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.
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- Study Uses Functional MRI to Answer Why Scratching Relieves Itching A study by Dr. Yosipovitch at Wake Forest University used...
- Skin Care Myths: Body Sweat Makes Acne Worse Someone thought this interesting enough to actually study it (Harvard...
241 Comments
Hi!
I am a 54 years old Norwegian woman and I have suffered from BPR for 15 years. I was sleepless and socially handicapped because of the itching. I tried everything without results, and it got worse every year. Then in June 2010 I went to the Greek island Chios. There they produce mastic from the Mastichi trees. I needed a new body lotion and bought the local “Mastic Care Body lotion”. To my big suprise, the itching sensation disappeared instantly when I applied the lotion. Again and again. For the last 14 months I have controlled the BPR with this lotion. I have a bottle beside my bed, at my work and in my handbag, and when the itching starts I just apply some lotion to get relief. I can highly recommend this body lotion to everybody that suffers from BPR. I wish you all the same relief that I have found. I by it online from http://www.e-anemos.gr
Best wishes,
Irene
I’m BAAAA-AAck! Itched from January to mid April. Was good until the beginning of August and it’s my right arm again. It usually switches, but this is twice in a row for the right arm. Was glad for the few months of relief but now it is so bad that I can barely remember those good months… Anything new out there???
I have had brp for 5 years, I have herniated cervical disk and am in the sun (live at the beach) I have tried everything neurologist, acupuncture and Lidoderm patch (numbs the skin)
The Lidoderm patch you wear for 12 hours on and 12 hours off, and it works, and the acupuncture relieves it to , I should say
they both relieve it but it always comes back, like most of you have said it is just a relief to know your not alone.
I went to allergists, neurologists and on and on and not one doctor diagnosed me, my daughter found it on the computer and I have to say my doctor is very receptive NOW , after I came in with BRP info….
Try the Lidoderm patch and Acupuncture it doesn’t cure it but I get some sleep now….
Does anyone know of a doctor in West Houston area who is aware of, and willing to treat this condition?.
I was very fortunate to be diagnosed by my dermatologist within the first year of this. He said it is very rare and I’m only the second or third case he has ever seen in his career. He pretty much went with the sun exposure theory but now (after a few years) I’m not so sure it is the only cause. I have had neck issues and he did not order any tests or MRI on my neck. It seems to be itching now even when I haven’t had any sun. Has anyone had neck surgery because of this and did it work??
Wow – this site is enlightening, in the fact that I’m not alone and not crazy!! I have had “the itch” for about a year now. All seasons, nothing stops it. I’ve tried everything I could think of also, but cannot take anything that would make me drowsy, even at night, because I have a 5 yr old and don’t want to be knocked out just in case he needs me. The severe PAIN of those shooting needle-like jabs that go, it seems, deep to the bone of my arms, around my neck, were sometimes so unbearable!! I tried not to scratch – but then I did it “just once…” well, you know what happened, there is NO STOPPING once you start the scratch! Finally, I saw my Dermatologist today, and he diagnosed me with BRP! I’m not crazy!!! I will tell you that what I have FINALLY found in the past month that stops the itching totally, is Hydroxazine-HCL 50mg every 6 hours. Now, this med makes some people drowsy and knocks them out; it doesn’t phase me – for which I’m grateful! I haven’t had “the itch” for over a week, since my daughter gave me her pills she used for a horrible case of poison oak this past spring! I tried the 10mg – NO GOOD; didn’t phase the itch! I’m going to go out and get the Capzacin-HP cream that was suggested, also, and try it. I cannot take the Hydroxazine forever, can I??
Irene – I went to the website that you posted, but didn’t know which Mastic Care Body Lotion you used – there were 3 of them, with diff things in them. Please let us know! Thanks!!
You have all become my support group – I’m so glad I’m not alone in this fight for a cure!
Kathy, I would be wary of the post you mentioned. Sounded like an advertisement to me. She also posted on other BRP sites the exact thing- word for word. I don’t believe any topical could truly be miraculous.
I’m so glad to have found this site. This is my third “season” for the insane itch. I was certain it had something to do with sun exposure! This is also my third summer for owning a convertible. Does anyone else wonder if it is a combination of sun exposure and eating sweets? BRP describes my symptoms exactly. I have even sprayed computer keyboard cleaner on my arm in desparation. I am 55 and female.
Lee Ann, I don’t know about the eating sweets thing. I don’t really eat sweets and have suffered with this for 17 years. I even hesitate to put much merit into the sun exposure theory because I have begun the “itch cycle” in the cold months when my arms were never exposed to the sun! As a matter of fact, I believe I have started the “cycle” in most or all months of the year. So, there isn’t even a particular season for me. Can never anticipate when it’s going to start. It’s very frustrating and I’ve cried many tears because of this. I am currently at the end of my second month of itching and hope that it doesn’t have too much longer to go. Good luck to you, ALL of you.
