Itching backs - transient or persisting?

So if you've found this page its likely that your itchy back is more than a random transient itch.

Most of us have an itchy back at some stage. An itch results in a touch, to dislodge whatever might be causing the itch, or to scratch the skin. There are many causes of itch and the most common would be thought of as skin conditions rather than nerve related.

However, since itch is a sensation reaching our consciousness, the signal traverses the nervous system and this signal can be modified or disturbed along its path as well as "false" or "phantom" itches being triggered where there is no real skin irritation.

Recently, as I was providing treatment to a client with a chronic lower back complaint, the comment was made "Oh, all my spinal muscles are very tight, and have been for long time". Understandably so, since this person had spinal surgery for a bulging lumbar disc, and still suffers periodic sciatica and back pain. The comment prompted me to ask "does your back ever itch?" - since the condition of notalgia paresthetica is thought to be from trapping or irritation of the small spinal nerves in the thoracic spine. If these muscles are always tight, then such people could be more vulnerable to this condition.

Well, this opened up a flood of responses: "Hell yes", "how did you know?", "I'm always asking my partner to scratch my back", "You'll see me rubbing me back up against a corner of a wall or door to settle the itch", "I though it was a rash", I didn't think it had a medical name", "I've had it for years".

So I tell my wife when I get home that evening, to which she responds,  "Yes, I've been having an itch across my shoulders and back the last few days. I thought it was a skin reaction from some over-spray of perfume - but I've washed the area and I've scratched it and it won't go away." Two days later, and unwittingly after a spinal manipulation (provided for other reasons) she says "you know - the itch has gone away. Whew! We won't claim another chiropractic miracle will we?

Moral of the story - You never now till you ask, and some symptoms are indeed transient, the cause of which could equally be a spinal nerve being temporarily trapped or a skin irritation that goes away by itself.

For those for whom the symptoms do not go away, I am working on a treatment regimen that addresses muscle entrapment of the spinal nerves which may provide relief for this condition. It is too early to make specific claim about its success yet - as there are so few potential subjects to test the treatment as well as the difficulty in objectively identifying the site of irritation of these nerves.

The beginning - an introduction

This is a blog related to my experiences as a chiropractor dealing with the condition called notalgia paresthetica (NP).

Notalgia is derived from the greek palindrome "noton"  and "algia". Noton means "back". The Greek god of south wind is called Notos. "Algia" is greek for pain. Hence notalgia.

Most most autocorrect features on computers as well as Google searches for "notalgia" returns the word "nostalgia". Nostalgia in greek literally means "pain from an old wound".


"Paresthesiae" relate to a skin sensations, such as burning, prickling, itching, or tingling, with no apparent physical cause. This comes from a combination of latin "Par" meaning like or equal to, and the Greek word "aisthesis" for sensations.


My first clinical experience with the condition was a person seeking my advice for a patch of numbness that had developed on a persons back. He perceived this as possibly spinally-related.

Being a reduction in sensation, clearly there had to be some nervous system involvement. Since this patch was limited - just to a patch across his back, the most likely site of compression is in the peripheral distribution of the spinal nerves. A problem affecting a nerve root would distribute symptoms along all of or any part of the nerve root. I knew this had to be what is called the "posterior primary ramus" which has several small branches that give nerve supply to the spinal facet joint, local spinal muscles as well as to the skin.

I didn't know that this portion of the nerve could be compressed, but recalled Janet Travell (famous for triggerpoint therapy, myofascial pain syndromes and being JFK's physician) making reference to muscles being the causes of nerve compression. Low and behold in the myofascial pain bible was reference to 'notalgia paresthetica'. Even though this didn't explain the numbness in my patient, it began my research interest in this condition and explaining such symptoms in other patients who have by luck or design crossed my path.

If you think you might have notalgia paresthetica read more pages of my blog to understand more about the condition.