The effect of local anesthetic injection in the treatment of notalgia paresthetica

Abstract

Summary Introduction Notalgia Paresthetica (NP) is a type of chronic sensory neuropathy characterized by localized itching, pain and dysesthesias including numbness, tingling, burning, coldness, hypo- and hyperesthesia. The purpose of this study was to evaluate the level of improvement in itching and burning sense and to ascertain the effectiveness of local anesthetic injection using 1% lidocaine solution in the treatment of NP. Material-Methods The research comprised 63 NP patients in all, ranging in age from 18 to 70. Patient files were evaluated retrospectively. S-LANNS and VAS were evaluated in patients who underwent a total of 3 local anesthesia at one-week intervals. Results It should not be forgotten that injections with local anesthetics may be alternative options with a high chance of success in the treatment of NP patients. Conclusion Injections with local anesthetics may be an alternative approach that can be effectively used to treat these patients.

Keywords

• Notalgia Paresthetica
• Local anesthetic injection
• Neuropathic pain
• Back pain
• İtching.

Notalgia parestetika tedavisinde lokal anestezik enjeksiyonunun etkisi

Öz

Özet Giriş Notalgia Paresthetica (NP), lokalize kaşıntı, ağrı ve uyuşma, karıncalanma, yanma, soğukluk, hipo ve hiperestezi gibi disestezilerle karakterize bir kronik duyusal nöropati türüdür. Bu çalışmanın amacı, kaşıntı ve yanma hissindeki iyileşme düzeyini değerlendirmek ve NP tedavisinde %1 lidokain solüsyonu kullanılarak yapılan lokal anestezik enjeksiyonunun etkinliğini saptamaktır. Materyal-Yöntem Araştırmaya 18 ila 70 yaş aralığında toplam 63 NP hastası dahil edildi. Hasta dosyaları retrospektif olarak değerlendirildi. Bir haftalık aralıklarla toplam 3 lokal anestezi uygulanan hastalarda S-LANNS ve VAS değerlendirildi. Sonuçlar NP hastalarının tedavisinde lokal anestezik enjeksiyonlarının yüksek başarı şansına sahip alternatif seçenekler olabileceği unutulmamalıdır. Sonuç Lokal anestezik enjeksiyonları bu hastaların tedavisinde etkili bir şekilde kullanılabilecek alternatif bir yaklaşım olabilir.

Anahtar Kelimeler

• notaljia parestetika
• lokal anestezik enjeksiyonu
• nöropatik ağrı
• sırt ağrısı
• kaşıntı

References

1. 1.Şenel E, Holt S, Sabancılar E, Sabancılar Z, Doğruer Şenel S. The etiology of notalgia paresthetica: a descriptive study of 117 patients. Ir J Med Sci. 2020;189(4):1311-6. [Crossref]
2. 2.Mülkoğlu C, Nacır B. Notalgia paresthetica: clinical features, radiological evaluation, and a novel therapeutic option. BMC Neurol. 2020;20:191. [Crossref]
3. 3.Ellis C. Notalgia paresthetica: the unreachable itch. Dermatol Pract Concept. 2013;3(1):36. [Crossref]
4. 4.Raison-Peyron N, Meunier L, Acevedo M, Meynadier J. Notalgia paresthetica: clinical, physiopathological and therapeutic aspects. A study of 12 cases. J Eur Acad Dermatol Venereol. 1999;12(3):215-21. [Crossref]
5. 5.Andersen HH, Sand C, Elberling J. Considerable variability in the efficacy of 8% capsaicin topical patches in the treatment of chronic pruritus in 3 patients with notalgia paresthetica. Ann Dermatol. 2016;28(1):86-9. [Crossref]
6. 6.Savk O, Savk E. Investigation of spinal pathology in notalgia paresthetica. J Am Acad Dermatol. 2005;52(6):1085-7. [Crossref]
7. 7.Savk E, Savk O, Bolukbasi O, Culhaci N, Dikicioğlu E, Karaman G, et al. Notalgia paresthetica: a study on pathogenesis. Int J Dermatol. 2000;39(10):754-60. [Crossref]
8. 8.Pagliarello C, Fabrizi G, De Felici B, Casanova D, Feliciani C, Di Nuzzo S. Notalgia paresthetica: factors associated with its perceived severity, duration, side, and localization. Int J Dermatol. 2017;56(9):932-8. [Crossref]

