Overview

Notalgia paresthetica may be a condition where the skin of the upper back becomes itchy, and there's often a darker patch of skin on the itchy area. Notalgia paresthetica could also be caused by a drag with the nerve cells that provide feeling to the skin of the upper back (sensory neuropathy). Skin changes, if present, are thanks to chronic rubbing and scratching of the affected area.

Who's at risk?

Notalgia paresthetica can affect people of any age, of any race, and of either sex. However, it is thought to be most common in middle-aged to older adults. Women seem to develop notalgia paresthetica more frequently than men.

Though researchers aren't certain what causes notalgia paresthetica, some studies have demonstrated spine disease within the spinal bone (vertebra) at the extent of the affected skin. Scientists speculate that spine disease thanks to age or injury may continue a nerve providing feeling thereto area of the skin, which results in itching.

Signs and Symptoms

The most common location for notalgia paresthetica is that the upper back, especially between the shoulder blades. The area could also be confined to just one side of the upper back, or it's going to occur within the middle of the upper back, over the spinal bones.

Notalgia paresthetica often occurs with none obvious changes to the skin. If skin changes do occur, there could also be a well-defined patch of darker skin (hyperpigmentation) over the affected area.

Although periodic itching is that the main symptom related to notalgia paresthetica, some people notice pain, tingling, or a change in feeling (sensation) within the affected skin.

Self-Care Guidelines

Dry skin may be a common explanation for itching, so it helps to use a moisturizer to the itchy area a minimum of twice each day.

If moisturizers aren't helpful, try an over-the-counter cream containing an extract of hot peppers, called capsaicin, and follow the package directions carefully. You will probably not get immediate relief, and therefore the capsaicin cream may take up to six weeks to possess its full effect. If the capsaicin cream is effective, symptoms will likely come after you stop using the cream.

When to Seek Medical Care

If moisturizers and capsaicin cream aren't helpful, see your doctor for an evaluation.

Treatments Your Physician May Prescribe

Your doctor could also be ready to diagnose notalgia paresthetica by taking your history and examining your skin. In addition, your doctor might order an X-ray or another sort of radiologic study, like an MRI or a CT scan.

If you are doing have a diagnosis of notalgia paresthetica, your doctor may try the following:

Ø  Prescription-strength anesthetic cream

Ø  Prescription-strength corticosteroid (cortisone) cream

If the itching or pain becomes intolerable or interferes together with your activities, your doctor may prescribe an oral anti-seizure (anti-epileptic or anti-convulsant) medication, such as:

Ø  Gabapentin

Ø  Topiramate

Ø  Oxcarbazepine

If these approaches are not effective, and if your symptoms are severe enough to justify it, more aggressive procedures may be performed to relieve pressure on the compressed nerve:

Ø     Injection of local anesthetic near the compressed nerves as they exit the spine (paravertebral block)

Ø    Spine surgery

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