Treatment of Notalgia Paresthetica Using LLLT/PBMT

Gentle. Drug-Free. Clinically Proven

Low Level Laser Therapy (LLLT), also known as Photobiomodulation Therapy (PBMT), is a highly effective, non-invasive, and drug-free treatment for notalgia paresthetica in Melbourne, Victoria. Led by Dr Shikha Parmar, a GP with expertise in managing and resolving chronic musculoskeletal pain, this treatment involves the application of red and near-infrared light to promote cellular repair in injured tissues. LLLT is safe, painless, and targets the root cause of the injury, unlike pain medications that simply mask the pain. Supported by scientific research from reputable institutions, including Harvard University and NASA, LLLT is an evidence-based therapy for nerve-related conditions, including notalgia paresthetica.

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Key Points

  • Notalgia paresthetica (NP) is a condition that causes itching, burning, or a tingling sensation, most commonly in the upper back.
  • It results from nerve irritation or damage, often in the area around the shoulder blades (scapulae).
  • Common causes include pressure on the nerve from surrounding structures, degenerative disc disease, or other conditions that cause nerve irritation.
  • Symptoms include persistent or intermittent itching, burning, or a “pins and needles” sensation, primarily along the upper back, sometimes radiating to the chest or shoulders.
  • Conventional treatments for NP, such as antihistamines, steroids, manual therapies, steroid injections and nerve blocks may offer temporary relief but don’t address the underlying nerve irritation or compression.
  • LLLT works by promoting cellular repair, reducing inflammation, and supporting nerve regeneration, providing a long-term solution for pain and irritation.
  • At Laser Pain Therapy, all LLLT treatments are GP-led by Dr Shikha Parmar and delivered as part of a medically supervised six-week program, including rehabilitation support tailored to each patient’s needs.
  • LLLT has been scientifically proven to reduce pain, restore nerve function, and improve outcomes in nerve-related conditions, including notalgia paresthetica.
Click here for FAQ/Costs

What is Notalgia Paresthetica?

Notalgia paresthetica (NP) is a sensory nerve disorder that causes persistent, often debilitating itching or a burning sensation, most commonly along the upper back. The pain and discomfort are typically felt in the area around the shoulder blades, although it can occasionally radiate to the chest or shoulders. This condition is believed to be caused by nerve irritation or damage to the sensory nerves in the upper back, often from structures such as the spine or discs that put pressure on the nerves. It is most commonly seen in older adults and may be associated with degenerative conditions such as disc disease.

Causes of Notalgia Paresthetica

Notalgia paresthetica can develop due to several factors, including:

  • Degenerative disc disease: Disc degeneration in the thoracic spine can lead to nerve compression or irritation, causing symptoms of NP.
  • Spinal stenosis: Narrowing of the spinal canal can lead to pressure on the nerves that cause notalgia paresthetica.
  • Posture: Prolonged poor posture may cause pressure on the nerve, leading to nerve irritation in the upper back.
  • Trauma or injury: A previous injury or surgery around the shoulder blades may lead to nerve damage or irritation.
  • Other conditions: Certain diseases or syndromes can also contribute to the development of NP.

Where LLLT May Help

Low-Level Laser Therapy (LLLT) is an effective, non-invasive treatment for notalgia paresthetica caused by nerve irritation or damage. LLLT promotes cellular repair, reduces inflammation, and stimulates nerve regeneration, providing long-term relief from the symptoms of NP.

However, LLLT may not be effective for notalgia paresthetica caused by more complex conditions, such as structural issues (e.g., severe spinal deformities or extreme nerve compression) where mechanical intervention may be required. In such cases, surgery or other medical procedures may be necessary.

Symptoms of Notalgia Paresthetica

The symptoms of notalgia paresthetica typically include:

  • Persistent or intermittent itching, tingling, or burning sensations in the upper back, especially near the shoulder blades
  • A feeling of tightness or discomfort in the skin or muscles in the affected area
  • Pain that may worsen with pressure or certain movements, such as slouching or reaching
  • Sometimes radiating pain or discomfort may be felt in the chest or shoulders

 

How is Notalgia Paresthetica Diagnosed?

Diagnosis of notalgia paresthetica is based on a thorough clinical evaluation. Dr Shikha Parmar will assess your symptoms, including the onset, duration, and nature of your pain. A physical examination will be conducted to assess the area of discomfort, and specific tests may be performed to identify any underlying nerve irritation or damage.

Imaging techniques, such as MRI, may be used to rule out other causes of nerve compression or irritation, such as spinal abnormalities or disc herniation. X-rays may also be used in some cases, although they are not typically necessary unless other underlying conditions are suspected.

