Orthopedics-Online

X-ray stimulation

What's this?

The term X-ray stimulus irradiation describes a treatment option that is used for a wide variety of clinical pictures (especially inflammatory overload reactions of the musculoskeletal system, see below) and makes use of the therapeutic effect of X-rays. The terms orthovolt therapy, pain radiation or X-ray depth therapy are also used as synonyms.

X-ray stimulus irradiation has been used for many decades and is intended to activate processes in the tissue that slow the progression of the disease and can initiate the body's own healing mechanisms. This includes, for example, the inhibition of immune cells, which are decisive for the development of an inflammatory reaction, and of fibroblasts, which are responsible for the formation of scars. On the other hand, blood circulation is also promoted, which facilitates the healing process.

From the points mentioned it can be deduced that the X-ray stimulus irradiation represents a rather symptomatic treatment: This means that usually not the causes of the disease are treated, but only the inflammatory side effects. For a long-term success of the treatment it is therefore necessary to keep this aspect in mind and, if necessary, to eliminate the triggering factors for the disease as comprehensively as possible.

Indications

X-ray stimulus irradiation is used for various diseases. It is an option worth considering, especially for patients in whom treatment attempts with pain medication or even operations have not shown any decisive effect.

Read more on the topic: osteoarthritis therapy

The diseases for which X-ray stimulus irradiation can be suitable primarily include degenerative joint diseases that are accompanied by an inflammatory reaction and thus chronic pain, e.g. Osteoarthritis of the hip, knee or shoulder. Other diseases that are associated with an inflammatory reaction and for which X-ray stimulation can therefore be considered are bursitis (Bursitis) in the joint areas, shoulder joint calcifications, heel spurs, Achilles tendon irritation or overload reactions such as tennis elbow.

In addition, under certain circumstances, the psoriasis (Psoriasis), as well as Dupuytren's disease, X-ray stimulation can be useful.

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procedure

X-ray stimulus irradiation is usually carried out at specialized radiation clinics under the direction of specialists in radiology. Often there is close interdisciplinary cooperation with specialists from other areas (e.g. orthopedists).

After the indication for X-ray stimulation has been checked by the specialist, the exact radiation dose, the number of sessions and the direction of the radiation are determined. Subsequently, radiation-sensitive body regions such as the thyroid or the genital or abdominal region are covered with lead aprons to protect them from the radiation. The X-ray stimulus irradiation itself lasts only a few minutes or even seconds.

As a rule, the X-ray stimulus irradiation is carried out in a series of 6-12 sessions with 2-3 sessions per week. In principle, the same devices are used as in radiation therapy for cancer, but the radiation dose per session is between 0.5 and 5 Gray (for heel spurs, possibly up to 20 Gray), while for cancer, doses of 40-70 Gray are used becomes.

If there is no improvement, another series can be carried out after a break of several months.

Risks

The risks and side effects of X-ray stimulus irradiation are to be regarded as very low compared to pain relieving medication. Since, in contrast to taking tablets, no active ingredients are introduced into the organism during X-ray stimulation, no direct systemic (i.e. affecting the whole body) side effects can be generated. Only locally, i.e. at the point of irradiation, is there the possibility of skin irritation in the form of reddening or dry skin. In order to avoid or at least alleviate these skin symptoms, it is advisable to consult the radiation therapist in charge of adequate skin care.

Read more on the topic: Dry skin - causes and care tips, skin changes

The long-term risks of X-ray stimulation must be distinguished from this. Despite the extremely low radiation dose, radiation therapy increases the risk of developing tumors or organ disorders to a small extent. This aspect makes regular follow-up examinations of the patients treated in this way necessary for a period of at least 6 months after radiation.

In children and pregnant women, X-ray stimulation should not be performed and medical or surgical therapy should be used.

Is that a cash benefit?

X-ray stimulation is a recognized service provided by statutory and private health insurance companies. However, a referral from a specialist is usually required: You should therefore e.g. In the case of joint pain, first present to a resident orthopedic surgeon, with whom you can then discuss the possibility of X-ray stimulation and who can then issue a referral if necessary.

If there is no noticeable improvement in the symptoms after several cycles of radiation therapy, the health insurance company may no longer take on any further cycles. In this case, you should, if necessary, send an inquiry to your health insurance company in advance to cover the costs.

X-ray stimulation of the shoulder

Chronic shoulder pain is often caused by calcification or irritation of the bursa or tendon attachments, as well as inflammation of the joint area (arthritise.g. as part of a arthrosis). In addition to the pain, the patients mostly complain of functional limitations in the shoulder joint. The diseases mentioned are usually first attempted to be treated with the help of physiotherapy and painkillers and anti-inflammatory drugs or by injecting cortisone and local anesthetics (local anesthetics).

