Notalgia Paresthetica: Finding Treatment For Neuropathic Itching

Notalgia Paresthetica: Finding Treatment For Neuropathic Itching

Imagine an itch so persistent, so maddening, that it affects up to 8% of patients with chronic pruritus. Now picture that itch concentrated on a spot on your back that's just out of reach. Welcome to the world of notalgia paresthetica, a neurological puzzle that's more common than you might think.

Notalgia paresthetica (NP) isn't just your average scratch-and-go situation. It's a chronic condition that can last for months, even years, silently tormenting its victims with an itch that refuses to be ignored. While it may sound like a rare affliction, this sneaky tormentor is part of a group of conditions affecting what is thought to be approximately 20% of the population over their lifetime, often flying under the radar of both patients and doctors alike.

A close-up of a person with long dark hair, showing their shoulder and part of their face against a dark background.

In this article, we'll dive into the mysterious world of notalgia paresthetica. We'll explore what causes this peculiar itch between your shoulder blades, why it's more than just skin deep, and most importantly, how you can find relief from this relentless neural nuisance. Did you know that women over 40 are most commonly affected? We'll scratch the surface on why this demographic is particularly susceptible.

Whether you're scratching your head (or your back) wondering if that persistent itch could be more than just dry skin, or you're seeking solutions for a diagnosed case of notalgia paresthetica, you're in the right place. Let's unravel the mystery of this common yet often misunderstood condition and discover how you can reclaim comfort in your own skin.

Dermeleve®

What Is Notalgia Paresthetica?

Most skin issues are caused by conditions like contact dermatitis. Notalgia paresthetica is different because it doesn't have an external cause.

We're not sure what causes notalgia paresthetica. It is widely accepted that NP is a neuropathy issue, not a dermatology issue. It has something to do with the nervous system misfiring, possibly from nerve damage.

A person in a white shirt facing away, scratching their back with both hands.

You might develop a case of notalgia paresthetica if you injure your back or spine. It might also be a side effect of degenerative disc disease, diabetes, or shingles. 

What Are The Clinical Features of Notalgia Paresthetica?

Most dermatology issues present with a rash or irritation. Notalgia paresthetica doesn’t usually have any visible signs. It causes intense itchiness on the inside of one or both shoulder blades. 

The lack of rash and localization of symptoms may be the key features of notalgia paresthetica.

Patients with NP might also experience other symptoms like:

  • A burning sensation - 

    • Many individuals report a persistent burning feeling in the affected area. This sensation can range from mild to severe a may be constant or intermittent, adding to the discomfort of the condition.
  • Tingling or numbness - 

    • Many individuals report a persistent burning feeling in the affected area. This sensation can range from mild to severe a may be constant or intermittent, adding to the discomfort of the condition.
  • Pain or sensitivity - 

    • Some individuals experience pain in addition to itching, which can vary from a dull ache to sharp, intense discomfort. The affected skin may also become hypersensitive to touch, making even light contact uncomfortable.
  • Sensations of heat or cold - 

    • Unusual temperature sensations are common in notalgia paresthetica. Patients might feel inexplicable warmth or coolness in the affected area, independent of actual skin temperature changes.

Person scratching an irritated, red patch of skin on their arm, likely indicating an allergic reaction or skin irritation.

Though notalgia paresthetica doesn’t cause a rash, you might have discoloration from chronic scratching and rubbing. This can be a key clue in the diagnosis of NP. 

Is Notalgia Paresthetica Dangerous? 

The good news is that NP is not dangerous in and of itself. It can certainly be related to some dangerous conditions. But on its own, it’s mainly a harmless nuisance. 

That said, notalgia paresthetica can cause mental distress because of the intense discomfort. It can affect your ability to sleep, decreasing your quality of life.

How Common is Notalgia Paresthetica? 

It’s difficult to say how common NP is. The symptoms can be difficult to pinpoint. 

The Cleveland Clinic says diagnoses are 8 percent of chronic pruritus (itchy skin). NP mostly occurs in women and people over age 50.

How is Notalgia Paraesthetica Diagnosed? 

Diagnosing cases of NP is relatively straightforward. It’s usually a matter of a physical examination and telling a medical professional about your symptoms. Blood or skin tests usually aren’t required. 

A healthcare professional uses a stethoscope to listen to the heart of a patient with curly grey hair wearing glasses and a blue blouse. They are in a clinical setting with medical charts on the wall.

What is The Treatment of Notalgia Paresthetica? 

Notalgia paresthetica is unfortunately tricky to treat. Unlike most other skin conditions, NP is a sensory neuropathy issue. That means that you may need to explore treatment modalities until you find one that works for you.

