Notalgia Paresthetica

What is Notalgia Paresthetica?

Notalgia Paresthetica is a type of nerve disorder also known as itch. Notalgia Paresthetica often appears in the upper or middle back on one side. I have seen patients with Notalgia Paresthetica where irritation or injury to nerves that give feeling to the skin is believed to be a factor. Changes in the spine or muscles nearby can sometimes be involved. Usually, there is no apparent reason for Notalgia Paresthetica.

Symptoms

Symptoms near a shoulder blade may include:

• Itching: I keep needing to scratch a part of my upper back. It just won’t stop.
• Burning sensation: The skin feels like it’s on fire. It’s hot and really irritating.
• Tenderness: light touches or the fabric of my clothes can hurt. It’s very sensitive.
• Skin discolouration: Because I scratch much the area has started to look darker and thicker, than the rest of my skin.

When to See a Consultant

If the itching does not go away if the itching keeps coming if the itching spreads to parts of the body or if the itching makes it hard to sleep you should ask for advice. I think you should go get evaluated if it becomes painful or if sores or signs of an infection appear because of the scratching. You should also get evaluated if you begin to experience weakness, if there is a spreading of numbness, if you start to lose your balance or if there are any changes to your bowel or bladder. These symptoms are all unusual. Could be a sign of another problem.

Causes of Notalgia Paresthetica

The exact cause is not fully understood. Possible contributing factors include:

• Nerve irritation: I have read that small nerves that supply the skin may become irritated or damaged. Nerve irritation can also be caused by irritation.
• Changes: I have read that disc problems or age related changes may affect nerves. Nerve health can also be influenced by changes in the spine.
• Injury: I have read that trauma to the back may affect nerves. Injury can also damage nerves.
• Shingles: I have read that previous infection can sometimes leave lasting nerve symptoms. Shingles can also cause long term nerve pain.

Diagnostic

After taking your history, a physical exam is necessary to establish the diagnosis. The doctor looks at the skin. Pays attention to how the skin appears and asks about symptoms like itching or burning. They also review health records. There are lots of different ways to get answers. One of the simplest and most cost effective ways is to figure out the timeline. When did the symptoms start? Having the patient think about this can help. Oftentimes diagnostic tests such as MRI and X-ray scans are unnecessary. However, if there are suspected issues involving the nerves or spine, or another medical condition is suspected, imaging may be indicated. Diagnostic skin tests will rule out skin issues.

Treatment Options

It's impossible to define one size fits all approach. A lot of things can be done to help reduce itching. Lotions to cool the skin can be helpful to provide comfort to some. Some topical preparations of local anesthetics, or even topical capsaicin can be applied.

A variety of different types of medications can be considered to reduce the chronic itch. Some medications can block the nerves that misfire, and send pain and itch signals to the brain. Physical activity can sometimes help. Stretches that are done to work out the back, along with other activities, might relax muscles and joints.

There isn't a one stop cure all. However, Mr. Irfan Malik may order tests or refer you to the proper specialist. His advice may change depending on your circumstances. What he recommends may work for others but not you.