Notalgia Paresthetica

Overview

Notalgia Paresthetica is a nerve-related condition that causes chronic itching, burning, or tingling—typically affecting the upper back, near the shoulder blades. It is considered a form of neuropathic pruritus, meaning the itch originates from irritated or compressed nerves rather than a skin condition.

At the Royal Buckinghamshire Hospital, our team provides specialist neurological assessment and symptom management for individuals living with Notalgia Paresthetica.

Causes of Notalgia Paresthetica

The condition occurs when small sensory nerves in the back become compressed or irritated, often due to:

• Degenerative changes in the spine
• Disc degeneration or spinal osteoarthritis
• Muscle strain or poor posture
• Direct nerve entrapment in the muscles
• Previous spinal surgery or trauma
• Less commonly, underlying neurological conditions

Common Symptoms

The hallmark symptom is a persistent or recurring itch or tingling sensation, typically in the:

• Upper back
• Shoulder blade area (usually one side)
• Sometimes extending to the arms or lower back

Other possible symptoms include:

• Burning or stinging sensation
• Numbness or hypersensitivity in the affected area
• Skin discolouration or thickening due to chronic scratching

Importantly, while the skin may appear irritated, the root cause is nerve-related, not a skin disease.

Diagnosis

Our specialists at Royal Buckinghamshire Hospital conduct a thorough neurological assessment, which may include:

• Nerve conduction studies or EMG, if needed, to assess nerve function
• Physical examination to assess sensation and muscle function
• Spinal imaging (X-rays, MRI) to identify degenerative changes or nerve compression

Treatment Options

There is no definitive cure for Notalgia Paresthetica, but symptoms can often be managed effectively:

• Physiotherapy to relieve muscle tension and improve posture
• Neuropathic pain medications (e.g. gabapentin, pregabalin)
• Topical treatments, such as capsaicin cream or anaesthetic patches
• Nerve block injections, if symptoms are severe
• Targeted rehabilitation, including posture correction and mobility exercises

In chronic or severe cases, multidisciplinary care including neurological and pain management specialists can provide significant relief.

Arranging To Visit A Private GP

If you are experiencing any signs or symptoms, schedule an appointment with Royal Buckinghamshire Hospital for expert evaluation and treatment.. Make an appointment with one of our private GPs who can refer you to our specialists. Appointments are available to everyone and can often be booked for the same day. There is no need to be registered with our The Royal Buckinghamshire Hospital, or live locally.

If you have insurance which covers a GP visit, we can in most cases invoice the insurer directly. Where you are paying directly, the cost for a 30 minute consultation is £100.

Any additional costs will always be discussed.

Our Resident Private GP

Dr Chamali is welcoming and highly experienced. He offers his patients sound diagnosis and treatment, along with individual care focused on their future health.

Dr Basel Chamali

General Practitioner

Field