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Brachioradial Pruritus: Intensely Itchy Arms

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Intensely Itchy Arms From Brachioradial Pruritus Via Wikipedia

Brachioradial pruritus (BP) is a condition where the person experiences intense itching, burning and/or stinging to one or both arms. The itching often occurs between the shoulder and the elbow on the sides of the arms but can also extend up to the shoulders.

Scratching can make the itching feel worse, rather than bringing relief. Using ice packs is one treatment that may calm the itch.

Why brachioradial pruritus occurs is unclear. There are two basic mechanisms that are thought to be the cause of this uncontrollable itch.

The first is the solar hypothesis. It is thought that people who have had chronic sun exposure develop an allergic type of histamine response in their skin.

This theory receives some support from the fact that people usually report more left-sided symptom over right-sided. This could be explained by the sun shining more on the left arm while driving.

In South Africa, where drivers sit on the right side of the car, the incidence of BP more frequently affects the right arm. Symptoms also often are worse in the summer and improve in the fall.

The second hypothesis is that BP may be caused by a neuropathy (problem with the nerves), specifically some type of irritation or compression of the cervical nerves in the neck. Treatments for cervical arthritis have shown to improve those with the condition.

This type of itching is called a neuropathic itch. Impulses are sent due to hypersensitivity of the nerve fibers. Sometimes people feel both pain and itching, as well as some type of sensory disruption such as altered sensation in the area.

A 1987 study even suggested that BP may be caused by a combination of the two stating that, “brachioradial pruritus is a photoneurological disorder caused by sun-induced damage to nerve endings that results in pruritus and altered sensation in susceptible individuals.”2

Another dermatology blog suggests that exposure to wind may also contribute.3

However, there are critics to both main theories.

The solar critics point out that people’s faces get just as much sun as the arms, so why doesn’t one’s face develop this problem?

1)  Brachioradial Pruritus. Medscape. Retrieved August 13, 2016.  
http://emedicine.medscape.com/article/1355312-overview

2) Berny-Moreno , Joanna, Szepietowski  Jacek C.. Neuropathic itch caused by nerve root compression: brachioradial pruritus and notalgia paresthetica. Serbian Journal of Dermatology and Venereology 2009; 2: 68-72.
http://www.degruyter.com/downloadpdf/j/sjdv.2009.1.issue-2/v10249-011-0006-z/v10249-011-0006-z.xml 

3) Thoughts about brachioradial pruritus.  The Online Journal of Community and Person-Centered Dermatology (OJCPCD). Retrieved August 13, 2016.  
http://ojcpcd.com/elpern-d-j/thoughts-about-brachioradial-pruritus

Add a Comment65 Comments

EmpowHER Guest
Anonymous

i have been dealing with this for thirty years now, but my itch seems somewhat different. every year seems different. my itch is always above the elbow, my shoulders and this year the back of my neck, between the shoulders. but now it has moved to my left shoulder and upper arm. it always starts in august and lasts 2 or 3 months. ice and ice only is my only relief. early in the summer i don't itch and i'm in the pool a lot, but once i start to itch i can't let the sun hit my arms or it starts itching worse. if i had to deal with this all year i think i would put a gun to my head! thanks everyone for all your ideas.

September 17, 2016 - 4:12pm
EmpowHER Guest
Anonymous

It is so frustrating to try to tell someone or even my doctor & they look at me like I'm crazy! I've had one doctor tell me that I am crazy that I need a shrink to get to the bottom of why I am making myself itch!!! I said if it was in my head I would be the first person to say I need a shrink ,because this itching is driving me nuts!!! I work in construction so I itch all summer long, I get some relief efforts by middle of winter, I have scars from where I itch myself open at night, not realizing I'm doing it!! Please tell me how do I get a doctor to listen to me??? I feel like sometines ripping my skin off , I know that wouldn't help but I just can't take it anymore!!!

September 13, 2016 - 2:11pm
EmpowHER Guest
Anonymous (reply to Anonymous)

