Itchy skin can be incredibly bothersome, and when that itch is located squarely on your upper back, especially between the shoulder blades, it can be particularly frustrating to reach and relieve. If you’ve been asking yourself, “Why Is My Upper Back So Itchy?”, you might be experiencing a condition known as notalgia paresthetica. While the name might sound complex, understanding this condition can help you find relief.
What is Notalgia Paresthetica?
Notalgia paresthetica is a nerve condition that primarily manifests as persistent itching in the upper back, most commonly in the area between the shoulder blades. The term “notalgia” itself refers to back pain, and “paresthetica” describes abnormal sensations, such as itching, tingling, or numbness. Although itching is the hallmark symptom, some individuals may also experience pain, tingling, burning, or a pins-and-needles sensation in the affected area.
The exact cause of notalgia paresthetica isn’t fully understood, but it’s believed to be related to nerve irritation or compression. Researchers speculate that changes in the spine due to aging, arthritis, or previous injuries could play a role. These spinal changes might put pressure on the nerves that supply sensation to the skin of the upper back, leading to the bothersome itch.
Who is at Risk of Developing Notalgia Paresthetica?
Notalgia paresthetica can affect anyone, regardless of age, race, or gender. However, it appears to be more prevalent in middle-aged and older adults. Studies suggest that women are more likely to develop this condition compared to men. While the underlying reasons for this are still being investigated, hormonal factors or differences in spinal structure might contribute to the increased risk in women.
Recognizing the Signs and Symptoms
The most telling sign of notalgia paresthetica is intense, localized itching in the upper back. This itch is often felt between or just below the shoulder blades, and it may be limited to one side or occur in the middle of the back, over the spine.
In many cases, notalgia paresthetica occurs without any visible changes to the skin. However, some people may develop a noticeable patch of darker skin in the itchy area. This hyperpigmentation is likely due to chronic scratching and rubbing of the skin.
Besides the characteristic itching, other symptoms can include:
- Pain: Aching or soreness in the affected area.
- Tingling: A prickling or pins-and-needles sensation.
- Altered Sensation: Changes in feeling, such as increased sensitivity or numbness.
Image: Person scratching their upper back to illustrate the symptom of notalgia paresthetica.
Self-Care Strategies for Upper Back Itch Relief
Before seeking medical intervention, there are several self-care measures you can try to alleviate the itching associated with notalgia paresthetica.
- Moisturize Regularly: Dry skin can exacerbate itching. Applying a thick, emollient moisturizer to the itchy area at least twice daily can help hydrate the skin and reduce irritation. Look for moisturizers like CeraVe Moisturizing Cream, which are designed for sensitive skin.
- Cooling Menthol Creams: Over-the-counter creams and lotions containing menthol, such as Sarna anti-itch lotion, can provide a cooling and soothing sensation that temporarily relieves itching. Keeping these products in the refrigerator can enhance their cooling effect.
- Capsaicin Cream: Capsaicin cream, derived from chili peppers, is another over-the-counter option. It works by reducing nerve sensitivity and can be effective in relieving itch over time. However, it’s important to note that capsaicin cream may initially worsen the itching before providing relief, and it can take up to six weeks to achieve its full effect. If effective, symptoms may return upon discontinuation.
Medical Treatments for Notalgia Paresthetica
If self-care measures are insufficient to control your upper back itch, or if the itching significantly impacts your quality of life, it’s advisable to consult a healthcare professional. A doctor can typically diagnose notalgia paresthetica based on your medical history and a physical examination of your skin.
Prescription treatments for notalgia paresthetica may include:
- Prescription-Strength Anesthetic Creams: Topical anesthetic creams, such as EMLA or Oraqix, can numb the affected area and provide temporary relief from itching and pain.
- Corticosteroid Creams: Prescription-strength corticosteroid creams, like Aristacort or Lidex, can reduce inflammation and itching.
- Oral Anti-Seizure Medications: In cases of severe itching or pain that interferes with daily activities, oral anti-seizure medications like gabapentin (Neurontin, Gralise) may be prescribed. These medications help to calm nerve activity and reduce pain and itching sensations.
- Paravertebral Nerve Block: For severe, persistent symptoms that don’t respond to other treatments, injections of local anesthetic near the affected nerves as they exit the spine (paravertebral block) may be considered. This procedure aims to directly block nerve signals and provide longer-lasting relief.
When to Seek Medical Advice
While upper back itch can sometimes be attributed to simple dry skin or irritation, persistent or severe itching, especially when accompanied by pain, tingling, or skin changes, warrants medical evaluation. If moisturizers and over-the-counter anti-itch remedies fail to provide relief, it’s important to see a healthcare professional to determine the underlying cause and receive appropriate treatment. Early diagnosis and management can help improve your comfort and quality of life if you are experiencing notalgia paresthetica.
References
Bolognia J, Schaffer JV, Cerroni L. Dermatology. 4th ed. Philadelphia, PA: Elsevier; 2018.
James WD, Elston D, Treat JR, Rosenbach MA. Andrew’s Diseases of the Skin. 13th ed. Philadelphia, PA: Elsevier; 2019.
Kang S, Amagai M, Bruckner AL, et al. Fitzpatrick’s Dermatology. 9th ed. New York, NY: McGraw-Hill Education; 2019.
Last modified on June 26th, 2024 at 11:06 am