Read more on the topic: Cortisone therapy for joint diseases, therapy of osteoarthritis

If these conservative attempts at treatment are unsuccessful, X-ray stimulation is an alternative to surgery. The aim of the irradiation is to promote blood circulation and thus the body's self-healing mechanisms, while the immune cells involved in the inflammatory reaction are inhibited. In the case of osteoarthritis, however, it is important to note that radiation therapy does not treat the osteoarthritis itself, but rather only inhibits the accompanying inflammatory reaction.

X-ray stimulation for osteoarthritis

Osteoarthritis, i.e. joint wear and tear, is one of the most common areas of application for X-ray stimulation. The hip, knee or shoulder joints are most frequently affected. Osteoarthritis is often associated with an inflammatory reaction of the joint, which is then referred to as "activated" osteoarthritis. This inflammatory reaction often occurs together with an effusion within the joint capsule and causes pain and movement restrictions in the affected joint.

In order to alleviate these symptoms, an X-ray stimulus irradiation can be considered as a supplement or as an alternative to physiotherapy and pain reliever and anti-inflammatory medication. It should be noted, however, that radiation therapy is only a symptomatic treatment option: It can inhibit the inflammatory reaction in the joint area and thereby alleviate pain and functional restrictions, but it does not affect the condition of the bones forming the joint - in contrast to, for example, surgical joint replacement.

Read more on the topic:

Surgery for osteoarthritis
Hip prosthesis
Shoulder prosthesis

The success of treatment with X-ray stimulation depends heavily on the extent of the osteoarthritis. A very advanced joint wear and tear as well as long-lasting pain in the joint (> 1 year) are considered negative prognostic factors.

Read more on the topic: Exercise for osteoarthritis

X-ray stimulation for a tennis elbow

The term tennis elbow describes a painful irritation of the tendon attachments radial humerus (thumb side) protrusion (Epicondyle) at the elbow joint. The cause does not necessarily have to be an extensive tennis game - misuse or overloading through other racket sports or at work (keyboard or mouse use during office work) can lead to such a clinical picture. In addition to the pain, there is usually a restriction in movement of the elbow joint.

In most cases, the tennis elbow is initially treated with pain reliever and anti-inflammatory medication as well as rest. If these measures are unsuccessful, X-ray stimulation can be an alternative to surgical therapy. Since tennis elbow is an inflammatory condition without structural damage to the joint bones, X-ray irradiation is - unlike osteoarthritis - a causal treatment option that treats the disease itself, and not just its symptoms.

Read more on the topic:

Bandage for a tennis elbow
Stretching exercises for a tennis elbow
Operation of a tennis elbow
Shock wave therapy to treat tennis elbow

X-ray stimulation of the heel in the case of heel spurs / plantar fasciitis

X-ray stimulation can be performed on the heel to treat a heel spur.The term heel spur is a bony extension in the heel area. A distinction can be made between the upper (rear) heel spur at the heel bone attachment of the Achilles tendon and the lower (front) heel spur in the attachment area of the tendon plate of the sole of the foot on the heel bone. The latter is occasionally associated with inflammation (Plantar fasciitis) socialize with this tendon plate. Both subspecies of the calcaneal spur are mostly expressed by stabbing pain when the calcaneus is loaded, i.e. mainly when walking and standing.

X-ray irradiation for treating heel spurs (with or without plantar fasciitis) can be considered especially if previous attempts at treatment with painkillers and anti-inflammatory drugs or cortisone injections have not been successful. The decision on radiation therapy should not be waited too long (a maximum of about 6 months), as the longer the pain, the less effective the X-ray stimulus irradiation. Radiation therapy for the heel spur usually includes 12 sessions and is carried out with a radiation dose of up to 20 Gray. This relatively high dose is necessary because in the case of heel spurs - in contrast to activated osteoarthritis or tendinitis, for example - superfluous bony tissue is to be destroyed and its breakdown stimulated.

Read more on the topic:

Shock wave therapy for heel spurs - does it work?
Surgery of a calcaneal spur
Home Remedies For Heel Spurs - Which Are The Best?

X-ray stimulation in the case of achilles tendonitis

In the case of an Achilles tendon inflammation - similar to tennis elbow - an inflammatory reaction occurs in the area of the attachment of the Achilles tendon on the heel bone due to incorrect or overloading. It therefore often occurs in long-distance runners, especially when the amount of training increases rapidly. Achilles tendonitis often results in an effusion and manifests itself in pain and restricted mobility.

In addition to pain relievers and anti-inflammatory drugs as well as rest and physiotherapy, X-ray stimulation can be an effective treatment option. It is gentler and less risky for the tendons than the injection of cortisone, which can further increase the risk of a tendon rupture, which is already higher in the case of Achilles tendonitis, and is therefore extremely controversial among doctors. X-ray stimulation for the treatment of Achilles tendonitis usually consists of 12 sessions.

Read more on the topic: