# Notalgia Paresthetica Responding Positively to Chiropractic Spinal Manipulation: A Case Report

## TL;DR

A woman with chronic nerve-related itching and pain found relief through chiropractic treatment, suggesting spinal manipulation may help this condition.

## Contribution

This case report demonstrates a novel response to chiropractic spinal manipulation for notalgia paresthetica.

## Key findings

- The patient experienced significant symptom improvement after two chiropractic sessions.
- Symptoms did not return during a one-month follow-up period.
- Degenerative spinal changes correlated with the patient's symptom distribution.

## Abstract

Notalgia paresthetica (NP) is a chronic cutaneous neuropathy characterized by localized pruritus and pain, numbness, and/or paresthesia, often linked to degenerative cervicothoracic changes. Treatment options for NP are limited. This case report details a 54-year-old woman with a six-year history of right-sided periscapular pruritus and cervicothoracic discomfort who presented to a chiropractor upon referral with a prior diagnosis of NP. Prior topical treatments yielded minimal relief. Radiographs revealed degenerative spinal changes at C5/6 and C6/7 which correlated with her periscapular symptom distribution. The patient responded positively to chiropractic spinal manipulative therapy (SMT), focusing on the cervicothoracic region, coupled with myofascial release. Symptoms significantly improved after a single SMT session and resolved after a second session, with no pruritus returning over one-month follow-up. While this case highlights the potential benefits of SMT for NP, further research is needed to explore the effectiveness of this treatment.