A study co-authored by IORBC Clinical Chair M. Heinrich Seegenschmiedt has found protracted pain improvement with low-dose radiotherapy is possible in painful shoulder syndrome.

The article, titled ‘Radiotherapy for painful shoulder syndrome: a retrospective evaluation’, was co-authored by Seegenschmiedt together with Ronny Leist, Oliver Micke, Irenaeus A. Adamietz, Kashyar Fakhrian, and Ralph Muecke.

The purpose of the retrospective clinical quality assessment was to evaluate the efficacy of low-dose radiotherapy for painful shoulder syndrome from an orthopedic perspective. It found protracted pain improvement with low-dose radiotherapy is possible in painful shoulder syndrome — and that patients with refractory pain because of subacromial syndrome or shoulder osteoarthritis should also be evaluated for radiotherapy.

Patients with painful shoulder syndrome were recruited for the assessment from January 2011 to December 2017 and treated with a linear accelerator or orthovoltage device. Individual doses were 0.5–1.0 Gy and total doses were 3.0–6.0 Gy.

Response was assessed via the von Pannewitz score with five levels as outlined below. Within this scale, “good treatment success” was defined as “significantly improved” and “symptom free”.

- “Worsened”
- “Unaffected”
- “Improved”
- “Significantly improved”
- “Symptom free”

Within-group and between-group differences were statistically evaluated. An overview of the approach and results are provided below:

• 236 total patients recruited (150 women, 86 men, mean age 66)

• 180 underwent radiotherapy with a linear accelerator

• 56 underwent radiotherapy with an orthovoltage device

• Fractionation was 12 × 0.5 Gy in 120 patients

• 6 × 0.5 Gy in 74, and 6 × 1 Gy in 42 patients

• Directly after radiotherapy, 30.9% (73 patients) had "good treatment success", which increased to 55.2% (90 patients) at follow-up

The report concludes that the study findings are in line with previous literature, that is, for those patients with painful shoulder syndrome, protracted pain improvement is possible via low-dose radiotherapy.

Access the full report at this link: Radiotherapy for painful shoulder syndrome: a retrospective evaluation.