Trager Robert J, Riffle Curtis P, Tao Cliff
Chiropractic, Connor Whole Health, University Hospitals Cleveland Medical Center, Cleveland, USA.
Family Medicine and Community Health, Case Western Reserve University School of Medicine, Cleveland, USA.
Cureus. 2024 Feb 1;16(2):e53382. doi: 10.7759/cureus.53382. eCollection 2024 Feb.
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.
感觉异常性背痛（NP）是一种慢性皮肤神经病变，其特征为局部瘙痒、疼痛、麻木和/或感觉异常，常与颈胸段退行性改变有关。NP的治疗选择有限。本病例报告详细介绍了一名54岁女性，有六年右侧肩胛周瘙痒和颈胸不适病史，经转诊后到一名脊椎按摩师处就诊，此前已被诊断为NP。既往的局部治疗效果甚微。X线片显示C5/6和C6/7节段有脊柱退行性改变，与她的肩胛周症状分布相关。患者对脊椎按摩脊柱手法治疗（SMT）反应良好，治疗重点为颈胸段区域，并结合肌筋膜放松。单次SMT治疗后症状明显改善，第二次治疗后症状消失，在为期一个月的随访中未再出现瘙痒。虽然本病例突出了SMT对NP的潜在益处，但仍需进一步研究以探索这种治疗方法的有效性。