Thank you Laurel. Can I ask your age? Mine does subside during the winter months but has kicked in occasionally during the cold season too. It is very frustrating! Do you know of any Doc gathering information on this? I was hoping this website was part of information gathering for treatment and potential cure.
I’d love to know if Seniors are affected by this. Or did have it and it finally went away. I would like to know if there is hope. I am being transferred to Panama for the next 6 months and am afraid that since I will be in eternal summer – mine might not subside like it normally does.
Lee Ann- I am 49 years old and have had this since age 32. My sister is 59 years old and also has it. I have a nephew in his 30′s and he has it as well. I remember my mother complaining of terribly itchy arms when I was young. (Before MY itch started). She would make herself bleed and I thought she was nuts! Lo and Behold, years later it affected me. I seem to remember that after years, she just didn’t complain about it anymore. I can’t really say whether it went away or she just stopped talking about it. There are a lot of other websites that address this issue. Just look up “Brachioradial Pruritis”. One of them is Medhelp. I post on that also. You may find some tips that are useful. In the meantime, keep applying a good sun BLOCK on your arms. I find that if the itch isn’t too bad sometimes that even helps. Something with the zinc oxide, I think. In the meantime we all keep ice packs in our freezers and this is the only real relief. By reading through other posts, you will see that some people have found doctors that knew exactly what this is and others are totally clueless. Gather up as much info as you can find, print it out and take it to your doctor. (Just in case he/she is one of the clueless ones)! Good luck and keep us all posted!
Laurel- thank you for the good advise. I did try some stuff called FREEZEIT. It is a spray for muscle/joint and helps to subside the itch. You are right, I started using a 60+ sunscreen with zinc in it and it helps. It is the rainy season here in Panama. Not much sun shining but still hot and steamy. I have had minimal itching this last week since I arrived but don’t know if it is just subsiding for a bit. Wish we could find that common denominator and know what to avoid.
Try going to a chiropractor regularly. That is the only thing that has helped me to keep this condition at a tolerable level. My Dr. also recently prescribed a topical numbing cream that is called ‘Emla’ (2.5% lidocaine/2.5% prilocaine) that has numbed the itching better than anything else I’ve ever tried.
I think it is from sun exposure also. We have a pool for our grandchildren and I spend a lot of time in the pool with our little ones during the summer. I especially got alot of exposure and got very tan this year. As soon as the tan was almost gone, the itching started. Next year will diffinately be different. Please take care of your skin
I guess I’m the rare one since I’m a (57 yo) guy. This summer was my first experience with BPR. I suspected it was a nerve condition since it was always the same areas above and below my elbows. Usually one arm or the other, not both at the same time. It is usually in the evening and lasts 2-5 hours or so. I can have a week or more between instances so it sounds like I get off easy compared to others.
I I also think the sun has played a big role in this. I started tiding a motorcycle again after a 20 year layoff. The itching started after a few all day rides in short ssleeves.
I have used all the things I have read here to deal with it like anti-itch cremes, slapping the spot so the pain overrides the itch and icing. I was going to go to the Dr. but after finding this site I belive that would be a waste and I will have to try long sleves and learn to live with it. One thing I find works pretty well for me I haven’t seen anyone else try is gently stroking the area with my fingertips. I apply just enough pressure to feel it and as long as I am stroking the area it feels better. It might be worth a try if nothing else works.
Like others have mentioned it’s nice to know I’m not crazy and finding the site has probably saved me $$ and frustration trying the medical route.
John, This is my third year for driving a convertible and my third year of this insane itch. Like you, mine comes on mostly in the evenings. I found a product called FREEZIT that is a spray for muscle, joint relief. It does seem to help subside the itch. Laurel – suggested a strong sun block with zinc in it. It also helps. I usually dig my nails in my arms versus stroking it but I’ll try that.
I have been having itching, most intense at night making it almost impossible to sleep, for about 2 months now. I have recently went to the doctor who thought it might be scabies because of the way the sores looked on my arm (not very many and not really bad sores) but I did not have these sores or severe itching anywhere else, especially where scabies would normally surface. Also, no one else in my family (my husband and 2 small children) do not have any itching or sores anywhere on them. So, the doctor prescibed me prednisone and dluocinonide cream for the itching. I’ve been on the prednisone for 4 days now, 2 more days to go and the itching is still there. The cream does help ease the itching and burning, but doesn’t take it completely away. The only relief I have at night is ice packs on my arm to numb the itching away. I have read about the BRP and mentioned it to my doctor, but she never really said anything about the problem. Does anyone else get small red sores on the places where it itches?