Notalgia Paresthetica – Treatment Overview

Low Level Laser Therapy (LLLT), also known as Photobiomodulation Therapy (PBMT), is a gentle, evidence-based treatment that targets the underlying cause of notalgia paresthetica: chronic nerve irritation, inflammation, and oxidative stress affecting the upper back. It promotes healing without mechanical stress to the sensitive cutaneous nerves.

Why Choose Low Level Laser Therapy (LLLT)?

Many patients present after limited relief from steroid creams, capsaicin, lignocaine patches, antihistamines, pain medications, neuropathic agents, massage, injections, or postural therapy. These approaches may temporarily ease itching, burning, or tingling but often fail to address persistent nerve irritation and may carry side effects. LLLT is particularly helpful where chronic nerve inflammation remains active and symptoms recur despite conventional care.

Why medications and injections may not support long-term recovery. Read more here.

How LLLT Supports Healing

LLLT uses red and near-infrared light to restore balance to the inflammatory process and stimulate soft tissue and nerve repair by:

  • Improving circulation and oxygen delivery
  • Enhancing lymphatic drainage
  • Reducing inflammation and oxidative stress
  • Increasing cellular energy (ATP)
  • Supporting nerve regeneration and restoring function

All without compressing or irritating the affected area of the upper back.

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Proven, Safe, and Effective

It is non-invasive, painless, and supported by extensive clinical research. Read more here.

See how LLLT helps restore the cellular environment needed for repair here.

Our Treatment Program

All patients are assessed by Dr Shikha Parmar (GP). Treatment is delivered within a structured six-week program, including:

  • Up to 12 LLLT sessions
  • Review after 6 sessions
  • Individualised advice and activity modification
  • Guided rehabilitation for durable recovery

Patients who respond typically show 15–20% improvement within the first 6 sessions, with best-case improvement of 70–90% over the full program.

View the full treatment protocol and expected outcomes here.

Ready for Lasting Relief?

If you are struggling with notalgia paresthetica, we invite you to contact our experienced team at Laser Pain Therapy. Our LLLT treatment offers a safe, effective, and lasting solution to restore your comfort, mobility, and quality of life.

Contact us today to arrange your consultation and take the first step towards recovery.
📍 Located in Melbourne
📞 (03) 8529 2225 Contact Us

View treatment cost here

Cost / FAQ

At Laser Pain Therapy, we use the terms Low-Level Laser Therapy (LLLT) and Photobiomodulation Therapy (PBMT) interchangeably, as they both refer to the same therapeutic approach. “LLLT” specifically focuses on the use of laser light, while “PBMT” is the broader scientific term describing how light interacts with the body to promote healing.

Both therapies stimulate cellular activity, reduce inflammation, repair tissue, and accelerate the healing process.

The initial consultation with Dr Shikha Parmar requires up to 60 minutes where your condition is fully assessed along with your medical history. Dr Parmar will take a thorough history of your problem from its onset, through its progression to now. She will review any imaging reports pertaining to your problem, and may recommend further investigations. Dr Parmar will give you a detailed explanation of your problem, and will discuss our holistic approach and management plan including the utilisation of Low Level Laser Therapy (LLLT). If your condition is amenable to LLLT the treatment is commenced at the initial consultation. A medical consultation with Dr Shikha Parmar, GP, is billed and is rebatable through Medicare for patients who hold a Medicare card.

The fee for an initial consultation including Low Level Laser Therapy treatment is $257.00. This includes a Medicare rebate for the GP consultation of $84.90, the out of pocket cost being $172.10.

Pension and Health Care Card holders receive a further reduced fee for the initial consultation of $207.00 only with the out of pocket fee (gap fee) being $122.10.

For each subsequent follow-up consultation  involving review of progress, tailored advice and management etc, and Low Level Laser Therapy treatment, a fee of $129.25 applies. This includes a Medicare rebate for the GP consultation of $43.90, the out of pocket cost (gap fee) being $85.35.

Longer review visits are charged at $210.20 which includes a Medicare rebate $84.90, the out-of-pocket cost being $125.30.
An $8.00 surcharge applies to appointments after 6pm.

Fees may be subject to change and will be confirmed with you at the time of booking. We utilise state of the art equipment from Europe and the USA operated with the assistance of highly trained clinic assistants.  No further rebate can be claimed from private health insurance. We are unable to offer bulk billing.

