Notalgia Paresthetica

Notalgia Paresthetica (NP) is characterized by itching, burning, pain, tenderness, or increased sensitivity on the skin of the upper back. Decreased touch and temperature sensation have also been reported. The most common location for NP is the upper back between the shoulder blades. Symptoms may be confined to one side of the upper back, in the mid upper back, or involve both sides of the upper back.

Though it is not known with certainty what causes NP, some studies suggest that pressure on a nerve due to age or injury may cause the symptoms. Others believe there may be a hereditary connection.

Notalgia Paresthetica affects people of any age, race, or sex. However, it is more common in middle-aged to older adults. Women tend to develop NP more frequently than men.

Dry skin is a common cause of itching, so twice daily moisturizes should be used.

If moisturizers are not helpful, an over-the-counter cream containing capsaicin (an extract of hot peppers) may be effective. Capsaicin cream does not provide immediate relief and may take up to six weeks for maximum effect. Even if capsaicin cream is effective, symptoms may return when it is discontinued.

Strong cortisone creams (prescription-strength) and/or topical anesthetics are often quite effective.