That Itchy Spot Near Your Shoulder Blade That Never Goes Away: Notalgia Paresthetica
SkinArticleA persistent itch beside one shoulder blade, often with a darker patch from scratching, is commonly a nerve-related condition called notalgia paresthetica. It's benign, more often reported in middle-aged women, and anti-itch creams and antihistamines usually disappoint. Here is what a medical review says helps.
In this article
Maybe it’s been going on for months or years: an itch in one spot beside your shoulder blade, usually on the side opposite your dominant hand, that you keep scratching.1 Over time the skin there may look darker or thickened.1 This pattern is often notalgia paresthetica.
What it is
Notalgia paresthetica is an itch caused by irritated nerves, not by a skin disease.1 It’s thought to come from irritation of the nerves that exit the upper and middle spine, sometimes linked to wear-and-tear changes in the spine or disc problems.1 It’s usually benign, often affects one side, and is reported more in older women.1
- There’s no rash at the start. Darker or thickened skin comes from scratching.1
- Some people also feel pain, burning, cold, tingling or numbness in the spot.1
How it’s diagnosed
Usually from your description and an exam alone.1 Imaging isn’t needed unless you have other back, muscle or nerve symptoms.1 A biopsy sometimes helps rule out look-alikes.1
What helps
The review notes that treatment can be disappointing, and that knowing the condition is harmless is enough for some people with mild itch.1
- Gabapentin, a nerve-calming prescription, has been reported as the most effective medicine.1
- Capsaicin creams or patches can give quick relief but may burn, and worked less well than gabapentin in a small study.1
- Antihistamines usually don’t help much with the itch, though sedating ones may reduce scratching at night.1
- Steroid creams help only if there’s inflammation.1
- TENS (a small nerve-stimulation device) helped some people in a small study.1
- Physical therapy to strengthen upper back muscles and stretch the chest has helped in some cases.1
- Botulinum toxin results have been mixed.1
When to look further
Get checked for a growth or mole that changes, back pain with weakness or numbness, or itching that spreads to many areas. Our guides to dry, itchy skin, skin self-exams and hives cover related causes.
Try: “I’ve had an itch beside my left shoulder blade for two years, and creams don’t help. Could this be notalgia paresthetica, and what treatment would you suggest?”
Skin, Head to Toe includes a short-shelf planner and a 12-week SkinLog. Use them to rate the itch weekly and note what you’ve tried. See the book.
This article is for general educational purposes only and is not medical advice. It isn't a substitute for diagnosis or treatment from a qualified healthcare professional who knows your health history. Please don't ignore professional advice or delay getting care because of something you read here. A new or changing mole or growth, a rash that spreads, back pain with weakness or numbness, or itching all over the body should be checked. If you think you may be having a medical emergency, call 911 or your local emergency number right away. This article discusses a medical condition and general treatment approaches. Girl Playbook does not endorse any specific product, test, or provider.
Girl Playbook sells this book. It provides education and worksheets, not individualized medical care.
Sources
The research behind this article, in the order it’s cited. How we source our articles.
- StatPearls, NCBI Bookshelf (National Library of Medicine)Notalgia Paresthetica (opens in a new tab)abcdefghijklmnopqr
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