There are many causes of chronic pain and, as a result, there is a broad range of different treatment types that can provide a lifeline to some people living with pain symptoms.

One of these is low-dose radiotherapy, which is particularly effective at helping alleviate musculoskeletal pain very quickly and very effectively.

Unlike radiotherapy for cancer care, these radiotherapy sessions are typically undertaken either as required or on an occasional basis, take a matter of seconds to complete and are entirely non-invasive. 

Many people are likely to start feeling the benefits before the treatment course is over and continue to enjoy a pain-free life for a long time afterwards, but because chronic pain has many different causes, the journey to recovery can look and feel different for different people.

One aspect of this is that some people will feel better and recover as the radiotherapy course is taking place, but others will notice a more intense spike in pain that gets better and leads to a less painful baseline.

Despite being very different sensations, they often both signify a road to recovery, but to understand why, we need to explore chronic pain, its causes and why radiotherapy can help in the first place.

What Is Pain?

Defining pain is both extremely easy and almost impossible, because whilst we intuitively know that pain hurts, we all feel pain differently and pain episodes will sometimes feel different to each other even if they have the same cause.

This is because pain is best defined as a biopsychosocial phenomenon; pain is not only caused by biological phenomena such as injury or tissue damage but is also caused or intensified by psychological factors and environmental conditions.

The British Pain Society notes that whilst acute pain is typically a warning signal to highlight that a body part is hurt or an infection is making you ill, chronic and intermittent pain often has no useful purpose and can be caused by a wide range of factors affecting nerve signals.

Pain is often situational, which is why people in a flight-or-fight situation may not feel pain when they are in that crisis situation even if they feel it afterwards.

When Can Low-Dose Radiotherapy Help Chronic Pain?

Chronic pain has a wide variety of causes and a major part of pain management and treatment is working out the root cause of chronic pain. Some of these causes can be effectively treated through radiotherapy, especially if medication and physiotherapy have proven to be ineffective.

One condition that radiotherapy has proven to be effective at treating is osteoarthritis, one of the most common chronic pain disorders in the world.

Recent research into the causes of arthritis symptoms notes the effect of inflammation on the progression and pain of the disease, and the anti-inflammatory nature of low-dose radiation makes it an ideal non-invasive treatment that has proven to be effective for many people.

It can also help with other, similar conditions involving soft tissue pain such as plantar fasciitis, as well as treating chronic pain and swelling around the joints, something that not only relieves pain but can improve range of motion as well as quality of life.

Finally, radiotherapy can sometimes be used palliatively in order to relieve the pressure and symptoms of a cancerous tumour by shrinking it, usually when it is considered to be otherwise inoperable.

Can Low-Dose Radiotherapy Cause Pain?

In the overwhelming majority of cases, radiotherapy is instant, painless and the effects can be felt very quickly, due to the targeted nature of the radiation used. 

However, there are a few very rare cases where a chronic pain relief treatment can cause pain to increase as a sign that it is effectively treating the condition causing chronic pain.

The principle is similar to delayed onset muscle soreness (DOMS), the pain felt following a workout that is typically caused by the same microscopic tears to muscles and ligaments that lead to muscle growth.

In some cases, chronic pain recovery is about activating parts of the body’s recovery and recuperative systems to restore function and lead to long-term benefits.

In those cases, and a doctor will let you know if that is likely to be the case, the pain is a sign that the joint, soft tissue or other area in the body is effectively responding to treatment. The pain will go away, and it will often lead to significant relief in chronic pain.

This is not always the case, and if you do not feel a spike in pain but do feel pain relief of chronic symptoms, that is just as effective a sign of recovery.

Every single part of cancer care is an essential part of ensuring the best possible outcomes for recovery, which starts as soon as possible when cancer is suspected and does not always end after the final visit to our internationally renowned radiotherapy centre.

There are no two identical cancer care journeys; even two people with the same treatment plan and course of radiotherapy may not necessarily have an identical road to recovery because their health and individual circumstances can sometimes be very different.

This is particularly true when travelling internationally for cancer care, and because of this, we prioritise the complete patient experience from assisting in preparation for their arrival to helping with extended stays, ensuring your support network can be there and putting you in the best possible place for recovery.

The most important factor in recovery is following the treatment plan, attending every radiotherapy session and following the advice of your care team between sessions, but once you reach the end of a particular course of treatment.

The after-effects of radiotherapy will start to go away gradually as your healthy cells recover from the effects of therapy. Whilst your cancer team and doctors will provide tailored health and advice, here are some of the best ways to boost your recovery and support the healing process.

Go At Your Own Pace

The end of cancer treatment is a period of upheaval and transition, and whilst the goal for many people is to get back to normal, it is important to listen to your body and mind, and go at their pace.

Radiotherapy continues to work to destroy cancer cells for weeks or even months after your final appointment, so it is essential to be gentle to yourself and move towards your new normal gradually.

