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Have itchy painful scalp with no rash. How to diagnose my symptoms?

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General & Family Physician
Practicing since : 2009
Answered : 9400 Questions
I have a feeling like "icy hot" on the back of my neck, and especially my scalp, it's very painful, very distracting, there is no rash on the scalp or neck, no lesions or anything. Sometimes the burning and 'icy hot" pain can spread into the top of my back as well, but mostly it's on the scalp, uniform pain both sides thank you
Posted Wed, 13 Mar 2013 in Skin Hair and Nails
Answered by Dr. Shoaib Khan 2 hours later

Thank you for writing to us.

If you don't mind answering a few more questions I would appreciate it. They are:
Any history of injury to the region or around it?
Any history of spinal cord or circulatory disorders? Dry or peeling skin in the region? Excessive sweating? Sensitivity to touch? Skin temperature/color/texture? Mobility of the affected region (swelling, stiffness, etc.)?

As of now it is difficult to conclude; but this could be related to any of the conditions - spinal cord injury, neuropathies, fibromyalgia, reflex sympathetic dystrophy, herpes zoster, etc.

I understand your frustration, and with a little more information from you, we should be able to reach a solution to your worries. If there are any more symptoms you experience, please do share them with me.

Feel free to write back to me with any further clarifications and with a kind reply to my queries. I am here to help.

Best wishes.
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Follow-up: Have itchy painful scalp with no rash. How to diagnose my symptoms? 3 hours later
no excessive sweating, no peeling skin, no known spinal cord injuries but I do have typical disc dessication related to aging in the cervical spine area. the scalp is painful to touch, very sensitive, even wind blowing on it hurts. Skin color is normal.
Answered by Dr. Shoaib Khan 16 minutes later

Your information has helped a lot. Thank you for that. For now I have narrowed the possibility down to 'reflex sympathetic dystrophy (RSD)' also called 'complex regional pain syndrome (CRPS)'. Although this needs to be confirmed by a doctor after evaluating you thoroughly. Let me provide you more information on this condition.

RSD/CRPS is a chronic systemic condition that causes severe burning/discomfort/pain, swelling and skin changes that is caused by a stimulus that should otherwise not cause pain in a normal individual (eg. wind blowing on the affected region causing the symptoms). There is no specific diagnostic test for this condition, diagnosis is purely made from the clinical presentation.

Treatment options include: physical and occupational therapy, medication, local anesthesia, tactile discrimination training, spinal cord stimulators, ketamine, etc.

You will need to visit a doctor to confirm this and/or rule out/diagnose any other possibility. I hope this information helps. Do write back to me for any further clarifications.

Best wishes.
Above answer was peer-reviewed by
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