Notalgia Paresthetica - Western SummaryWestern Medicine Summary

Western Medicine

Western Summary

Notalgia paresthetica is a condition where a person can feel a sense of burning, itching, or stinging along the right or left upper back (along the shoulder blade). There is typically no rash or abnormality that can be seen on the skin.  


Notalgia paresthetica is a condition in which one feels a strong urge to scratch the skin on the upper back although no rash is present. Notalgia paresthetica commonly occurs in adults and tends to localize to the skin of the mid-upper back by the shoulder blade. Often secondary symptoms present in the area, such as brown patches or scratch marks. Notalgia paresthetica comes and goes and can persist for years, causing distress.



The cause for notalgia paresthetica is not known. Most researchers believe that notalgia paresthetica is the result of a problem with the nerves that innervate the skin of the back, but a direct cause has not been found. Notalgia paresthetica is sometimes associated with a history of disease in the spinal column of the neck and upper back (such as previous trauma, degeneration of the vertebral bones, etc.), but there is no clear connection.  



There are no definitive treatments for notalgia paresthetica. Therefore the goal is to address the symptoms and treat any spinal problem if present. Treatment for notalgia paresthetica may include creams such as capsaicin, topical steroids, and topical numbing agents (e.g. pramoxine). If spinal disease is present, treatment by an orthopedic surgeon may help to improve notalgia paresthetica symptoms.

Exercise may play an important role in relieving the symptoms notalgia paresthetica[1] and the exercises that were used included:

  • Shoulder shrug: Perform backward and forward motions ten times and in two sets
  • Shoulder rotations: Perform backward and forward motions ten times and in two sets
  • Upper body rotation: Hold one arm across the body and then gently twist your body and then hold for 15 seconds and repeat several times to both the right and left sides. 
  • Back stretch: After sitting on a chair, cross arms across the lap and then gently bend forward to stretch the back and hold for 15 seconds. This move is to be repeated several times as well. 
  1. Zagarella S, Kapila S, Fallahi A. Notalgia paraesthetica: A pilot study of treatment with simple exercises and stretches. Australas J Dermatol.2016;57(3):222-224; PMID: 26499931 Link to research.