Yes.  LLLT has been in active and beneficial use in Europe for nearly 30 years. There are more than 200 double blind positive studies confirming the clinical effect of LLLT.
Published in the world’s top scientific journals:

  • Nature, Pain, PNS, Blood, BMJ, Spine, Muscle and Nerve, The Lancet, Circulation, BJSM
  • 30 LLLT papers published a month
  • Over 4000 laboratory studies and over 400 randomised controlled trials

Over 2,500 clinical studies and published research reports have shown the effectiveness of LLLT for a variety of health issues. Looking at the limited LLLT dental literature alone (370 studies), more than 90% of these studies do verify the clinical value of laser therapy.
LLLT has been a staple in veterinary practices for decades.
In the past 6 years, professional sports teams have begun utilising LLLT.

In the last 10 years 8 systematic reviews have found in favour of LLLT

  • American College of Physicians Guidelines include a “strong recommendation” for Low-Level Laser Therapy as a non-invasive Treatments for Acute, Subacute & Chronic Low Back Pain. (2017) Click here
  • BMJ LLLT for chronic non-specific low back pain: a systematic review and meta-analysis of randomised controlled trials found “moderate quality of evidence” and “clinically important benefits” in the short term. (2016) Click here
  • BMJ sports medicine journal, systematic review of surgical and conservative interventions for frozen shoulder found “strong evidence” for LLLT. (2010) Click here
  • The BMJ clinical evidence recommendations for tennis elbow 2011 now include LLLT Click here
  • American Physical Therapy Association guidelines recommend LLLT for Achilles tendonitis. (2010) Click here
  • Lancet systematic review: “LLLT reduces pain immediately after treatment in acute neck pain and up to 22 weeks after completion of treatment in patients with chronic neck pain”. (2009) Click here
  • World Health Organisation (Bone and Joint Task Force) for neck pain Low Level Laser Therapy “more effective than no treatment, sham, or alternative interventions” (2008) Click here

Laser Therapy does not heat or cut tissue, unlike high intensity lasers. The question is often asked “If it’s a laser aren’t they used in surgical operations, to cauterise tissue?” The answer is “Yes” – hot lasers are able to cauterise (cut) tissue. However, the ones we use are “Low Level Lasers” of class 3B, the most researched and proven class in LLLT, and with designed parameters that make it impossible to damage even one cell in the body. Our lasers stimulate and energise the cells.

In the past 4 years, the FDA has ruled that LLLT (Low Level Laser Therapy) is safe and the only contraindication (warning) is not to use it directly in the eyes.

For the past 30 years the technology of Low Level Laser Therapy (LLLT) has been formally accepted in many parts of the world such as Canada, USA, Brazil, Europe, Scandinavia, Russia and Japan. In all this time there have been no recorded long-term adverse effects from its use. It is considered to be non-invasive, painless and safe.

Industry has been using laser diodes for years in such applications as barcode readers, CD players, DVD players, laser printers and pointers. The FDA has listed bio-stimulation lasers as non-significant risk (NSR) devices.

Hundreds of research studies have shown Laser Therapy to be safe and effective. Laser Therapy is non-invasive, non-toxic and non-thermal. Unlike other forms of radiation, Laser Therapy is beneficial rather than harmful to tissue. Over 400 LLLT clinical trials (RCTs) and over 2500 laboratory studies have been published. It has proven more effective and safer than pharmaceutical anti-inflammatories across a range of musculoskeletal conditions.

LLLT also improves healing and reduces muscle fatigue, muscle damage and delayed onset muscle soreness or DOMS.

There are normally no adverse effects from LLLT, however, patients occasionally experience mild discomfort/ache after treatment. This is due to a restimulation of the inflammatory phase and should settle down after 24 – 48 hours.

The answer is no. No mutational effects have been observed resulting from light with wavelengths in the red or infrared range and of doses used within LLLT. But what happens if I treat someone who has cancer and is unaware of it? Can the cancer’s growth be stimulated? The effects of LLLT on cancer cells in vitro have been studied, and it was observed that they could be stimulated by laser light. However, with respect to a cancer in vivo, the situation is rather different. Experiments on rats have shown that small tumours treated with LLLT can recede and completely disappear, although laser treatment had no effect on tumours over a certain size. It is probably the local immune system, which is stimulated more than the tumour.

The situation is the same for bacteria and virus in culture. These are stimulated by laser light in certain doses, while a bacterial or viral infection is eradicated more quickly after treatment with LLLT.