Never feel guilty if you need to rest or take breaks and do not feel like you need to rush back to work or return to anything you do not feel quite ready for. You will get there but it may take more time than you may expect.

Exercise When You Are Ready And Able

During the prehabilitation stage leading up to your first radiotherapy sessions, as well as during and after your course of treatment, we recommend getting active when you feel like you can, and a physiotherapist will often be available as part of a multidisciplinary care team.

Once you get going, exercise can be very beneficial to your energy levels, physical health, mood and wellbeing. It can also boost your circulation, which itself helps with your recovery considerably.

This does not have to be an intensive, regimented workout, although some people can find that helpful. Gentle stretches, walks in the park and light aerobics can all help with the healing process and can be built upon to have a massive effect on your overall health.

If you have any questions about when and how to exercise post-treatment, do not hesitate to contact your cancer care team, as they will be able to answer any questions you may have and provide advice on how to listen to your body and avoid overtraining when you are still healing.

Focus On Hydration

One of the first pieces of advice you will receive from your radiotherapist is to keep hydrated, and that will continue to be true long after treatment.

There are various reasons for dehydration during cancer treatment, but keeping a bottle of water to hand to drink whenever you need it can help a lot with reducing fatigue, dizziness and nausea.

You may be recommended electrolyte powders, drinks and tablets, which can help restore the minerals that are typically lost through sickness, nausea and sweating.

Similarly, try to reduce and minimise alcohol and caffeine intake, as both can potentially cause or exacerbate dehydration.

Eat A Nutritious Diet

Nutrition is a key part of recovery, and this is especially true when it comes to recovering from intensive treatment.

Eating a balanced diet or one advised by your dietitian will help keep your energy levels high, provide you with adequate nutrition to ensure that your body can recover more quickly and help to improve your mood and mental health.

Find the right meal plan to suit you; if you are struggling to get your appetite back, start with smaller meals eaten more frequently.

Take Care Of Your Skin

You will receive advice early into your treatment regarding ways to take care of your skin during radiotherapy, and you should keep following them for at least a few weeks following your cancer treatment, as any changes to your skin will peak then.

If you have any questions, please get in touch with your cancer care team or cancer support services, as they will be more than happy to help you as you navigate the road to recovery.

Following a diagnosis of cancer or a benign tumour that requires radiotherapy to treat, most people will have a lot of questions and uncertainty about what to expect when it comes to the next steps of their treatment.

For many people, there will be quite a few changes to their lifestyle, but your cancer multidisciplinary team will be there to help manage all of your needs and ensure that you receive the best possible treatment based on decades of evidence and expertise.

In a lot of cases, the primary treatment will be doses of radiotherapy provided every weekday for a set number of weeks, with breaks taking place during weekends.

In most cases, you will receive short daily treatments using radiation scheduled around your other priorities, although this can vary depending on the type of treatment you are having.

Here are the reasons why radiotherapy is provided on a daily basis, why there might be exceptions to this and what to expect throughout your course of treatment at our clinic.

Why Is Radiotherapy Administered Every Day?

In the vast majority of cases, your radiotherapy team will provide small doses of radiation that build up over the total course of treatment to gradually kill cancer cells whilst preserving as much healthy tissue as possible.

This is often known as fractional radiation because the total dose of radiation was traditionally split into fractions of equal intensity, although most clinics today will typically describe a course of treatment in terms of visits to a hospital or clinic.

There are a lot of reasons for this, but by far the most important is that it is a much safer and more effective way of providing radiotherapy treatment.

The pioneering radiotherapist Henri Coutard developed what was known at the time as the “protracted-fractional method” after he found that radiation administered over time was more effective at killing cancer cells without the often dangerous side effects of acute doses of radiation.

A beneficial side effect of this is that fractional radiotherapy treatment is painless, quick and will allow people to get on with their day and get everything done that they need to.

The standard dosing schedule is five daily doses a week administered in sessions every weekday, with a break at weekends to allow the body to recover.

Are There Any Exceptions To This?

In many cases, cancer treatment is personalised and tailored to meet the needs of the person receiving treatment. Your treatment plan will take into account your health, any existing conditions, the stages of cancer and where it is located.

Most of the time, a daily schedule of radiotherapy over the course of between two and eight weeks is the most appropriate option, but this is not always the case and one of the main focuses of research in the field of radiotherapy concerns alternative treatment schedules.

Some cancer types, including those that affect the head and neck, will often have twice-daily treatments, typically administered at least six hours apart, which allows for more recovery time by dividing the dose further.

Accelerated fractionation works on the same principle but instead of following the same schedule, as many doses as possible are given as quickly as is safe, which may include weekend treatments to ensure someone is treated as quickly as possible.

Conversely, some types of cancer are treated using fewer radiotherapy sessions but with significantly higher doses of radiation.

