Focused Ultrasound Therapy
Focused ultrasound is an early-stage, non-invasive, therapeutic technology with the potential to improve the quality of life and decrease the cost of care for patients with painful neuromas which can occur after an amputation. This is a very specific type of neuropathic pain. This novel technology focuses beams of ultrasonic energy precisely and accurately on targets deep in the body without damaging surrounding normal tissue. Where the beams converge, the ultrasound produces precise ablation (thermal destruction of tissue) enabling the neuromas to be treated without surgery.
The primary options for treatment of painful amputation neuromas include medication and invasive surgery.
For certain patients, focused ultrasound could provide a non-invasive alternative to surgery with less risk of complications and lower cost.
- Focused ultrasound is non-invasive, so it does not carry added concerns like surgical wound healing or infection.
- Precise targeting minimizes damage to non-targeted tissue.
- Focused ultrasound treatment can be repeated, if necessary.
In Israel, there is a clinical trial using focused ultrasound to ablate painful neuromas (visualized on MRI) that are causing amputee stump pain, and the impact on the patient’s level of pain is assessed.
For a full list of neuropathic pain clinical trials, please see here.
Regulatory Approval and Reimbursement
Focused ultrasound treatment for painful amputation neuromas is not approved by regulatory bodies or covered by medical insurance companies.
Prabhala T, Hellman A, Walling I, Maietta T, Qian J, Burdette C, Neubauer P, Shao M, Stapleton A, Thibodeau J, Pilitsis JG. External focused ultrasound treatment for neuropathic pain induced by common peroneal nerve injury. Neurosci Lett. 2018 Sep 25;684:145-151. doi: 10.1016/j.neulet.2018.07.037. Epub 2018 Jul 26.
Youn Y, Hellman A, Walling I, Gee L, Qian J, Burdette C, Frith L, Pilitsis JG. High-Intensity Ultrasound Treatment for Vincristine-Induced Neuropathic Pain. Neurosurgery. 2018 Feb 9. doi: 10.1093/neuros/nyx488.
Mourad PD, Friedly JL, McClintic AM, Olmstead TA, Loeser JD. Intense Focused Ultrasound Preferentially Stimulates Transected Nerves Within Residual Limbs: Pilot Study. Pain Med. 2017 Sep 7. doi: 10.1093/pm/pnx188.
McClintic AM, Dickey TC, Gofeld M, Kliot M, Loeser JD, Richebe P, Mourad PD. Intense focused ultrasound preferentially stimulates subcutaneous and focal neuropathic tissue: preliminary results. Pain Med. 2013 Jan;14(1):84-92. doi: 10.1111/j.1526-4637.2012.01510.x. Epub 2012 Nov 8.
Click here for additional references from PubMed.