Some people have huge success with one treatment of chronic pruritus while others get no relief. The good news is that there are several treatment options. Most people do find treatments to aid in the management of NP. 

Medical Treatments 

The usual first route for relief is to try an over-the-counter oral antihistamine. Your dermatologist might also prescribe gabapentin. This is usually used to treat nerve pain. Because NP has something to do with nerve damage, it has a high success rate.

Some studies have shown that gabapentin helps most people get significant relief. It might even banish the itching altogether. There is a mild risk of gastrointestinal discomfort, fatigue, or dizziness. This usually resolves within a few weeks. 

The main drawback of taking gabapentin is that it doesn’t take effect right away. It will be at least a few days before you start feeling relief and about a month before it reaches maximum effect. 

Clinical Treatments 

For more severe cases, your dermatologist might suggest a clinical treatment. These include Botox injections, spinal blocks, and TENS sessions. 

A person receives electrotherapy treatment on their lower back, lying face down while a practitioner adjusts the settings on a handheld device connected to electrodes.

Botox treatment involves using botulinum toxin to block nerve signals. It stops your nerves from communicating in the affected area. Notalgia paresthetica treated this way has a high success rate.

Another option is transcutaneous electrical nerve stimulation (TENS). Patients wear a device that sends mild electric pulses to their nerves. This helps block pain signals and promote healing. 

A spinal block is a cutaneous application of anti-inflammatory medication. In other words, it's a minor shot near your spinal nerve to help reduce symptoms. Notalgia paresthetica generally responds well to this treatment.

This sounds extreme, but these are successful methods of soothing nerve irritation. They target the nerves themselves to help numb or recalibrate your nervous system. 

Physical Therapy

Notalgia paresthetica isn’t an independent condition. It’s a side effect of other illnesses or injuries. Depending on the cause of your symptoms, physical therapy may help. A custom exercise routine might provide relief because it reduces nerve damage. This usually involves gentle stretching and strengthening exercises.

At-Home Treatment Options

Most people try different ointments or creams to relieve the itching of NP. This may or may not offer relief, but it’s worth a try. Topical capsaicin is a common treatment for many types of nerve irritation. Other ointments include corticosteroids and local anesthetic.

The drawback is that most topical treatments treat surface irritation, not neuropathy itching. And many of them use topical steroids, which can have serious side effects.

Dermeleve® is formulated to soothe those hard-to-reach itches without dangerous side effects. Free from steroids, this gentle product helps provide safe at-home relief.

A tube of Dermeleve Soothing Cream stands on a counter in front of shelves filled with other skincare products. The label notes that it is steroid-free and helps relieve dry, itchy, and irritated skin.

Dermeleve® uses the safest ingredients to tackle your itch. You can feel safe knowing that quick, effective relief is on the way — without the risks.

Does Notalgia Paresthetica Last Forever? 

For most people, conditions like NP don’t last forever. But it’s tricky to say exactly how long they’ll affect your life. Some people only have symptoms for a few months. Others deal with chronic scratching for years.

Wrap-Up 

The management of notalgia paresthetica is still something of a mystery. If you have severe itching on your shoulder blades, see a dermatologist right away. Successful treatment of notalgia paresthetica looks different for everyone. Finding the right one can dramatically improve your quality of life.

If you want to treat the itch at home, Dermeleve® is a safe and effective method. Formulated to target deep irritation, it is steroid-free and gentle on skin. That means it’s a safe option without dangerous side effects. To learn more about Dermeleve®, check out our website.

FAQ

What Causes Notalgia Paresthetica? 

The simple answer is that we aren’t sure what triggers notalgia paresthetica. It seems to be caused by issues with the nervous system. The condition can be triggered by a physical injury to the back like a ruptured disc or a pinched nerve.

How Do You Treat Notalgia Paresthetica At Home? 

There are several options for treating NP at home. You can take oral antihistamines or gabapentin with a prescription. Topical ointments with capsaicin or numbing agents might also soothe the irritation. 

What Kind of Doctor Should I See For Notalgia Paresthetica? 

If you have chronic pruritus, make an appointment with a dermatologist. They will assess your symptoms and review your medical history. If you have other symptoms, they might also recommend blood tests. 

How Do You Stop Notalgia Paresthetica? 

There is no surefire treatment for NP. Some patients with notalgia paresthetica find relief from oral medications, topical ointments, or therapeutic exercises. Others have to seek out more intense options like Botox injections or TENS treatment.

What Ointment Is Best For Notalgia Paresthetica? 

There are several ointment options that may be able to soothe nerve irritation. Topical corticosteroids might help relieve neuropathic itching. Some people also have success with numbing creams like Lidocaine. For faster, more effective treatment without dangerous side effects, try Dermeleve®.

Back to blog