, and shockwave therapy, which contributed to significant pain reduction and improved mobility.
- Patient testimonials indicate high satisfaction levels and significant improvements in quality of life after treatment.
6. 💬 Patient Experiences and Recovery Stories
- A radiation ecologist experimented with radiation therapy inspired by German data for his Achilles tendinopathy. He successfully recovered without a limp after applying radiation on one side and using steroids with PRP on the other, suggesting radiation as a viable treatment option.
- High hamstring tendinopathy treatment using radiation demonstrated significant success, especially in women, with a protocol of 3 Gray over six treatments in two weeks. This method showed longer-lasting effects compared to traditional cortisone shots, highlighting radiation's potential as a superior alternative.
- Radiation therapy effectively addresses the cytokine storm in arthritis, offering a non-invasive alternative to steroid injections. This treatment reduces risks such as tendon rupture, a common issue with multiple steroid injections, making it a safer long-term solution.
7. 🔍 Keloid Treatment and Broader Applications
- Keloid treatment is non-invasive and allows patients, including athletes, to continue their daily activities without interruption. This treatment is especially advantageous for those who cannot afford downtime.
- A crucial aspect of the treatment is the immediate application of radiation following surgical resection to prevent keloid recurrence. Radiation is ineffective on intact keloids.
- The necessity of administering the first radiation dose on the same day as surgery is emphasized to inhibit fibroblast proliferation.
- Cosmetic outcomes post-radiation are favorable, as scars remain flat and dermatitis-free, ensuring patients are not burdened by visible damage.
- Awareness of this treatment is limited, causing unnecessary distress for those with keloids, especially on exposed body parts.
- The treatment's principles have broader applications for chronic conditions such as tennis elbow, golfer's elbow, Achilles tendinopathy, and hamstring tendinopathy, which affect one in seven people and pose significant socioeconomic challenges.
- Chronic conditions can diminish quality of life and restrict physical activity, potentially worsening other health issues.
- Treatment durability for osteoarthritis at the AC joint varies, with some patients requiring annual treatments based on their anatomical needs.
8. 🩺 Treating Diverse Conditions with Radiation
- Radiation treatment for osteoarthritis has shown varying effectiveness depending on structural issues, with some patients experiencing relief lasting months to years.
- German studies suggest the possibility of two retreatments due to the low radiobiological dose, indicating a potential for periodic usage.
- Anecdotal evidence from a doctor who treated his own neck, shoulder, and spine suggests long-term effectiveness without the need for retreatment over 15 years.
- Radiation appears to be more effective than cortisone shots for certain conditions, providing longer-lasting relief.
- Rheumatoid arthritis and gouty arthritis cases have been treated with radiation, targeting specific inflammatory joints with positive outcomes.
- While not a cure for systemic diseases, radiation can provide significant relief for localized inflammatory symptoms, particularly if applied early in the disease progression.