Symptoms of notalgia paresthetica include chronic itching and altered sensations in the upper back, usually between the shoulder blades. Nerve impingement or irritation in the affected area is commonly responsible for this sensory neuropathy. We provide an in-depth understanding of notalgia paresthetica, including its causes, symptoms, diagnosis, treatment, and prevention, in this comprehensive article.
Many factors can contribute to the development of notalgia paresthetica, including:
The symptoms of notalgia paresthetica can be caused by nerve impingement in the upper back, such as the dorsal rami of spinal nerves.
Symptoms of nerve irritation can be caused by chronic muscle tension or spasms in the upper back region.
Notalgia paresthetica can be caused by poor posture, repetitive movements, or activities that strain the upper back.
Notalgia paresthetica can be exacerbated by certain dermatological conditions, such as atopic dermatitis or psoriasis.
Chronic itching or altered sensation in the upper back, between the shoulder blades, is the primary symptom of notalgia paresthetica. Additional symptoms include:
Feeling of burning or tingling
Numbness or stinging
Patches of hyperpigmented or hypopigmented skin
Sensitivity or tenderness of the skin
Notalgia paresthetica symptoms can vary in intensity and worsen with certain activities or positions.
Notalgia paresthetica is diagnosed through clinical evaluation and ruling out other possible causes. The following diagnostic approaches may be used:
An evaluation of the patient's medical history, including the onset and characteristics of symptoms, along with a physical examination focusing on the upper back region, including an assessment of skin changes and sensory abnormalities, is essential.
The healthcare provider will rule out other possible causes of itching or altered sensation in the upper back, such as dermatological conditions, nerve impingement, and systemic diseases.
It may be necessary to order imaging studies, such as X-rays or magnetic resonance imaging (MRI), to evaluate spinal structures and rule out underlying causes.
Under a microscope, a skin biopsy may be performed in rare cases to examine skin tissue and nerve fibers.
Notalgia paresthetica is treated by relieving symptoms and addressing any underlying factors. Treatment options include:
Infections, allergies, and depression may also be treated with medications, including antihistamines, corticosteroids, and topical anesthetics.
Massage, heat, cold, and electrical stimulation can also relieve pain and discomfort during physical therapy by improving posture, mobility, and strength of the upper back.
Blocking the transmission of pain signals from the affected nerves to the brain with nerve blocks can provide temporary or long-term relief from pain. An injection of local anesthetics, steroids, or botulinum toxin near the spine can be used to perform nerve blocks.
It is possible to decompress or release the affected nerves by surgery and restore normal nerve function. Surgery can also correct any spinal abnormalities or injuries that may cause or worsen notalgia paresthetica.
Since notalgia paresthetica is caused by multiple factors that are not fully understood or controlled, there is no definitive way to prevent it. However, some of the possible ways to lessen the risk or severity include:
Good posture and ergonomics, and avoiding activities that strain or injure the upper back
If you have problems with your muscles or joints, you should practice regular exercise and stretching, and seek professional help if necessary
Moisturizing the skin and avoiding irritants or allergens that may cause itching or inflammation
Managing stress and anxiety, and seeking psychological support if necessary
Follow your doctor's advice and treatment for any underlying or associated conditions, and receive regular check-ups and screenings
