Notalgia paresthetica
A chronic sensory neuropathy affecting the back
Notalgia Paresthetica[edit | edit source]
Notalgia paresthetica is a chronic sensory neuropathy characterized by localized itching, pain, and altered sensation in the upper back, typically between the shoulder blades. It is often associated with a hyperpigmented patch of skin in the affected area.
Signs and Symptoms[edit | edit source]
The primary symptom of notalgia paresthetica is a persistent itch in the upper back, usually on one side. Patients may also experience:
- Paresthesia, or abnormal sensations such as tingling or burning
- Hyperalgesia, or increased sensitivity to pain
- A well-defined area of hyperpigmentation
Pathophysiology[edit | edit source]
The exact cause of notalgia paresthetica is not well understood, but it is believed to involve nerve entrapment or irritation. The dorsal rami of the thoracic spinal nerves, particularly T2 to T6, are thought to be involved. This condition may be related to degenerative changes in the spine, such as osteophytes or herniated discs, which can compress the nerves.
Diagnosis[edit | edit source]
Diagnosis of notalgia paresthetica is primarily clinical, based on the characteristic symptoms and physical examination. Dermatologists and neurologists may be involved in the evaluation. Imaging studies, such as MRI or CT scan, may be used to rule out other causes of the symptoms.
Treatment[edit | edit source]
Treatment options for notalgia paresthetica focus on symptom relief and may include:
- Topical treatments, such as capsaicin cream or lidocaine patches
- Oral medications, including gabapentin or pregabalin
- Physical therapy and exercises to improve posture and reduce nerve compression
- Transcutaneous electrical nerve stimulation (TENS)
Prognosis[edit | edit source]
Notalgia paresthetica is a chronic condition that can persist for many years. While it is not life-threatening, it can significantly impact quality of life due to the persistent itching and discomfort. Management focuses on alleviating symptoms and improving the patient's quality of life.
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