Exercise, Manipulative Therapy, and Physical Modalities in the Treatment of Notalgia Paresthetica: A Case Report

Objective: The purpose of this case report is to describe the care of a patient with notalgia paresthetica (NP). Clinical Features: A 61-year-old man presented with a 7-year history of upper back pain, concentrated in the right periscapular region. Physical examination revealed a hyperpigmented area in the right dorsal paravertebral and infrascapular region with local paraesthesia. After investigations, a diagnosis of NP was made. Intervention and Outcome: An exercise program including back and shoulder stretching and shoulder strengthening exercises, and transcutaneous electrical nerve stimulation resulting in a reduction of symptoms. Conclusion: In the case described here, the patient's symptoms regressed when treated conservatively with exercise and physical therapy modalities.