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Brachioradial Pruritus: Intensely Itchy Arms

By HERWriter
 
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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 Comment76 Comments

Helpful Info:
What has given my wife relief, is what gives everyone relief. Cold….
Her favorites over the last 8-9 years are (for the day time), the Rite-Aid Reusable Cold Packs that have the bubbles that freeze(Similar to the CryoMAX Reusable Cold Packs - Likely at any Rite-Aid type store). These last for a long time and she can put a light cloth between or over a light shirt, will protect her are.

For the evenings, she uses packs similar to "Nature Creation Relief Packs". We have both the bubble cold packs and these cloth packs in our freezer. Note: There are quite a few sites for DIY or you can even pick them up from Goodwill at times. Depending on the size of your itching surface, you can choose between the shoulder wraps, back packs, etc… Any of those well built packs, can be frozen and for my wife, weren't so cold to damage the skin. The day bubble packs could get too cold and she didn't like to use them at night. At times at night, she would have to get a fresh cold pack from the freezer in the middle of the night if it was an extreme night.

November 16, 2016 - 2:01am

So, I am writing this from a spouse's perspective.
My wife has had this issue for the last 8-9 years. Summer unbearable itching that calms near winter, colder months. Exactly what is described in this article and forum.

My first request is for a personal request for the name of a doctor in the Southern California area, near North OC area (Anywhere within the few surrounding counties). Please personally message me with the name of a local doctor that we won't have to convince or educate them around BP - Brachioradial Pruritus. I would like to find a physician that has the option to provide the (Piroxicam .2%; Gabapentin 3%; Lidocaine 2%; Prilocaine 2%; Impramine 1%; Ibuprofen 2.4%) and/or Advantan 0.1% 15G compound cream ointment or anything that is topical that can provide my wife relief.

I have no problem letting a physician diagnose the issue and determine the best protocol for the problem. What I have an issue with, is "turning/educating" a physician around. That their 4-5 options they know for these symptoms, don't work. They aren't broadening their scope of issues/solutions enough to resolve the problem. Most physicians run out of ideas and turn to depression and psychological drugs, which is frustrating when you can't sleep, wanting to take a steak knife to your arm, etc... This problem is similar to Fibromyalgia back just a few years ago. Doctors/Physicians used that, once they came up with the word, as a garbage can until just a couple of years ago. It was always viewed as mental instability and psychological problems. The sad thing is, once you get FM and other Auto Immune Issues, you become more susceptible to more problems being lopped on....

This issue is tough to watch a loved one go through because you need to eat well, exercise, sleep well, etc… Those that have this, know that the itching doesn't stop at bed time, it ramps up. Once you stay up going crazy with this itchy arm, it piles up and doesn't allow you to freely exercise, sleep well, etc..

November 16, 2016 - 2:00am
EmpowHER Guest
Anonymous (reply to SpearFishing1)

Me too!
I am in agony all day and all night. Would like to rake both arms, constantly. It came on suddenly, so it seems. Arms are scarred-up.

November 20, 2016 - 2:46pm
HERWriter (reply to SpearFishing1)

Hello SpearFishing 1,

I am sorry your wife has had such difficulty but glad she has at least found a couple of things that help her.

I do not know of a doctor to help in So. Cal but what I suggest people do is go to Castle Connelly's website to find doctors in the speciality area and part of the country.  You want to get the names of those to call and determine if they have knowledge to help you.  

Their website: https://www.castleconnolly.com

Call a found doctor's office and ask to speak to either a nurse manager or the most experienced nurse in the office to determine if the doctor has experience in the area you need.

A word about drugs that are for depression. Some of those depression drugs such as Elavil have properties that make them reduce nerve driven pain. Itching can be from nerve irritation so don't write off trying one of these types to block those erroneous impulses that are perpetuating the itch.

The direction to pursue in terms of finding a doctor is to try and determine if the problem is dermatologically driven or neurologically driven.  If it is neurological, then a chronic pain doctor may also be worth visiting.  

Let us know how it goes,

take care,

Michele

 

 

November 16, 2016 - 2:07pm
(reply to Michele Blacksberg RN)

Thank you very much Michele for the feedback. I really appreciate your feedback and guidance. I hope to provide you positive details soon.

Thanks,
Bryan

November 17, 2016 - 12:10am
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)

Gabapentin was the only thing that worked for me until
recently when I attended physiotherapy for a pulled muscle
In shoulder.. I was given neck exercises which seemed to
stop the tingling/ burning / itching in the nerve endings.. I have
to do them daily or it comes back.. I think bad posture
contributes to this as does sun exposure.. It's always triggered
after I come back from a foreign holiday.. Hope this helps.. Helen

October 17, 2016 - 7:40pm
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)

Does your insurance cover this cream? It is hard not to itch. Only thing that helps are ice packs. It feels like little bugs are biting under my skin. Ugg

October 20, 2016 - 3:33pm
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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.