Brachioradial Pruritis: Scratching Makes the Itching Worse
A 45 year old woman presented to my office complaining of a burning itching rash on both her arms.She had seen several doctors and tried various creams and oral antihistamines without relief. Only applying an ice pack seems to alleviate her symptoms. She is frustrated. On exam she had a few subtle excoriations (scratches) on her forearms, but no other signs of rash or disease.
Brachioradial pruritis is a condition characterized by intractable itching on the top of the forearms (overlying the brachioradialis muscle). Patients often report that the itching actually gets worse with scratching instead of better. It affects mostly middle aged women (which all my patients have been) and presents as a burning and itching sensation on the arms. The symptoms can sometimes be described as tingling or even painful. It can involve one or both arms.
Unfortunately the cause is not well understood. Current thinking is that it is associated with sun damage and/or with cervical nerve root impingement. The sun damage theory is that deep penetrating ultraviolet light (UVA) damages fine pain nerve fibers in the skin of the arms. The cervical spine theory is that impingement (pinching) of the C5 to C8 cervical nerve roots leads to nerve damage. The nerves that emerge from these roots provide sensation to the arms, so damage to them might cause the burning and itching symptoms. Although studies have found that cervical spine disease is more common in patients with brachioradial pruritis, no study has demonstrated that cervical spine disease causes the condition.
Treatments for brachioradial pruritis include:
- Avoidance of sun exposure (probably most important)
- Topical capsaicin (hot pepper oil)
- Gabapentin
- Cervical spine manipulation
- Anti-inflammatory medications such as naproxen (Alleve®)
- Above all, I think it is helpful just to have a physician who understands that the patient’s symptoms are real and who is willing to try various treatments until a satisfactory remedy is found.
Hi Vicki-Glad that the antihistamines are working for you. But I have to question the Dr.’s explnation that when one has BRP the antihistamines’ are “dumped into the bloodstrream” – wouldn’t one itch all over ones body then? Why just the arms? Did he give an explanation forthis? Just curious, because i still tend to think it is related to pressure on the Brachioradial nerve. Keep usposted on your progress- andcould you post the addy for the other blog?
Hi Janice,
I guess I did not make my self clear. It is all a little over whelming and a little hard to repeat what he say. He did tell me that it does involve the Brac. nerve and that the nerve runs into your forearms and shoulders and pinching of the nerve causes the itch and causes the your body to release to much histamines. And also causes the redness and burning sensation…that we have experienced. You memtioned posting this on another blog–I don’t know any other site. I hope this answered your questions..
Vickie
my arms have itched before, but I never thought much of it, besides scratching it till it was pink.
Last night, at a praise and worship evening with Jesus Culture, my arms suddenly started itching again. I thought it was the sweat and heat of the church I was in.After not being able to sleep, I jumped online to find out about BRP.
To those who are itching, rest assured, it’s been interesting to see how the blogs and forums have developed over the years, narrowing the beast down more and more, until finally there is a pin-pointed remedy. Until then, pray for it in Jesus’ name. He lead me online. He’ll lead you to your remedy too.
Im 22 years old. Fit and active, from South Africa.