Back itching is one of the most common human skin complaints. At one time or another, almost everyone has suffered from an itchy back. Itchy back is so prevalent that there are even specially made back scratchers to help us with this very annoying complaint. Most itching is in the middle of the back, just past easy reach.
Separately, itch may be generalized and all over the body. Generalized itching may be caused by multiple issues and is not called notalgia. The majority of patients with itching are generally very healthy and don’t have any other associated medical problems. However, there are other medical causes of pruritus which may need further evaluation by your dermatologist or primary physician. Other causes include liver disease, malignancy, diabetes, thyroid disease, chronic kidney disease, neurologic disorders, certain medications, blood disorders, etc. Much of these other causes can be evaluated through complete lab tests and physical exam.
While most itchy back issues are temporary and go away on their own, there is a growing epidemic of persistent itchy back lasting for months and years. The internet is full of people on chat rooms and self help sites talking about their itchy back. Some attribute their symptoms to clothing tag allergies, bra strap allergies, and the like.
Recent research on potential causes of localized itchy back has related this problem to possible pinched nerves in the neck. There is a condition called Notalgia Paresthetica or NP for short that is known to cause a one sided itch on the middle of the back. The same type of pinched neck nerve can also cause intermittent itching down one or both arms. This is called BRP for short or Brachioradial pruritus.
A recent UC Berkeley wellness report discussed the common cause of back itching around one shoulder blade (Notalgia) as resulting from a temporary pinched nerve in the spine. Treatment for this type of localized back itching involves spine therapy and TENS.
A 2011 research article published by Dr. N. Alai and Dr. H. Skinner at The Skin Center confirmed that the itchy back called notalgia was strongly associated with changes on a neck MRI at disc C4-C6. Based on these research findings, creams and lotions applied to the back skin simply don’t work because the itching is caused by a pinched nerve way below the skin. The paper by Dr. Alai showed that many cases of back itching (Notalgia) are most effectively treated by applying TENS ( a home, battery powered nerve stimulator) to the back base of the neck. TENS neck treatments for 10-15 minutes a few times a day seemed to immediately resolve the back itching.
On a basic symptom level, the largest majority of patients with Notalgia often do not recognize their symptoms as having a medical association and rarely present to a doctor with their complaints. Many Notalgia patients attribute their symptoms to numerous causes including laundry soap, clothing tag allergy, bra strap allergy, and elastic band irritation. A very large proportion of Notalgia cases are diagnosed in women who describe their mid back irritation originating from the bra strap.
Do’s of Itchy Back
- Do avoid neck strain and prolonged head flexion ( looking down)
- Do try lying down on a home acupressure/acupuncture mat for 1-2 minutes when itchy
- Do massage your neck muscles and apply heat packs
- Do see your doctor if your itching does not get better in 1-2 months
Don’ts of Itchy Back
- Don’t keep scratching ( can cause skin breaks and infection)
- Don’t ignore your neck health