Notalgia Paresthetica: Symptoms, Causes, and Treatment

Written by Medicover Team and Medically Reviewed by Dr Vishal Sawale , Neurologist

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Notalgia Paresthetica (NP) is a long-term nerve-related condition that causes itching and discomfort in the upper back, especially between the shoulder blades. It affects the sensory nerves in the skin and often goes undiagnosed. Early recognition and proper care can improve comfort and prevent long-term skin damage.

What Are the Different Types of Notalgia Paresthetica?

Notalgia Paresthetica is classified into two types:

Primary Notalgia Paresthetica:

• Idiopathic (unknown cause)
• Usually linked to nerve irritation or compression in the spine

Secondary Notalgia Paresthetica:

• Caused by underlying conditions like:
  • Degenerative disc disease
  • Herniated discs
  • Spinal arthritis

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What Are the Symptoms and Warning Signs of Notalgia Paresthetica?

NP symptoms are mostly skin-related, but they stem from nerve issues in the spine. These symptoms can last for months or years and affect daily comfort.

Common Symptoms

• Itching (usually on one side of the upper back)
• Darkened skin in the itchy area (hyperpigmentation)
• Tingling or burning sensation
• Skin thickening from repeated scratching

Severe Symptoms

• Sharp or stabbing pain
• Numbness in the affected area
• Tender skin that's sensitive to touch
• Sleep disturbances due to discomfort

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What Are the Common Causes and Risk Factors of Notalgia Paresthetica?

This condition usually results from pinched or damaged nerves in the spine. Understanding causes and risk factors can help with prevention and management.

Causes

• Spinal degeneration due to aging
• Past back or neck injuries
• Muscle overuse or strain
• Poor posture during sitting or desk work
• Nerve damage from underlying conditions (e.g., diabetes)

Risk Factors

• Age (common after 50)
• Spinal disorders
• Diabetes or nerve-related conditions
• Obesity
• Family history of nerve issues
• Prolonged poor posture

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How is Notalgia Paresthetica Diagnosed?

NP diagnosis is mainly clinical but may include several tests to rule out other causes.

Diagnostic Steps:

• Medical History Review: Understanding symptoms and past health issues
• Physical Exam: Checking for changes in skin and nerve sensation
• Neurological Testing: Assessing nerve function in the spine and back
• Imaging Tests: X-rays, MRI, or CT scans to find spinal compression
• Skin Biopsy: Sometimes used to rule out skin diseases

Our advanced diagnostic centers provide spine imaging, dermatological evaluations, and neurological consultations, all under one roof for faster diagnosis.

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What Are the Treatment Options for Notalgia Paresthetica?

Treatment aims to reduce discomfort, relieve itching and pain, and improve skin condition. While NP may not be completely curable, it can be well managed.

Topical Treatments

• Capsaicin cream: Reduces itching by calming overactive nerves
• Lidocaine patches: Provide numbing relief for pain and itching
• Topical steroids: Reduce inflammation and skin irritation

Oral Medications

• Antihistamines: Help with itching and improve sleep
• Gabapentin / Pregabalin: For nerve pain relief
• Antidepressants: Like amitriptyline, are used to manage chronic pain and improve sleep

Physical Therapies

• Stretching and strengthening exercises: Improve posture and reduce strain
• Massage therapy: Relieves muscle tension and improves circulation
• Acupuncture: May help reduce symptoms by stimulating nerves

Lifestyle Modifications

• Correct posture during sitting or computer work
• Use ergonomic chairs or workstations
• Manage stress with relaxation techniques like yoga

Advanced Treatments

• Nerve block injections: Temporary relief through targeted pain control
• Botox injections: Relax muscles and reduce nerve compression
• Surgery (rare): To relieve pressure on compressed nerves in severe cases

Our expert team combines neurology, dermatology, and physiotherapy for a holistic, individual NP care plan. We also offer minimally invasive treatments and rehabilitation support.

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When to See a Doctor?

Don't ignore prolonged itching or discomfort in your back. Seek medical attention if:

• Itching persists for more than 2 to 3 weeks
• You experience pain, numbness, or skin changes
• Symptoms interfere with sleep or daily activities

High-Risk Individuals: Older adults, those with spinal issues or diabetes, and people with sedentary jobs should seek early medical advice.

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What Is the Recovery Process After Notalgia Paresthetica Treatment?

Notalgia Paresthetica is a chronic condition, but symptom control is possible with ongoing care.

Post-Treatment Expectations

• Symptom relief varies based on cause and treatment type
• Regular follow-ups may be needed to adjust therapy
• Gradual improvement with consistent treatment and lifestyle changes

Lifestyle Tips

• Maintain good posture and spinal health
• Stay physically active and manage weight
• Avoid scratching to prevent skin damage

Our care doesn't stop at treatment, we offer post-treatment rehab, ergonomic counseling, and patient education to prevent flare-ups.

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What Precautions Can Help Prevent Notalgia Paresthetica?

While NP may not always be preventable, you can lower your risk with these tips.

Prevention

• Maintain a healthy spine through exercise
• Use proper posture while working or sitting
• Take breaks from long periods of sitting
• Manage blood sugar levels if diabetic

Possible Complications if Untreated

• Long-term skin discoloration
• Chronic pain and discomfort
• Sleep disturbances
• Reduced quality of life

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Our Experience Treating Notalgia Paresthetica

At Medicover, we understand the hidden burden of chronic nerve-related skin conditions like Notalgia Paresthetica. With advanced diagnostics and expert care teams, we offer prepared treatment plans that relieve symptoms and improve daily life. Your comfort is our priority, from diagnosis to long-term support.

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