Back pain deserves a second diagnosis

Q. 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?

A. 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 it is thought to be the result of nerve damage.

The skin on the affected areas is often darkened, and scratch marks are present. In some cases, there is scarring caused by 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.

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