Laser Therapy should be avoided in the following instances:

  • Over the womb for women in pregnancy
  • Over cancerous tumour, primary or secondary (LLLT is not a treatment for these conditions)
  • Direct irradiation of the eyes

At Laser Pain Therapy, we use state-of-the-art, TGA-approved laser devices, applied by highly trained assistants. Our laser devices deliver the appropriate red and infrared laser energy to trigger the desired tissue response. With the application of up to 37 diodes (laser lights) across multiple devices, we ensure time-efficient treatment without compromising dosage or energy delivery. Unlike LED devices, our laser technology provides deeper penetration and more effective tissue healing.

Dr Shikha Parmar, an experienced GP with over 30 years in General Practice and 14 years of expertise in photobiomodulation therapy, leads our clinic, making her one of the most experienced doctors in this field. Treatment at Laser Pain Therapy is medically supervised, ensuring each patient receives a thorough assessment that takes into account not only their presenting condition but also relevant health factors, such as co-morbidities, medications, lifestyle, work, personal activity demands, and nutritional deficiencies. This holistic approach allows us to tailor care with LLLT at the core, supported by personalised advice.

Additionally, our treatment plans are finite, with clear goal-setting and regular progress reviews, ensuring that each patient is on track towards long-term recovery and optimal outcomes.

At Laser Pain Therapy, we use advanced equipment with laser diodes, not LED lights. Unlike LEDs, laser diodes provide more focused light with deeper penetration, making them significantly more effective for treating musculoskeletal conditions.

Our state-of-the-art equipment features 37 laser diodes, allowing us to efficiently cover a larger surface area. This optimises treatment time, ensuring deeper penetration for superior results. Unlike devices that use just 2-4 diodes, our technology delivers more effective treatment in less time, promoting faster healing, reduced inflammation, and long-lasting pain relief.

The effects of LLLT are accumulative. The good news is that for most patients undergoing a treatment program, the results from the treatments are sustained. While some patients get immediate results, improvements are often not noticed until after 3 to 5 treatments. Most patients usually require 6-12 treatments to achieve resolution of the problem or a lasting effect.

More severe conditions will require more treatments than less severe injuries. Since each person’s condition varies in severity the doctor will determine after reviewing your condition how laser treatments may benefit you and how many you might require

Your situation will be assessed after 6 treatments and if there is no improvement after 6 to 8 treatments (very uncommon), LLLT will not be continued and alternatives will be looked at for your future management.

You will need to follow precautions in order to avoid re-injury or the pain may return. Low Level Laser Therapy not only helps injured tissues heal faster, it also makes them stronger and less vulnerable to re-injury.

Contact us to book a consultation at our clinic or to learn more about how this form of therapy could help you.

No. Low level lasers do not generate perceivable heat. Therefore, when the laser contacts the skin the patient experiences no burning as a result of the laser. Most people feel nothing at all while a few may feel a slight tingling or warmth during the treatment.

No. As Dr Shikha Parmar is a General Practitioner a doctor’s referral is not required.

With our dedicated clinic in Melbourne, contact us at Laser Pain Therapy to discuss how we can assist you

Images and Illustrations Disclaimer
Please note that the images, diagrams, and illustrations used on this website are for demonstration and illustrative purposes only. They are intended to provide a general overview of Photobiomodulation Therapy (PBMT) and Low-Level Laser Therapy (LLLT). The specific methods and equipment we use at Laser Pain Therapy may differ from those depicted. For instance, while some images may show a small laser being applied to the skin, we utilise advanced cluster lasers equipped with multiple diodes, offering superior coverage and effectiveness for treating musculoskeletal conditions. Our treatment protocols are tailored to each patient’s unique needs, using the latest technology for optimal results.

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Laser Pain Therapy

South Yarra, Victoria
Suite 8, 200 Toorak Road
(Ground floor from William St)
South Yarra, Vic 3141
Ph: 03 8529 2225
Email us:
info@laserpaintherapy.com.au

 

Location

TRANSPORT ACCESS:
Train: South Yarra Station, 100m, 1 minute walk
Tram: Route 58, stop no. 127

Easy free street parking:
If driving you will find many free 1P and 2P spots on and around Toorak Rd and William St near the clinic.

 
Call now: 03 8529 2225
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Our Mission

We are dedicated to helping our patients with the most technically advanced, proven and affordable medical therapies. Our treatment modalities offer evidence-based, safe, non-invasive and painless solutions to improve health, well-being and quality of life.

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The contents of this website have not been evaluated by the Australian Government Department of Health. The information of this site is not intended to diagnose, treat, cure or prevent any disease. Individual articles are based upon the opinions of the author, who retains copyright as listed…..Continue Reading

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