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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Hello Everyone,
I just wanted to tell everyone that I was diagnosed with BRP on my last visit to the Derm. And it is a nerve condition. Your body releases histamines in low level, but the Dr. told me that is not slowly release when you have BRP that is dump into your blood stream which causes the nerves to go haywire and cause the unbearable itching. I can honestly say that my itching has been gone seen I have been on the medicine. I have been taking 1 singulair once a day and 2 periactin twice aday and 2 Claritin a day.. It is a lot of medicine but it works..And I just wanted tell everyone that the rash that I had is from scratching is what the Dr. said. There is BRP and also notalgia paresthetica which is the same thing as BRP except it is year around.. We dont know if mine is gone from the summer months or if is the medication. The Dr. does not want me to go off the medicine just incase it is notalgia paresthetica. I know that I have suffered 10 years+ and I am so thankful that I found this Derm. He has done a biopsy , lots of blood work.. And has be
talking to a specialist at UVA. I do believe that my prayers have finally been answered.
If anyone has any question you can contact me by e-mail at saylor540@comcast.net Sun screen is a must and cover your arm at all times when you are outside.. I wish everyone good luck.. Hello Janice
Vickie
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.
Hi fellow BRP sufferers. I have not been on this site in a long time, but that doesn’t mean I’m not suffering. For a quick fix but not very long lasting, Solarcaine has been helping me out. Remember Solarcaine? They still make it, and it will take the itch away until you can get busy with something else to take your mind off it. I don’t know if you can put aerosol cans in the fridge, but that might even feel better! I’m still on the fence about all the spine stuff… I’ve been a sufferer for 15 years now. Yes, I’ve had scoliosis surgery way back when. My mom had this, my nephew has it and one of my sisters has it. And why would it be at only certain times if something is wrong with your spinal column??? If there’s something pinching something, how would it know to pinch during certain seasons???
Lalurel- It is thought that UV rays aggravate the nerve endings to exaccerbate the itching. Hence, sun exposure will supposedly worsen the itch. I’m still itch-free after 14 months on gabapentin!!
I went to my neurologist who was not helpful at all- she told me that it wasn’t a big deal and that there was nothing I could really do.
I did find an accidental cure, however- due to the massive amounts of snow we had this year. Because of the snow I had to hike out to my car daily (driveway was too long to plow- a quarter of mile)- at any rate, I stopped wearing high heels for about a month while our driveway thawed and all my itchiness (and most of my migraines) disappeared. When the snow cleared and I pulled out high heels again it all came back. I have given up the heels for good and have not had one itchy moment since.
My guess is the high heels were causing some sort of pinching that caused it all for me… I’m not a doc but this is a better explanation (and cure) than my neurologist could come up with!
@Janice
Hi Janice. But still, I’m not out in the sun during the winter months with my arms exposed. The itch will come. My left arm started to itch about 3 months ago. I used everything in my personal arsenol, of course ice packs are a saving grace when nothing else works. Now, here we are mid-May and my arm is fine. Spent plenty of time in the sun doing yard work and such. It disappeared just as quickly as it appeared. I think there is much more research to be done on this. I really don’t want to start taking pills for this as I am already on meds for HBP. This didn’t start with me until I was 32 and pregnant. I was SO hoping it was a hormone thing… But, like I said in previous posts, my mom had it, ONE of my sisters’ has it and my nephew has it!!! Go figure. My arms are scarred from my “home remedies”.
thank you. i have this I am sure but noone has been able to figure it out. I am more than convinced this is exactly what I have on my arms. It feels much better to know I am not crazy
laurel- same here-I would have intense itching during winter months also- but then around March or april it would subside, only to re=appear over the summer. So, I don’t know if the UV light theory has any merit or not.
Hello,
I am glad I found this site. My wife has recently been suffering from this but her’s seems to be very erratic and only in the shoulder area? It seems to hit mostly at night. I read somewhere that some Doctor’s believe that someone who has previously had shingles could be more susceptible to this condition? Anyone have input on that?
Thanks.
Hello fellow scratchers! Like most of you I’m elated that I not only found this site but that I’m not alone and I’m not crazy! I’ve had “the itchies” for about 13 years. I’ve only asked one doctor about my condition. He told me the reason my left arm itched was because I’m right handed! I wonder what his diagnosis would be now since my right arm is affected as well. As I write this I’ve got a bag of frozen peas on my arm. It seems like I used to get it in the winter months so I’ve always been grateful I had some reprieve but it’s the end of July and I’m going crazy! I’m very curious about the cervical issue. Would there be back pain associated with the pinched nerve? I have a very strong back and rarely have pain. Two things however are that a chiropractor once told me I have slight scoliosis. When I questioned him as to why I don’t look it he said because I’m thin that if I were heavier it would be more apparant. Another chiropractor many years ago told me I have no curve in my neck and I do get neck pain on occassion. I’ve tried every single remedy mentioned in the 106 posts I’ve just red but I have one to add. Out of sheer desperation I used my dog’s medicated itch stick! Didn’t help much. Unfortunately I don’t have insurance so being tested is out of the question. I live in Portland Oregon and once stumbled upon an article about a doctor at Oregon Health Sciences University that was conducting a study. I’m hoping she’d like a new “speciman” Also,it’s interesting that about 25 years ago I apparantly had what I’m sure would be considered a minor case of shingles. I’ve never had a reoccurance but for about the past 5 or 6 years I’ve been prone to hives. I’ve attributed that to an allergy I believe may be caused by evergreens (I think cedar) and/or lycra. Because of that I tend to believe it may be an auto-immune deficiency. I’ll keep checking back to let you know if I have any luck with the dr. at OHSU. I just can’t imagine living with this condition for the rest of my life! Also I’m 55 so was in my early 40′s. I’m a poster child! Bless us all for being here for each other.