National Center for Advancing and Translational Sciences Genetic and Rare Diseases Information Center, a program of the National Center for Advancing and Translational Sciences

Notalgia paresthetica

Not a rare disease Not a rare disease
Notalgia paresthetica is a common chronic, localized itch, that usually affects patches of skin on the upper back. Occasionally it can be more widespread and involve other parts of the back, the shoulders and upper chest. People feel both the sensation of an itch and paresthesia (a sensation of tingling, pricking, or numbness of the skin).  There are no signs on the skin except for signs of chronic scratching and rubbing.  Amyloid deposits (a collection of a specific type of protein) may be found in skin biopsies, but this is thought to be a secondary event.  The cause of the itch in notalgia paresthetica may be due to the compression of spinal nerves by bones or muscles as the nerves emerge through the vertebrae to the back muscles.  Sometimes degenerative changes in the area of the vertebrae that innervate the affected back muscles can be seen, but not always.  Symptoms of notalgia paresthetica may respond to topical capsaicin treatment.[1][2]
Last updated: 6/14/2011
There is no current treatment for notalgia paresthetica (NP) that is consistently effective. Evaluation and treatment of NP will often involve a multidisciplinary team of specialists. First-line therapy for NP will usually include treatment of the underlying spinal disease by orthopedic surgeons or physical therapists. Topical therapies may include steroid creams, tacrolimus, or capsaicin. Additional therapies have included botulinum toxin injections, gabapentin,  physical therapy, nerve blocks, and transcutaneous electrical nerve stimulation (TENS). Some have suggested that a combination of approaches, such as medication along with muscular rehabilitation exercises, may work best. [3][4][5]

Last updated: 11/29/2018

Research helps us better understand diseases and can lead to advances in diagnosis and treatment. This section provides resources to help you learn about medical research and ways to get involved.

Clinical Research Resources

  • ClinicalTrials.gov lists trials that are related to Notalgia paresthetica. Click on the link to go to ClinicalTrials.gov to read descriptions of these studies.

    Please note: Studies listed on the ClinicalTrials.gov website are listed for informational purposes only; being listed does not reflect an endorsement by GARD or the NIH. We strongly recommend that you talk with a trusted healthcare provider before choosing to participate in any clinical study.

These resources provide more information about this condition or associated symptoms. The in-depth resources contain medical and scientific language that may be hard to understand. You may want to review these resources with a medical professional.

Where to Start

  • DermNet NZ is an online resource about skin diseases developed by the New Zealand Dermatological Society Incorporated. DermNet NZ provides information about this condition.
  • Skin Sight provides more information about notalgia paresthetica.  Click through the different sections on this condition using the bottom right hand buttons.

In-Depth Information

  • Medscape Reference provides information on this topic. You may need to register to view the medical textbook, but registration is free.
  • PubMed is a searchable database of medical literature and lists journal articles that discuss Notalgia paresthetica. Click on the link to view a sample search on this topic.

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  1. Misery, Laurent. What is Notalgia paresthetica?. Dermatology. 2002;
  2. Greaves, Malcom W. Pathophysiology and Clinical Aspects of Pruritus. In: Freedberg, Irwin, et.al.. Fitzpatrick's Dermatology in General Medicine, 6th Edition. United States: McGraw-Hill; 2003; 1:398.
  3. Alai, Ally. Notalgia Paresthetica. Medscape. July 10, 2018; https://emedicine.medscape.com/article/1599159-overview.
  4. Howard M, Sahhar L, Andrews F, Bergman R, and Gin D. Notalgia paresthetica: a review for dermatologists. Int J Dermatol. April, 2018; 57(4):388-392. https://www.ncbi.nlm.nih.gov/pubmed/29243804.
  5. Robbins BA, Ferrer-Bruker SJ. Notalgia Paresthetica. StatPearls [Internet].. Oct 27, 2018; https://www.ncbi.nlm.nih.gov/books/NBK470597.