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Do you imagine having hands or feet pain every day? Inflammatory and degenerative musculoeskeletal disorders (MSD) of hand and feet are common causes of pain and functional disability in western countries and there is still no definitive cure. Herein, we present clinical outcomes of 127 with hand or feet degenerative/inflammatory disorders undergoing LDRT for symptomatic pain and functional relief. 

Between April 2015 and August 2021, 127 patients (25 men and 102 women) with a median age 51 years-old were prospectively enrolled. (Table 1)

LDRT comprised of 6 fractions of 0.5-1 Gy on every-other day up to a total dose of 3-6 Gy. Clinical response was evaluated according to the visual analogic score (VAS) for pain level and to the von Pannewitz score (VPS) for joint functionality. Those patients not reaching subjective adequate pain relief after 12 weeks from treatment were offered a second identical LDRT course.

With a median follow-up of 10 months (range 1-43) and starting with a median VAS before treatment of 8 (range 3-10), 80% of the patients referred improvement of the pain describing median VAS at 3, 6 and 12 months of 4 (range 0-9), 2 (range 0-9) and 2 (range 0-9), respectively, being this reduction statistically significant (p<0.001) (Image 1). Eighty-five patients (67%) needed a second course of treatment at a median time interval of 13.6 weeks (range 7.4-21).

70% of patients reported functionality improvement after LDRT according to von Pannewitz score.

In the univariant analysis we did not find any differences between variables.

No acute or late complications were observed.

LDRT appears to be safe and useful for hand and feet degenerative/inflammatory MSD associating good rates of pain relief and functionality improvement without treatment related toxicities. However, further studies are necessary to confirm these promising results.