DEAR DR. GOTT:
I am a 45-year-old female in good health except for back pain. I have muscle and joint pain from the base of my skull to my lower back.
Despite regular yoga, chiropractic care and massage, I wake up stiff and uncomfortable. It lasts all day. The left side of my back from my shoulder to the mid-back is also noticeably more developed or pronounced than the right side. A few years ago, a physician diagnosed me as having notalgia paresthetica.
What are your thoughts on this situation? Where should I go from here?
DEAR READER:
Notalgia paresthetica is defined as a chronic, localized itch that usually affects patches of skin on the upper back. It can occasionally affect the shoulders, upper chest and other portions of the back.
Symptoms include itching, tingling, prickling, and/or numbness, usually on one side of the back. The cause is unknown, but is thought to be the result of nerve damage.
Upon presentation to a physician, the affected areas are often hyper-pigmented (darkened), scratch marks are present and in some cases, scarring is also due to chronic scratching. Little treatment is available but some physicians have had success using topical capsaicin or certain types of botox.
That being said, this condition sounds nothing like what you are experiencing. I recommend you speak to your primary care physician or an orthopedic specialist. You may need imaging studies of your neck, back and hips (to get a full view of your entire spine).
Your back pain may be the result of a herniated disc, degenerative changes in the spine or more. You have taken appropriate steps by seeing a chiropractor, massage therapist and keeping physically fit and limber with stretching exercises. However, with little or no results to show, it is now time to move on to more aggressive testing and diagnosis.
In the meantime, I suggest you try using over-the-counter pain relievers such as acetaminophen or ibuprofen. Hot and cold packs may also be of benefit.
To give you related information, I am sending you a copy of my Health Report “Managing Chronic Pain”. Other readers who would like a copy should send a self-addressed, stamped number 10 envelope and $2 to Newsletter, PO Box 167, Wickliffe, OH 44092. Be sure to mention the title.
About Dr. Gott