Notalgia Paresthetica
A form of localized itching, notalgia paresthetica is an abnormality of the small cutaneous nerves over the middle-to-upper back. Patients may experience additional sensory symptoms such as tingling, burning, tenderness or pain, but itching is usually the most prominent and often only complaint. There are little-to-no skin changes (other than scratch marks), as the symptoms are due to nerves rather than rash or cutaneous inflammation.
Treatment
Management may include symptomatic treatment and/or intervention on the underlying nerves or spine. See below for examples of topical and oral medications, as well as recommended physical therapy exercises. If symptoms persist despite treatment, a referral to a neurologist may be warranted or helpful.
- Topical anesthetics
- Topical capsaicin
- Topical corticosteroids
- Oral medications – hydroxyzine, oxcarbazepine, and gabapentin
EXERCISE #1
- Lie on your back, keeping hands rested near your body.
- Raise your head and bring your chin as close to the chest as possible.
- Stop if you feel pain and do NOT force yourself
- Range of motion should gradually improve.
- Repeat 5-10 times.
EXERCISE #2
- Lie on your stomach with hands near your body.
- Try to raise your head as much as possible.
- Again, do NOT push yourself against any pain.
- Lower your head.
- Repeat 5-10 times.
EXERCISE #3
- Lie down on your back with your arms stretched out to the side and palms facing up.
- Lift up your arms and hands in the air and bring them to midline in front of you.
- Your arms should remain outstretched with palms facing one another.
- Slowly lower your hands.
- Repeat 5-10 times.