Methods and systems for non-invasive neuromodulation of the spinal cord utilize a transducer to deliver pulsed ultrasound energy to up regulate or down regulate neural targets for the treatment of pain and other disease conditions. The systems provide control of direction of the energy emission, intensity, frequency, pulse duration, pulse pattern, mechanical perturbation, and phase/intensity relationships to achieve up regulation and/or down regulation. One embodiment focuses an elongate tubular ultrasound beam which can be aligned with a target region of the spinal cord.
