Persistent Left Back Itching and Numbness: Seeking Answers in Medical Care - Internal Medicine

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It sounds like you have been experiencing persistent itching and numbness in your left back, particularly near the scapula, for about five months. This sensation, which you describe as deep and unrelenting, has understandably caused you significant discomfort and concern. Given the complexity of your symptoms and the various specialists you have consulted, it is important to consider a few potential avenues for further investigation and management.

Firstly, the fact that you initially sought help from a cardiologist and underwent tests such as X-rays and an electrocardiogram (ECG) suggests that you were right to rule out any cardiac issues. However, the subsequent consultations with gastroenterology and pulmonology have not yielded satisfactory answers, which can be frustrating. Your experience of relief from medication prescribed for esophageal issues does raise the possibility that there may be a gastrointestinal component to your symptoms, even if imaging studies did not reveal any abnormalities.

It is worth noting that the sensation of itching and numbness can sometimes be linked to nerve irritation or damage. Conditions such as thoracic outlet syndrome, herniated discs, or even shingles (herpes zoster) can cause similar symptoms, particularly if there is nerve involvement. Given that your symptoms have persisted and evolved to include mild pain, it may be beneficial to consult a neurologist. A neurologist can perform a thorough neurological examination and may recommend additional imaging studies, such as an MRI of the thoracic spine, to assess for any nerve compression or other neurological issues.

Additionally, you mentioned that the itching is deep and not relieved by scratching, which can sometimes indicate a neuropathic component. Neuropathic itching can occur due to nerve damage or irritation, and it may not respond to typical anti-itch treatments. In such cases, medications that target nerve pain, such as gabapentin or pregabalin, may be considered.

Another important aspect to consider is your overall health and any other symptoms you may be experiencing. For instance, if you have a history of gastrointestinal issues, it might be worth revisiting the gastroenterologist for further evaluation, including the possibility of an endoscopy if warranted. Sometimes, conditions like esophageal spasms or motility disorders can cause referred sensations that mimic other issues.

In summary, I recommend the following steps:
1. Consult a Neurologist: Given the nature of your symptoms, a neurologist can help determine if there is a nerve-related issue contributing to your discomfort.

2. Consider Further Gastrointestinal Evaluation: If you still suspect a gastrointestinal cause, discussing the possibility of an endoscopy with your gastroenterologist may be worthwhile.

3. Keep a Symptom Diary: Documenting when the itching and numbness occur, any triggers, and how long they last can provide valuable information for your healthcare providers.

4. Explore Pain Management Options: If neuropathic pain is suspected, medications specifically targeting nerve pain may be beneficial.

5. Stay Persistent: Continue to advocate for your health. If you feel that your concerns are not being addressed, seeking a second opinion or exploring other specialists may be necessary.

Your symptoms are complex, and it may take time to find the right diagnosis and treatment plan. Don't hesitate to reach out for help and keep pushing for answers until you find relief.