Notalgia paresthetica is a common medical condition that causes a small area of skin to constantly itch and tingle. Most cases are isolated to a region on the middle of the back just to one side of the spine, but notalgia paresthetica can also affect the lower back, shoulders, or chest. Itching may be accompanied by slight burning sensations or numbness. Medical research shows that the condition is related to abnormal nerve activity, but doctors are unsure what triggers the unique symptoms. Most people are able to control symptoms with daily topical analgesics.
It is unclear exactly why this condition arises, but medical professionals have identified risk factors. The condition is much more prevalent in people who have suffered spine injuries or have congenital spine disorders, probably because small nerves in their backs were damaged. Since not everyone with a spine injury develops symptoms and many people with healthy spines get notalgia paresthetica, it is difficult to determine a clear causal factor. The condition is most commonly seen in men and women between the ages of 40 and 80, though symptoms can emerge at any age.
The most prevalent sign of notalgia paresthetica is a chronic itching and burning sensation that is only temporarily relieved by scratching. The affected area of skin may also feel tingly or numb at times, which are signs that sensory nerves are involved. The skin may become dry, rough, and discolored, partly due to the original condition and frequent scratching. Recurring bacterial infections are possible if scratching breaks open the skin.
Symptoms are mild in many people, and the condition often goes undiagnosed because individuals never seek professional advice. When a person does meet with a dermatologist, the doctor can usually diagnose notalgia paresthetica based on the appearance and location of the affected area. He or she may refer the patient to a radiologist to perform x-rays and check for signs of spine damage and nerve compression. If spine disorders or deformities are found, surgical treatment may be necessary.
There is no cure for this condition, but patients can usually find relief with over-the-counter anti-itch creams. Topical creams that contain capsaicin, menthol, or camphor have been found to be the most effective in clinical trials. In a severe case, a dermatologist may prescribe a high-strength topical steroid ointment to relieve itching and burning. Patients are advised to avoid scratching if at all possible to reduce the risk of infections.