9. 9.Shin J, Kim YC. Neuropathic itch of the back: a case of notalgia paresthetica. Ann Dermatol. 2014;26(3):392-4. [Crossref]
10. 10.Ansari A, Weinstein D, Sami N. Notalgia paresthetica: treatment review and algorithmic approach. J Dermatolog Treat. 2019;3:1-9.
11. 11.Low R, Swanson LA, Swanson DL. Notalgia paresthetica relieved by cervical traction. J Am Board Fam Med. 2017;30(6):835-7. [Crossref]
12. 12.Savk E, Savk SO. On brachioradial pruritus and notalgia paresthetica. J Am Acad Dermatol. 2004;50(5):800-1. [Crossref]
13. 13.Maciel AA, Cunha PR, Laraia IO, Trevisan F. Efficacy of gabapentin in the improvement of pruritus and quality of life of patients with notalgia paresthetica. An Bras Dermatol. 2014;89(4):570-5. [Crossref]
14. 14.Robbins BA, Ferrer-Bruker SJ. Notalgia paresthetica. In: StatPearls [Internet]. Treasure Island, FL: StatPearls Publishing; 2019 [cited 2025 Sep 25]. Available from: https://www.ncbi.nlm.nih.gov/books/NBK557437.
15. 15.Riehl melanosis. In: StatPearls [Internet]. Treasure Island, FL: StatPearls Publishing; 2025 [cited 2025 Sep 25]. Available from: https://www.ncbi.nlm.nih.gov/books/NBK557437.
16. 16.Chtompel Y, Eghtesadi M, Vargas-Schaffer G. A case report of refractory notalgia paresthetica treated with lidocaine infusions. Am J Case Rep. 2017;18:1225-8. [Crossref]
17. 17.Willatts DG, Reynolds F. Comparison of the vasoactivity of amide and ester local anaesthetics. An intradermal study. Br J Anaesth. 1985;57(10):1006-11. [Crossref]
18. 18.Takao Y, Milkawa K, Nishina K, Maekawa N, Obara H. Lidocaine attenuates hyperoxic lung injury in rabbits. Acta Anaesthesiol Scand. 1996;40(3):318-25. [Crossref]
19. 19.Egli S, Pfister M, Ludin SM, Puente de la Vega K, Busato A, Fischer L. Long-term results of therapeutic local anesthesia (neural therapy) in 280 referred refractory chronic pain patients. BMC Complement Altern Med. 2015;15:200. [Crossref]
20. 20.Wewers ME, Lowe NK. A critical review of visual analogue scales in the measurement of clinical phenomena. Res Nurs Health. 1990;13(4):227-36. [Crossref]
21. 21.Bennett MI, Smith BH, Torrance N, Potter J. The S-LANSS score for identifying pain of predominantly neuropathic origin: validation for use in clinical and postal research. J Pain. 2005;6(3):149-58. [Crossref]
22. 22.Savk O, Savk E. Investigation of spinal pathology in notalgia paresthetica. J Am Acad Dermatol. 2005;52(6):1085-7. [Crossref]
23. 23.Girolomoni G, Magni R, Magnoni C, Fantini F. Notalgia paresthetica. G Ital Dermatol Venereol. 1992;127(11):553-6.
24. 24.Bernhard JD. Notalgia paresthetica, macular posterior pigmentary incontinence, macular amyloidosis and pruritus. Acta Derm Venereol. 1997;77(2):164. [Crossref]
25. 25.Shumway NK, Cole E, Fernandez KH. Neurocutaneous disease: neurocutaneous dysesthesias. J Am Acad Dermatol. 2016;74(2):215-28. [Crossref]
26. 26.Zagarella S, Kapila S, Fallahi A. Notalgia paresthetica: a pilot study of treatment with simple exercises and stretches. Australas J Dermatol. 2016;57(3):222-4. [Crossref]
27. 27.Fleischer AB, Meade TJ, Fleischer AB. Notalgia paresthetica: successful treatment with exercises. Acta Derm Venereol. 2011;91(3):356-7. [Crossref]
28. 28.Frank BL. Neural therapy. Phys Med Rehabil Clin N Am. 1999;10(3):573-82. [Crossref]
29. 29.Mermod J, Fischer L, Staub L, Busato A. Patient satisfaction of primary care for musculoskeletal diseases: a comparison between neural therapy and conventional medicine. BMC Complement Altern Med. 2008;8:33. [Crossref]
30. 30.Moore PA, Hersh EV. Local anesthetics: pharmacology and toxicity. Dent Clin North Am. 2010;54(4):587-99. [Crossref]