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Table of Contents
Causes
Symptoms
Diagnosis
Treatment
Frequently Asked Questions
Notalgia paresthetica(NP) is the presence of an intense burning, itching, or tingling feeling between the shoulder blades (along the spine). This part of the back is an inconvenient place to have an itch because it’s unreachable to all but the most flexible people.
In scratching to satisfy the itch, a discolored patch of skin often develops. Though skin changes and itchiness are sometimes a symptom of cancer, notalgia paresthetica (NP) is not. There’s no link between NP and cancer.
NP is not linked to any diseases. Instead, it’s due to pressure on anerve root in the spine. This article will explain notalgia paresthetica, its causes, symptoms, diagnosis, treatment, and how it is not a sign or symptom of cancer or linked to cancer.
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What Causes Notalgia Paresthetica?
Nerves come from the spinal cord in the upper back, travel through the back muscles, and make a 90-degree turn toward the skin. The changed sensation (burning, itching, etc.) in the back is due to compression or injury of the nerves of the skin.
Causes can include physical trauma to the back,spinal cord compression,herniated or slipped disks, degenerative diseases of the nerves, infections likeshingles, or even a sunburn.NP can sometimes start after excessive, intense exercise that leads to stiff muscles.
Notalgia Paresthetica Symptoms
The most apparent symptom of notalgia paresthetica is an itching, burning, or tingling sensation between the shoulder blades, usually on either the right or left side of the spine. Scratching can feel good but doesn’t make the itch go away.
In a study of NP patients, in addition to intense itching, 49% felt a burning pain, 31% felt a pricking pain, 16% felt a tingling pain, and 4% felt coldness as their pain sensations.
Scratching or rubbing the itchy skin patch may result in scratch marks, eczema, scarring, or the skin turning lighter or darker. The area may have a changed sensation or be unable to sweat.
When to See a Healthcare Provider
It is unclear how common notalgia paresthetica is, but it’s likely underdiagnosed. It can come and go or stay for months or years. It’s most common in women age 54–62.
A healthcare provider can use imaging to check for visible damage to the vertebra, disks, or the nerves in the area. A biopsy (removal of a sample of tissue to analyze in the lab) can rule out other causes of skin changes.
Similar ConditionsConditions that a healthcare provider may mistake for notalgia paresthetica includefungal infection,eczema(an inflammatory skin condition),parapsoriasis(a skin disorder with a scaly patch),neurodermatitis(a chronic condition of itching and scratching the leads to inflamed skin), and macular amyloidosis (a condition of protein deposits in the skin).
Similar Conditions
Conditions that a healthcare provider may mistake for notalgia paresthetica includefungal infection,eczema(an inflammatory skin condition),parapsoriasis(a skin disorder with a scaly patch),neurodermatitis(a chronic condition of itching and scratching the leads to inflamed skin), and macular amyloidosis (a condition of protein deposits in the skin).
In children, notalgia paresthetica can be a sign ofmultiple endocrine neoplasia 2A, a genetic disorder linked to growths on the endocrine (hormone-producing) glands.
Most of these treatments will likely only provide temporary symptom relief.
Physical therapy focused on back-strengthening and flexibility exercises may also help, including the following:
Summary
Treatments vary but can effectively relieve symptoms, at least for a short time. Physical therapy or surgery may offer more long-lasting relief.
A Word From Verywell
An itch between the shoulder blades is practically unscratchable without extreme contortions or a back scratcher. See a healthcare professional if the itch persists so you can get to the root cause. Ask about treatments or getting a referral to a physical therapist, if needed. Exercise may help relieve this obnoxious problem.
Frequently Asked QuestionsMost of the time, notalgia paresthetica (NP) is due to pressure on the root of the nerve supplying sensation to the back between the shoulder blades. In children, though, NP may be a sign of the genetic disordermultiple endocrine neoplasia 2A.Notalgia paresthetica can last for months or years. Depending on the cause of your notalgia paresthetica, you may find relief through medications or physical therapy. Surgery may be an option if the cause of the itching is compression of the nerve from problems with the spinal disks.Depending on the cause of your notalgia paresthetica, you may see a dermatologist (specialists in skin conditions), an orthopedic surgeons, radiologists, pain specialists, massage and physical therapists, or acupuncturists.
Most of the time, notalgia paresthetica (NP) is due to pressure on the root of the nerve supplying sensation to the back between the shoulder blades. In children, though, NP may be a sign of the genetic disordermultiple endocrine neoplasia 2A.
Notalgia paresthetica can last for months or years. Depending on the cause of your notalgia paresthetica, you may find relief through medications or physical therapy. Surgery may be an option if the cause of the itching is compression of the nerve from problems with the spinal disks.
Depending on the cause of your notalgia paresthetica, you may see a dermatologist (specialists in skin conditions), an orthopedic surgeons, radiologists, pain specialists, massage and physical therapists, or acupuncturists.
4 SourcesVerywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.American Osteopathic College of Dermatology.Notalgia paresthetica.DermNet NZ.Notalgia paraesthetica.Mülkoğlu C, Nacır B.Notalgia paresthetica: clinical features, radiological evaluation, and a novel therapeutic option.BMC Neurol. 2020;20(1):191. doi:10.1186/s12883-020-01773-6Ellis C.Notalgia paresthetica: the unreachable itch.Dermatol Pract Concept. 2013;3(1):3-6. doi:10.5826/dpc.0301a02
4 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.American Osteopathic College of Dermatology.Notalgia paresthetica.DermNet NZ.Notalgia paraesthetica.Mülkoğlu C, Nacır B.Notalgia paresthetica: clinical features, radiological evaluation, and a novel therapeutic option.BMC Neurol. 2020;20(1):191. doi:10.1186/s12883-020-01773-6Ellis C.Notalgia paresthetica: the unreachable itch.Dermatol Pract Concept. 2013;3(1):3-6. doi:10.5826/dpc.0301a02
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
American Osteopathic College of Dermatology.Notalgia paresthetica.DermNet NZ.Notalgia paraesthetica.Mülkoğlu C, Nacır B.Notalgia paresthetica: clinical features, radiological evaluation, and a novel therapeutic option.BMC Neurol. 2020;20(1):191. doi:10.1186/s12883-020-01773-6Ellis C.Notalgia paresthetica: the unreachable itch.Dermatol Pract Concept. 2013;3(1):3-6. doi:10.5826/dpc.0301a02
American Osteopathic College of Dermatology.Notalgia paresthetica.
DermNet NZ.Notalgia paraesthetica.
Mülkoğlu C, Nacır B.Notalgia paresthetica: clinical features, radiological evaluation, and a novel therapeutic option.BMC Neurol. 2020;20(1):191. doi:10.1186/s12883-020-01773-6
Ellis C.Notalgia paresthetica: the unreachable itch.Dermatol Pract Concept. 2013;3(1):3-6. doi:10.5826/dpc.0301a02
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