Hi, it's me again.
OK, my wife and I replaced our foam/latex/rubber mattress for a brand new spring type with a different underlay material. Apart from now getting an even better sleep, $2,500 later the mattress (and removing the electric blanket) made no effect on my itchy arms. So I went to my doctor who after a while chatting and asking me questions diagnosed it as a form of echzema.
He prescribed to me a cream ointment called ADVANTAN 0.1% 15G that should be applied twice daily and very sparingly because it is quite potent. My chemist where I usually go to buy other medicines said it is the best product available on the marketplace. I have been using it for several days now and it works like a charm - itching sensation completely gone and my arms are now repairing themselves and the red irritated skin is gradually disappearing slowly. You cannot just buy this product over the counter and you need to see your doctor and get him/her to prescribe it for you if your symptoms are the same as mine. I really hope it works for you and all the other sufferers having the same problems. My doctor also said avoid stress, get good sleep and rest and eat healthy food and exercise a bit. A healthy appetite leads to a healthy body and ensure you eat your fruits daily. He said DON'T scratch the area as this makes the symptoms worse. Apply some cold packs and don't have hot showers on the affected areas even though it might feel nice - apply some cold water to the areas after a warm shower to soothe the itch.
Good luck and let me know how you get along now. You can Google the data sheet and read the product for safety purposes. Also please don't try and self diagnose - go and see a doctor. That's what they are there for.

September 15, 2016 - 1:58pm
EmpowHER Guest
Anonymous (reply to Anonymous)

Tell your dr you have Brachioradial Pruritus. Most have never heard of it, so you need to give them a little time to get up to speed. If they won't, FIND ANOTHER DOCTOR! I found relief with a compound cream of Gabapentin, lidocaine, ibuprofen and a few other ingredients (if you want the full list, ask). I also did 8 weeks of physical therapy for my neck. This combo WORKED for me. I screwed it up on a trip to Germany (9 days of bad pillows). In back in PT with another round of cream and its working!! I have not iced my arms in almost 2 weeks! I believe this is fixable. My luck was that my new Dr believed me.
Good luck!!!

September 13, 2016 - 4:14pm
(reply to Anonymous)

Is the cream called GABAPENTIN, or is that simply one of the ingredients? If it's just one of the ingredients, can you tell me what all of the ingredients were that helped you?
I'm pretty sure I have what you mentioned because I just finished some neck therapy with a chiropractor, then one day after being outside a little longer than usual (at a cemetery service) I started the itching on my forearms. Since I live in South Florida I thought it might have been ZIKA. However, even the picture here, with it's pinpoint red dots is exactly like what I have on my skin. I've been getting somewhat decent relief from Econazole Nitrate (1%), or hydrocortisone (1%), or Lanacane (benzethonium chloride .002% and Benzocaine 20%), or Benadryl (diphenhydromine hydrochloride 2% and Zinc acetate 0.1%). Since they all have different ingredients I'm trying to see which works best.

September 14, 2016 - 2:03pm
EmpowHER Guest
Anonymous (reply to empowhermodaso)

Hello! I hope this reply works - it will be my 3rd attempt to answer.
Yes! It is Gabapentin. Here is the cream breakdown: Piroxicam, 0.2 %, Gabapentin, 3%, lidocaine, 2%, prilocaine, 2%, impramine 1%, ibuprofen, 2.4%. My itching has always been worse at night, which makes sense. As gravity pulls you down during the day it compresses your neck and spine (you're always taller in the morning). I am again having very good success with physical therapy, neck traction, chiropractic and the cream. I haven't used the cream at all in 4 or 5 nights. I have never had any alteration of symptoms in the sun or not being in the sun. I shower at night and happen to like hot showers, and sometimes the hot water will aggravate my arms, but because I've been scratching them and the skin is irritated. I'm not discounting the sun theory, I just know for me it's my neck.
I hope you can find a Dr that will listen. I find typically Dr's don't care for it much when a patient has self diagnosed, but after the bristling, my new Dr listened to what I had to say, admitted she wanted to study it further, and gave me what I needed. I was initially surprised at the PT, but it worked! Especially the neck traction. I think that helps a LOT. GREAT luck to you! If I can answer anything else let me know. Hopefully I will be successful in posting this reply!

September 15, 2016 - 7:03am
EmpowHER Guest
Anonymous

I experienced this beginning in July of 2014. I itched for 18 months before finding this article/site. It was such a relief to know I wasnt crazy. I already used laundry products with no dye or perfume, I went on a 17 day fast to eliminate possible food related allergies (no change), I changed my shampoo, body soap, deodorant, I stopped wearing perfume. Years ago I began to only wear cotton, silk or rayon. I went to the dermatologist, allergist, chiropractor, acupuncturist, voodoo priest (okay I made that one up), and finally a new general MD (I am new to this area and needed a new Dr anyway)
In my case, this is 100% because of my neck. So I am firmly in the camp that believes this to be a compression of the 6th cervical vertebrae. My new Dr made me a compound cream of Gabapentin, lidocaine, and a few other ingredients, sent me to physical therapy for 8 weeks and I was cured! I have never been so happy or grateful. It lasted A blissful 4 months. Then I went to Germany on a work trip, and while the bed was comfortable the pillows were horrible. On the return trip home I started to itch again, this time at my elbows. This has been almost 2 months now. I'm on my way in an hour back to my chiropractor and physical therapy. I pick up my new compound cream after PT. SIGH.
So the moral of my story is that I need to take my pillow with me wherever I go. I am a side sleeper and have a pillow for that.
I just know that this was coming from inside me (my brain, literally), and had nothing to do with my skin. Ice packs are the only real relief when the nerve endings are firing. I do live in a sunny climate, but my itching has never changed because of season or exposure.

