Brachioradial Pruritus: Intensely Itchy Arms

 
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People who have intensely itchy arms but have skin that appears totally normal may be suffering from condition called brachioradial pruitus. It can occur to one or both arms. Typically the itching is on the back of the forearm but may extend to the upper arms and shoulders. Scratching the itching areas seems to only make it worse and some people find that applying ice packs are the only way to get some relief.

Brachioradial pruritus was first reported in 1968 in Florida and seems to occur more to people who live warmer, humid climates. The condition is thought to be caused by a neuropathy. Neuropathies occur when nerves are disrupted by some event (for example, infection or injury) so pain is felt even when there is nothing stimulating it. In the case of brachioradial pruritus, the pain is transmitted as an itching sensation.

There are two theories believed to be the cause of brachioradial pruritus. The first is the sun hypothesis, where it is thought that people who have had chronic sun exposure develop an allergic type of histamine response in their skin. The fact that people with brachioradial pruirtus tend to have worse symptoms on their left arm, which is the driving side of the car and gets more sun exposure goes along with this hypothesis.

The alternate cause of brachioradial pruritus is believed to be due to some type of cervical (neck area) nerve damage. Treatments for cervical arthritis have shown improvement in those with the condition. However, there are critics to both theories. The sun 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? The cervical nerve damage critics point out that cervical neck degeneration occurs to 70 percent of elderly women and 95 percent of elderly men so without further studies it doesn’t make sense that many other older adults don’t develop this condition.

Regardless of cause, brachioradial pruritus does have some treatments that may help. Most people describe the itching as prickly and burning and that can keep them awake at night. Ice packs are the first best therapy to try to stop the itch.

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EmpowHER Guest
Anonymous

Hi I hurt my neck two years ago and had pressure on my nerve. my right arm started itching at nite when I relaxed. My chiropractic fixed it pretty good . In the last month I have hurt my neck in the same way and the itching has started again. I find this so amazing I also get really bad pins and needles when I finsh work . Thanks for the insite

May 7, 2015 - 2:30am
EmpowHER Guest
Anonymous

I have been suffering with this condition for over a year. There have been many nights of an incredibly itchy forearm. I have scratched it until it bled previously. Now I TRY to just use China gel or ice packs. My condition is on my left arm which makes sense due to the fact that I'm a mail carrier in Florida. Drives me absolutely bonkers!

April 29, 2015 - 9:11pm
EmpowHER Guest
Anonymous

Thank you for your article. I too have started this crazy itch in my forearms 3 months ago. Exactly as your article states it, my left arm is worse then my right however they both have terrible rash and a rating scars.

I live in Hawaii, and am 54 years old.
I dont know yet what the triggers are but there is definitely a problem. I also do have arthritis on my upper spin, and neck.

I did see a Allergist and Dermatologist and I mainly took antihistamine meds and Steroid cream.

Most of the rash has calmed down but a area on my upper left arm is taking forever to heal. It still itches at night.

April 29, 2015 - 2:50am
EmpowHER Guest
Anonymous

I get this also mainly right forearm and up to the shoulder, I will also note when I do have this and apply a bit of thumb pressure to the area, it is quite tender and yet I have been off work for a few weeks and doing nothing heavy, ?? am here in Brisbane Australia, plenty of sun , but that is always the case.

April 18, 2015 - 3:00am
EmpowHER Guest
Anonymous

I've been experiencing this type of itching on my upper arms consistently for the last year and a half, since moving to central California from the Pacific Northwest. I've often had my arms exposed in the PNW sun, but it isn't nearly as intense there. I don't intentionally tan, but do wear tank tops more often. I've never had the problem before and immediately equated it with increased sun exposure on my upper arms as soon as the symptom began to appear. My skin on my upper arms also seem to feel thicker and have less topical sensation. I'm mentioning this here because the article talks of the debate about whether sun plays a part and for me, it seems it has. As far as I know, I do not have any cervical or spinal disorders and currently I'm 46. So far I haven't tried many things to relieve the symptoms, so I don't have anything to offer there, but I do hope that the information I have offered can be useful.

March 16, 2015 - 5:35pm
Michele Blacksberg RN HERWriter (reply to Anonymous)

Thanks for your input anon.

I hope it settles down.

Michele

April 6, 2015 - 1:20pm
EmpowHER Guest
Anonymous (reply to Anonymous)

I suffered with this in 2013. It came on for no reason. I was put on 100 mg IC Gabapentin and it seemed to fix the problem completely. I went all of 2014 once again systom free. This year, I went to Costa Rica in February and did get sun exposure. It has now been 6 weeks that I have once again found myself suffereing from it. I am back on the IC Gapentin, however, it has not gotten rid of the problem as of yet. My doctor has increased the dose and I am so frustrated as there seems no 'sure way' to know what triggers it. I live in the Boston area so I have not been exposed to any sun since February. I can go a few days without any itching and then BOOM...it comes on full force and drives me totally crazy for several hours at a time. I do, then, put on ice and it does help. I think it just freezes the arm and the nerves and that is why the relief. I just wish I knew if there was another way that it is triggered. I just turned 55 and had never had this problem until recently. Like I said at the beginning, the thing that makes NO sense to me is why after I suffered for one whole summer, why the next year I was totally symtom free only to be once again feeling like this is controlling my life. It is not only extremely itchy but painful and I feel like my arm is like leather as I scratch it so much. HELP!

April 6, 2015 - 12:24pm
Michele Blacksberg RN HERWriter (reply to Anonymous)

Hi Anon,

Triggers and nerve pain can be like that.  It is frustrating why do nerves respond to something one time but then do not respond when it appears that the same situation is repeated?  It may be something else is the driver to keep your itching happening.  Perhaps it is your diet or your detergent you use to wash your clothes.  

I assure you it can be a very small thing that is setting things off.  And it is also not uncommon for a nerve calming medication to work for a while then stop working.  I wonder if some topical compounded cream that has lidocaine might help or even a topical creme that has Gaba or elavil (another med used for nerve pain/sensitivity) might help.  

You might want to see a chronic pain doctor just because they are experienced in choosing other meds to try.  I do suggest you call a compounding pharmacy close to you (google compounding pharmacy) and ask to talk with a pharmacist and see what they suggest.  Then if your primary dr is willing, he can write a prescription for some topical medication to try.

Good luck,

Michele

April 6, 2015 - 1:26pm
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