Background Low-dose radiotherapy (LD-RT) has been reported to alleviate symptoms in osteoarthritis (OA) by modulating soft tissue inflammation. While supported by experimental and guideline-based evidence, its clinical effectiveness in everyday practice remains debated, particularly in Germany.

Methods A nationwide postal survey was conducted among 6,943 practicing physicians in Germany, including orthopaedic surgeons, hand surgeons, general practitioners, and radiotherapists. A standardized three-question questionnaire assessed estimated annual LD-RT usage, rates of symptom resolution, and the need for a second treatment series. Responses were returned via fax and analyzed descriptively.

Results A total of 618 physicians (response rate: 8.9%) reported treating 37,754 OA patients annually with LD-RT, averaging 61 patients per physician (median: 20). Across all respondents, the mean reported rate of long-term symptom relief was 45%, with a second LD-RT series administered in 47% of cases. Reported effectiveness varied by specialty: general practitioners (59%), radiotherapists (58%), orthopaedic surgeons (44%), and hand surgeons (31%).

Conclusions This physician-reported survey suggests that LD-RT is perceived as a moderately effective intervention for osteoarthritis, typically used as a last-resort therapy. Its reported effectiveness in nearly half of treated patients supports the rationale for broader clinical evaluation, and potentially earlier use in the treatment course. Further prospective trials are needed to validate these observational findings.

The authors have declared no competing interest.

did not receive funding

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