Hopefully now that I know what to do, once this has resolved (again), I can be itch free forever!

I wish that for all of you, too!!!

August 29, 2016 - 7:30am
EmpowHER Guest
Anonymous

Hi, I live in Perth Western Australia. The summers here are unforgivingly hot - our sun here literally burns steel! I never had this itching problem before. My wife and I contracted it at the same time about 3 months ago - on our forearms in the elbow region. Coincidentally we both developed a sore elbow joint - like an arthritis attack. My itch spread to the stomach about 4 inches away from my belly button. I tried various creams, ie Dettol etc from the supermarket and chemist with moderate results. I used a cut lemon and rubbed it over the itchy areas and it helped somewhat. I even used Listerine mouth wash and that gave me some relief. If it is the sun, then why not the rest of the body and long time ago? I have a bad neck (arthritis in joints) and broken back with concussed spine but that occurred years ago and why flare up now? It's winter here and I only started to get this itchy condition at the start of winter. We use an electric blanket, sleep on a rubber/latex mattress and use Duve's purchased from Ikea. My theory is it's an allergy condition of sorts. Perhaps the rubber/latex mattress is undergoing hysteresis (ie rubber/latex compounds slowly breaking down via the heat from the electric blanket). But why just the arms? Does anyone else with this condition sleep on rubber/latex mattresses or mattresses with memory foam? It could be the culprit as my wife and I have not altered our food, perfumes, detergents etc in recent times. I'll go and see my doctor if he can put an angle on it. One thing for sure is that I'm allergic to the band aid called Elastoplast which is made of a latex cloth fabric having a strong adhesive. My doctor put a patch on me about 2 years ago when I went for a checkup and gave a blood sample. The area on my arm where the Elastoplast band aid was applied went red and remained very itchy for over 6 months and took about 12 months to disappear! Could there be a connection - an allergy to rubber/latex materials?

August 25, 2016 - 6:34am
EmpowHER Guest
Anonymous (reply to Anonymous)

I've also begun to believe it's allergy related. Mine has been going on for years. But, it only occurs on my arms. Different areas of my arms at different times. I've finally realized it only happens to me in the Fall. Beginning in late August & running through late November. I live in in the southern state of Georgia in the United States. I feel it may be something that blooms here this time of year. That is also the time of year that is worst for my sinus allergies.

When I first saw my Dermotilogist about this she had no clue. There is no rash on my skin. There is nothing but the awful itch. I really think she thought it was all in my head. I followed her advice of no perfumed lotions & dye free/fragrance free laundry detergent. But, the itching still occurs every Fall. I use ice packs to numb it & that helps stop it temporarily.

August 25, 2016 - 2:00pm
EmpowHER Guest
Anonymous (reply to Anonymous)

Hi again,
I have read most of the reports published on this site and one common thread I noticed is that most itchy attacks occur in autumn and leading into winter. It seems not many attacks occur in summer and that should tell us something - ie there is a positive correlation between lack of heat and/or sunlight and increased attack of itchiness. Is it a Vitamin D deficiency? Some doctor or expert should investigate this correlation. Secondly, yes after winter sinus aggravation is caused by all the new seeds and pollen in the air. However I don't think sinus problems cause itchiness on the forearms and elbow regions. It is too localized. Do you sleep on a latex/rubber mattress or foam mattress and use an electric blanket to pre-heat the bed in winter months? That is the only difference in our household that changed in recent months and both my wife and I contracted itchy arms at the same time (mine worse than hers). Neither of us have experienced this problem before. This is too much of a coincidence to say the least. Initially I thought it was insect bites such as Kangaroo ticks or pepper ticks. I've been bitten by them before and they cause severe itching and take many months to go away. The red itchy areas can recur again years later in the same spots if bitten again by another tick. They have a nasty virus they inject into your body that can remain for a very long time. Hmm - I'm bewildered. Are you bushwalking or hiking in the countryside in forests and tall grasses where ticks are prevalent?

August 26, 2016 - 6:40am
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We value and respect our HERWriters' experiences, but everyone is different. Many of our writers are speaking from personal experience, and what's worked for them may not work for you. Their articles are not a substitute for medical advice, although we hope you can gain knowledge from their insight.