Notalgia Paresthetica: Say What?

Things are Looking Up!

Things are sunny and warm and bright and colorful and pleasant in this overhead shot from a walkabout last week. I need to remember we will still have some color, some warmth and un-blustery days ahead. (This will NOT be one of them.)

The weekend looks good for leaf-peepers on the Parkway, so y’all come on up, enjoy some time and spend some dollars in Floyd.

Meanwhile, I am enjoying what the NIH describes as a rare disease. For real.

I came home from Chattanooga on October 6 with what you’d expect from four days of bus rides, hour upon hour of sitting, and tension. It got much worse a few days later taking minutes at my first board meeting after coming home–like somebody stabbed my left shoulder blade with an ice pick. I think I actually hollered it surprised me so.

And two weeks later, it was the same. But different.

I made the mistake of complaining. I had realized that, while my original symptoms seemed like the all too familiar myofascial pain I have suffered intermittently for decades, the condition had become more of a skin disorder. Very curious.

Stinging, itching, shocky, raw–it was the skin just where you can’t reach, and all on the left below my shoulder blade and toward my spine.

“It’s shingles!” she declared, ” and you’d better get to the dermatologist tomorrow!” and the Queen of Dire Consequences did proceed to lay out the bleak future I was to face if I failed to comply with her warnings.

Shingles didn’t fit my symptoms. While feigning obsequious intentions of obedience, I sought my own diagnosis and found it: notalgia paresthetica.

And that is what it turns out to be. I tell you this because it is not uncommon after all, it is very strange, and you’ll think you’re making it up. Or your spouse or significant other will accuse you of whining about imaginary arthropods under your skin. She’ll say you’ve been watching too many episodes of X-files. Trust me on this one.

Because there may be nothing to see here–just your own private experience of tiny crabs crawling under your skin spreading itch powder and red chili pepper with their tiny terrible cleated track shoes.

The root cause is often trauma to thoracic nerve roots (car wreck, a fall, etc) but in my case was probably just postural overload. This is good news, because the traumatic type can go on indefinitely–years, decades or the rest of your life.

I did see a PA at the dermatologist office yesterday who quickly confirmed my self-diagnosis (told you so! dear.) and sees it not infrequently. She thought it likely that my planned course of action (cervical and thoracic stretches and  upper torso resisted exercises) will make things better. Eventually.

Meanwhile, my little pets are doing wind sprints and jumping jacks and various other leaping and crawling gymnastics only on the left–this disorder is apparently almost exclusively on the LEFT–go figure.

So just when I thought my life was going to get boring and “normal” again, some other stuff happens. Other stuff always happens. You have, perhaps, seen the bumper sticker?








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Fred First holds masters degrees in Vertebrate Zoology and physical therapy, and has been a biology teacher and physical therapist by profession. He moved to southwest Virginia in 1975 and to Floyd County in 1997. He maintains a daily photo-blog, broadcasts essays on the Roanoke NPR station, and contributes regular columns for the Floyd Press and Roanoke's Star Sentinel. His two non-fiction books, Slow Road Home and his recent What We Hold in Our Hands, celebrate the riches that we possess in our families and communities, our natural bounty, social capital and Appalachian cultures old and new. He has served on the Jacksonville Center Board of Directors and is newly active in the Sustain Floyd organization. He lives in northeastern Floyd County on the headwaters of the Roanoke River.

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  1. Bummer, Fred! Sorry you are not at a hundred percent. Hopefully this will not be long lasting for you. I’ve had shingles before and they aren’t very pleasant either.

  2. First, gorgeous photo, Fred.
    Your skin ailment sounds awful! I got shingles and that’s no fun either. Take lots of relaxing walks, don’t sit at the computer much, lie down a lot, and do whatever Googling turns up! Good luck with a rapid recovery.

  3. I have indeed seen the bumper sticker. I have never heard of your condition, but I like the way you described it.

    “tiny crabs crawling under your skin spreading itch powder and red chili pepper with their tiny terrible cleated track shoes.”

  4. I am 58 years old male, and got the same thing about 2 years ago. No injury involved, just noticed tingling, itching, and burning in left lower shoulder blade area medial to the spin. I also get tingling around the nap of the neck like ant crawling under the skin. Fun stuff, and it seems to come and go. I use the full strength capsaicin cream. It seems to also be associated with very stiff muscles in the upper back and neck.

  5. It was such a relief to read this! I visited a dermatologist yesterday and described to her how it felt. She mentioned Notalgia Paresthetica and l googled it today……mystery solved. For the last 6 months or so l kept backing up to my husband telling him to rub “that spot”. It feels like a swirling electric charge. I can’t reach it except with a long wooden spoon. It is beyond annoying…..