Review Article

Focused Ultrasound (FUS) for Chronic Pain Management: Approved and Potential Applications

Table 1

HIFU for pain management.

SiteGuideFUS applicationTargetOngoing clinical trialsPublished resultsStage

CNSMRChronic neuropathic painThalamus (CL nucleus)NCT03111277[51,52]Human
MRChronic pain from spinal cord injury
MRPhantom limb pain
MRChronic trigeminal neuropathic painMedial thalamusNCT03309813
NAChronic neuropathic painSpinal commissurotomy[53]Preclinical (not further developed)

PNSManagement of tumor-related pain
MR or US(1) Bone metastases and primary bone malignancies related painLesionNCT02616016
NCT02718404
NCT01833806
NCT03106675
NCT00981578
NCT01091883
NCT02076906
[5467]Human ¶, §
MR or US(1) Osteoid osteoma and other benign bone tumors related painLesionNCT02618369
NCT02923011
[6875]Human ¶
MR or US(1) Uterine fibroids related painLesionNCT02736435[7693]Human ¶, §
MR or US(1) Breast fibroadenoma related painLesionNCT02488655
NCT03044054
Human ¶
MR or US(1) Pancreatic cancer-related pain palliative treatmentLesionNCT01786850 (expanded acc.)
NCT00637364 (suspended)
[94114]Human ¶
NA(1) Recurrent rectal cancer-related pain palliative treatmentLesionNCT02528175Human
NA(1) Recurrent gynecological cancer-related pain palliative treatmentLesionNCT02714621[78]Human (case report)
NA(1) Advanced rectal and gynecological cancers-related pain palliative treatmentLesionNCT01097239
Other nontumoral gynecologic conditions
US(1) Endometriosis related painLesion[103, 115117]Human
US(1) Adenomyosis related painLesion[118]Human
Management of bone/joint nontumoral pain
MR(1) Low back pain from lumbar facet joint osteoarthritis (without radiculopathy)Facet joint/lumbar medial branch nerveNCT03321344[119, 120](a) Human ¶
(b) Preclinical
MR(1) Low back pain from lumbar sacroiliac joint dysfunctionSacroiliac joint[121]Preclinical
NA(1) Spinal disc herniation related painIntervertebral disc[122, 123]Preclinical (not further developed)
MR(1) Knee osteoarthritis related chronic painKnee joint[124]Human
Other
MRPhantom/residual limb painStump neuromasNCT03255395Human
MR or USChronic neuropathic pain (nerve ablation, irreversible conduction block)Peripheral nerves[120, 125128]Preclinical

¶ = CE marked; § = FDA approved. CL = central lateral, CNS = central nervous system, CT = clinical trial, FUS = focused ultrasound, HIFU = high-intensity focused ultrasound; MRg = magnetic resonance-guided, NA = not applicable, USg = ultrasound-guided, and PNS = peripheral nervous system