This is most notably seen with stereotactic radiosurgery (often known as Gamma Knife), which is typically a single session of treatment that can take up to four hours or more to complete.

Some other cancers can be treated in a similar way or with higher doses provided every other day over a shorter course of treatment. Whether this is possible will depend a lot on the type of cancer and where it is located.

Finally, palliative radiotherapy intended to relieve symptoms is typically given less often, as the goal is not to destroy the cancer but to shrink it in order to relieve symptoms.

What Should You Expect From Radiotherapy Sessions?

A radiotherapy session is typically very short, with the total amount of time you will spend in the clinic ranging from 15 minutes to an hour, although only a small amount of that will be spent undergoing radiotherapy.

The preparation, which typically involves changing into a hospital gown and moving into position to ensure that the radiation beam is precisely positioned, will often take longer than the treatment itself, which usually only takes a few minutes.

You will need to keep as still as possible, although you should breathe normally. It will otherwise look and feel like a medical scan and is typically painless.

Our team will guide you through every stage and ensure that you’re comfortable during each visit. Contact us for more information.

The versatility of specialist radiotherapy treatment means that whilst it is primarily associated with cancer care, it can and has been widely used to treat a wide range of benign and non-malignant diseases.

A particularly unusual but vital example of this is that radiotherapy can be used to help treat people affected by heterotopic ossification, a condition which causes bone to grow in tissue and parts of the body where it is not meant to.

It is relatively uncommon and even less common for it to be substantial enough to cause problems, but it is a condition that radiotherapy can help with as part of a complete course of treatment.

Here are the causes of heterotopic ossification, how it is diagnosed and how radiotherapy can help treat it.

What Causes Heterotopic Ossification?

Heterotopic ossification can be either a separate condition or a symptom of another disease or injury. These are typically classified as genetic and nongenetic, and the former is significantly rarer than the latter.

Genetic heterotopic ossification is any bone growth in soft tissue that is caused by a genetic condition such as progressive osseous heteroplasia, where extra bone develops inside skin, tissue, muscles and other deep tissue where bone should not form.

Another genetic condition, fibrodysplasia ossificans progressiva, is extremely rare, and causes the body to repair minor damage such as bruising or cuts by developing bone instead.

Outside of rare genetic disorders, more localised forms of heterotopic ossification can sometimes occur following traumatic injury, fractures, amputation or major surgery such as hip or joint replacement.

In these cases, following significant damage to the bone, some abnormal bone growth can sometimes occur, causing swelling, tenderness and pain around the fragments of bone.

Whilst still relatively uncommon, it is most commonly a side-effect of joint replacement surgery, where the bone will grow around the metal plates or joints.

When Does It Need Treating?

Much like the relatively similar bone spurs, nongenetic heterotopic ossification typically only needs treatment if it is causing issues with pain or movement, such as by creating painful swellings or forming around a joint to restrain movement.

In the case of fibrodysplasia ossificans progressiva, many treatments that would be used for nongenetic ossification are typically not recommended, as the typical healing process for surgery and other similar treatments would lead to further bone growth and progression.

Typically, a treatment plan for heterotopic ossification will be formed following examination from a specialist in consultation with a multidisciplinary team, using a range of scans and tests to determine the cause and ensure that treatment would be the best course of action.

How Is Heterotopic Ossification Treated?

In some cases it is not treated at all, if the amount of unexpected bone growth is small, there is little risk of progression and it is not causing any problems, it may be possible that no treatment is recommended.

Outside of this, heterotopic ossification often requires tailored treatments based on how the bone forms and the cause of the ossification, in order to avoid any potential future issues as much as possible.

At the lowest level of progression and risk, a doctor may prescribe physical therapy or pain relievers, which help to relieve inflammation, manage pain and increase the range of motions around joints.

Some nonsteroidal anti-inflammatory drugs can stop bone cells from being formed, which can be effective at preventing significant further growth, as can the use of the blood thinner warfarin in some limited incidences as it can reduce the effectiveness of vitamin K.

In some cases, where there is a concern about progression, corticosteroids may also be prescribed to slow down the rate of bone growth, and this is part of the typical course of treatment for genetically progressive forms of the condition.

Radiotherapy treatment can also be undertaken as a form of preventative treatment following surgery that risks the formation of heterotopic ossification in order to stop additional and unwanted bone growth.

In more severe cases where the quality of a person’s life is being significantly affected by the additional bone growth, surgery to remove the excess bone can sometimes be recommended, typically in combination with radiotherapy to stop it from growing back.

This is typically seen as a treatment of last resort, is not recommended for progressive genetic form of bone growth and is typically only undertaken if there are no alternatives, following the maturation of the bone.

If surgery is performed too quickly, then the bone will keep growing, undermining the surgery and often requiring an additional procedure and extending recovery time.