The Value of Roentgen Irradiation in the Treatment of Painful Degenerative and Inflammatory Musculoskeletal Conditions:A Double-blind Study

Abstract

A double-blind trial was carried out to study the effect of roentgen radiation treatment in 104 patients presenting 127 painful disorders of the joints and muscles. 64 disorders received genuine treatment and 63 had sham treatment. Improvement occurred in 59% of the genuinely treated group and in 65% of the placebo group. The results were about the same 2 weeks and 6 weeks after termination of treatment. Thus there was no significant difference between the groups.

Radiation Therapy for Nonmalignant Diseases in Germany

“…[8,26]. Older controlled studies of RT for nonmalignant disorders have been inadequate due to lack of state-of-the-art scientific methods, i.e., lack of appropriate study design, inadequate definition of inclusion and exclusion criteria, incomplete consideration of confounding factors, lack of prospective long-term evaluation and adequate endpoints [3,23,38]. Graves' orbitopathy [15,24] and heterotopic ossification prophylaxis [4,10,11,31,34] are good examples of improved clinical efforts and clinical studies, as RT for nonmalignant diseases will only be broadly accepted if a favorable risk/benefit ratio is established.…”

Use of ‘sham’ radiotherapy in randomized clinical trials

“…Marcus et al 14 15 2 0 1 1 4 Prummel et al 16 2 0 1 1 4 Ciulla et al 17 2 0 1 1 4 Gorman et al 18 21 2 1 1 (suboptimal) 0 4 Prummel et al 22 2 0 1 1 4 MS/ALS Cook et al 23 2 0 1 0 3 Comi et al 24 2 0 1 0 3 Drachman et al 25 2 0 1 1 4 Wiles et al 26 2 0 1 1 4 Devereux et al 27 2 0 1 1 4 Musculoskeletal Valtonen et al 28 2 1 1 0 4 Goldie et al 12 1 0 1 1 3 Other Tyrrell et al 13 2 0 1 1 4 Chantelau et al 29 2 0 1 0 3 Yu et al 30 2 0 1 0 3 Pilepich et al 31 2 0 1 0 3 Restenosis Fritz et al (external RT) 32 2 0 1 1 4 Scheinert et al 33 2 0 1 0 3 Popma et al 34 2 0 1 0 3 Waksman et al 35 2 0 1 1 4 Reizner et al 36 2 0 1 0 3 Teirstein et al 37 2 0 1 1 4 †A method to generate the sequence of randomization will be regarded as appropriate if it allowed each study participant to have the same chance of receiving each intervention and the investigators could not predict which treatment was next. Methods of allocation using date of birth, date of admission, hospital numbers, or alternation should be not regarded as appropriate.…”

Teleradiotherapy of joints in rheumatoid arthritis: lack of efficacy

“…This principle has been used previously for several painful rheumatic conditions. [2][3][4] A double blind, placebo controlled trial of roentgen irradiation in periarthritis of the shoulder and osteoarthritis did not result in significant differences of pain. 4 Only a few reports have investigated the efficacy of such teleradiotherapy in inflammatory arthritides.…”

“…[2][3][4] A double blind, placebo controlled trial of roentgen irradiation in periarthritis of the shoulder and osteoarthritis did not result in significant differences of pain. 4 Only a few reports have investigated the efficacy of such teleradiotherapy in inflammatory arthritides. [5][6][7][8] A high success rate of local doses of 5-7 Gy was reported in comparison with laser therapy and concomitant local glucocorticoid injections.…”