Wow, my sister and I have suffered from this for three years now. We thought we had bed bugs or some other creature under our skin. I even went to my doctor out of frustration and he prescribed anti anxiety meds!! We start feeling the tingle and itch around the end of August. Usually the intensity hits after 5PM and goes through the night. We both have scabs from scratching. I am up for trying anything.
sharon
Sharon! I also thought I had bed bugs. Mine has been going on just about as long as yours. I have tried anti-itch creams but nothing works. I also have scabs from scratching so hard that my arms start to bleed. It has also carried to my legs, right behind my knees, and also to my stomach and back. I feel your pain!
Im glad, like a lot of others to have found this site. Does anyone know if this s in any way related to shingles? I have been a carrier since 1990 but have never broken out but have had the burning itching sensation in my back on the left side, and its my left arm that is affected now.
Hi, I have been having an itchy left arm for so long I cant remember! All of a sudden my left arm would just start itching like hell, scratch, scratch, so much I couldnt sleep. I first started looking up on the internet a few years ago, I couldnt find anything about just itchy arms but I did read stuff about itching if you had a dodgy liver, but I thought, surely you wouldnt itch on just your arms to do with your liver!! But I have noticed latley that if I drink too much on a particular weekend (not that often) it seems to trigger it off, well I think so, this could be my imagination. So I would like to know all those people with itchy arms, do you drink spirits or wine? this is purely for me to wipe out my fear!!
First of all, let me just say that I feel for all of you. As a very long time sufferer, I know the frustration you all feel. I am NOT very computer literate so I can’t send the link but you all need to look up Brachioradial Pruritis and look for the site that starts; itchy arms=Brachioradial Pruritis. It is Medhelp. There are SO many of “us” out there. Read through all the posts and you will find that it is most likely due to nerve compression in the neck. This makes sense to me. Some doctors have heard about this and some (most) haven’t. As far as seasons, mine has no preference. Just comes and goes randomly although it seems to be with me more than not lately. It has definitely intensified over the years… Good luck to you all!
I have had this insane itching on my upper arms for about 8 years now. So bad I lose sleep and just want to take a knife to scratch through the skin…..I have tried everything nothing helped until now.
I started to take Milk Thistle daily and at night i clean my arms with Witch Hazel…after that dries I rub them down with Dr. Fred Summit Arthritis & Sport rub (found at big lots & it is red liquid) after that dries I liberally apply vics vaporub and I do not rub it in…then I put on a long sleeved shirt and it seems to control the itch for most of the night! Hope this helps some of you!
I have had this for 2 years! I’m only 16. I read on another website that this may last up to EIGHTEEN years. ): I haven’t found anything that works for me. I haven’t been to a doctor yet. Because I can’t find a cure, should I go see a doctor & they would be able to prescribe something for me? Helpp meeee.
I am a 59 year old female who has had BRP for about 20 years. I also believe the sun was connected somehow. Ice would be the only relief. I would go to bed with those “ice packs” for more years than I want to remember. It definitely felt like the nerves were involved with all of the “prickling” sensations. It would come and go and for the person who has it only on one arm, I, too would go for months with only one arm involved. What is really bad is when both arms are involved (not enough ice packs!!) I thought it was food allergies (til everything I ate would bring on the itchiness), I thought I was crazy…..then I went to a Dermatology Nurse Practitioner and she said she could not find such a diagnosis but that my skin was VERY dry (it didn’t look bad to me, nor obviously dry) and she recommended applying lotions or creams to my arms NO LESS THAN THREE TIMES A DAY. I decided to try it. Since someone tried shea butter, and since I am very concerned about what I put onto my skin to be absorbed systemically so I tried L’Occitane Organic Shea Butter. EUREKA!!!! I do it 3 times a day as recommended – if I do less, I may itch that night. I have been doing it for about 3 months now with great success! After I heard there was a Chiropractic adjustment that might possibly help and viewed the “procedure” on line, I was not convinced nor did I want someone that close to my brain…..
Please try the shea butter, it works !!!!!!!!!!!! Merry Christmas!!!!!
I also have this itching on my elbows and upper arms. The dermatologist I went to perscribed a lot of antihistamines, perscription and over the counter. It didnt help at all. Then I went to his partner and he diagnosed BRP. He has me on Gabapentin 300 MG. I take 3 pills at night. He said it would knock me out but it really doesnt. It helps somewhat. I would say around 80%. I can now sleep through the night without the ice packs. But I still itch badly at times.
I have had this now since Sept. of this year. I also have some skin eruptions elsewhere but I dont know if it is related.
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