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What is Notalgia Paresthetica?

By D. Jeffress
Updated Mar 03, 2024
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Notalgia paresthetica is a common medical condition that causes a small area of skin to constantly itch and tingle. Most cases are isolated to a region on the middle of the back just to one side of the spine, but notalgia paresthetica can also affect the lower back, shoulders, or chest. Itching may be accompanied by slight burning sensations or numbness. Medical research shows that the condition is related to abnormal nerve activity, but doctors are unsure what triggers the unique symptoms. Most people are able to control symptoms with daily topical analgesics.

It is unclear exactly why this condition arises, but medical professionals have identified risk factors. The condition is much more prevalent in people who have suffered spine injuries or have congenital spine disorders, probably because small nerves in their backs were damaged. Since not everyone with a spine injury develops symptoms and many people with healthy spines get notalgia paresthetica, it is difficult to determine a clear causal factor. The condition is most commonly seen in men and women between the ages of 40 and 80, though symptoms can emerge at any age.

The most prevalent sign of notalgia paresthetica is a chronic itching and burning sensation that is only temporarily relieved by scratching. The affected area of skin may also feel tingly or numb at times, which are signs that sensory nerves are involved. The skin may become dry, rough, and discolored, partly due to the original condition and frequent scratching. Recurring bacterial infections are possible if scratching breaks open the skin.

Symptoms are mild in many people, and the condition often goes undiagnosed because individuals never seek professional advice. When a person does meet with a dermatologist, the doctor can usually diagnose notalgia paresthetica based on the appearance and location of the affected area. He or she may refer the patient to a radiologist to perform x-rays and check for signs of spine damage and nerve compression. If spine disorders or deformities are found, surgical treatment may be necessary.

There is no cure for this condition, but patients can usually find relief with over-the-counter anti-itch creams. Topical creams that contain capsaicin, menthol, or camphor have been found to be the most effective in clinical trials. In a severe case, a dermatologist may prescribe a high-strength topical steroid ointment to relieve itching and burning. Patients are advised to avoid scratching if at all possible to reduce the risk of infections.

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Discussion Comments

By anon1005803 — On Nov 24, 2021

I agree with Starrynight. I believe that notalgia paresthetica is in some way related to shingles. Mine is episodic, starts with itching, with the skin intact. Next, the rash breaks out, the skin breaks down and scabs over. The itching subsides when the scabbed area heals. Then the cycle repeats.

The area of my shoulder blade always itches during the itch portion of cycle. For whatever reason, of all the medications I have tried, generic Tinactin spray keeps the breakout under control. Creams and lotions just aggravate and prolong the breakout. Years ago, just one pinpoint spot itched, and hardened. As time passed, it has progressed to my present symptoms. It took a couple of years for the dermatologist to admit it might be something more than dry skin. He advocated lotion which caused my entire back to break out. It almost drove me insane with the non-stop itching.

By azsungrrl — On Feb 19, 2015

I've suffered from severe hives maybe six times in the past that were daily reoccurring lasting for months then out of blue would stop. Many tests later, multiple doctors, dermatologists and allergy specialists couldn't pinpoint the cause. Now I am suffering from this itchy back almost non-stop on a daily basis.

I've already been to a few different doctors but feel that its the same answers I received during my hives outbreaks so I'm going to do as much research as possible regarding this. At this time, the only thing that seems to help is using a tooth brush with itch cream on it to apply/ scratch the hard to reach scratchy patch on my back. Not sure if this is related but I have been hospitalized (for 3 days) for viral meningitis, which is the less serious version of bacterial meningitis. I am in process of putting an in depth comparison of these symptoms and issues.

If anyone else has had two or more of these symptoms/issues within their lifetime and would like to share their story please post.

By anon932417 — On Feb 12, 2014

My dermatologist diagnosed this in under 60 seconds. Several spine doctors kind of gave me a "crazy menopausal chick" look and implied it was in my head! I got a prescription for a topical creme from a pain MD and that helped.

Then I was at costco and saw a body pillow for 12 bucks. After six years of poor sleep from shoulder pain that I thought was due to tendinitis in the shoulder, that disappeared in one night with a cervical roll pillow, I thought the body pillow might do something. And Voila! It prevented me from sleeping on my stomach and the itching, numbness, and pain the the NP has almost has disappeared! It has only been a week but it makes sense.

By anon340051 — On Jun 29, 2013

A topical cannabis tincture works wonders on this condition and has zero side effects. It is the only thing that gives me instant relief. Acupuncture is helping too.

By anon322888 — On Mar 01, 2013

@anon245961: I have the same issues as you. Mine was never itchy, and has always been painful. I have had it as long as I can remember but was only diagnosed with it about five years ago.

I take Lyrica to help manage the pain, and it helps a bit, but the pain is always there to some extent. The worst part is that people don't take it seriously or believe me when I tell them that I am in pain - and get ticked off when I refuse to do certain tasks because of the pain.

By anon245961 — On Feb 07, 2012

I have been recently diagnosed with notalgia paresthetica. The itching never occurred until about two or three months ago and is not 24/7, but happens throughout the day. My other symptoms are a chronic, aching pain, feeling sharp pins and needles, and the inability to hold heavier items with that arm.

I have had to quit my job and stick with desk jobs to minimize the pain, but being at a keyboard still hurts a lot. I am only 22 years old, by the way.

I get steroid injections for pain, and have been tossed around different doctors for over four years now, including physical therapy and chiropractic care. The symptoms have only gotten more severe over the past years. I am getting a tens unit to help with pain, but if anyone has any more information they can give, that would be amazing!

By starrynight — On Jul 10, 2011

@JaneAir - I've suffered from hives before and let me tell you that constant itching is no fun.

It's interesting that this condition may be caused by a problem with the spinal nerves though. It almost sounds similar to shingles. In shingles the rash shows up on the area of the skin that is served by the particular nerve that the virus is in. Maybe doctors could use the research done on shingles to help with notalgia parasthetica.

By JaneAir — On Jul 09, 2011

I've never heard of this condition before! As far as skin diseases go it sounds fairly benign because it won't kill you. But the constant itching and burning could probably drive someone crazy after awhile.

I'm glad to hear there are treatments and ways to control this condition though. At least over the counter anti-itch creams aren't very expensive!

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