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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?

The cervical nerve damage critics point out that cervical neck degeneration occurs in 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.1

Regardless of cause, there are some treatments that may help brachioradial pruritus.

For most people with BP, the itching is prickly and burning, and that can keep them awake at night.

Ice packs are the first best therapy to try to stop the itch.

Capsaicin is a topical cream that is believed to help with pain-related nerve conditions by interfering with the sensory nerves' perception of pain. It may take several weeks for the capsaicin to work.

Sometimes a topical steroid cream can take the edge off.

With a doctor’s prescription, a lidocaine 5% gel or patch can be applied to the skin. Lidocaine provides relief by blocking nerve impulses.

Other oral medications that act to block erroneous nerve impulses such as gabapentin, lyrica or amitriptyline can also be tried. However, they are also fairly sedating and have other side effects, so they may not be well tolerated.

Alternate treatments include acupuncture and topical anti-itch oils such as menthol or spray-on antihistamines, which may give some relief. Oatmeal or black tea tannin compresses may also be of help.

Chiropractic adjustments of the neck have also been found to be helpful by some. Wearing protective clothing such as long-sleeved shirts to protect your arms from wind and sun may help.

Brachioradial pruritus is a very frustrating and difficult condition that requires understanding from others, as well as patience and persistence to come up with some amount of relief.

Michele is an R.N. freelance writer with a special interest in women’s health care and quality of care issues.

Originally written March 2, 2011
Updated August 16, 2016 by Michele Blacksberg RN
Edited by Jody Smith

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 Comment128 Comments

EmpowHER Guest
Anonymous

Hello, l have suffered seasonally with this intense itching, stinging, burning , needles on my upper arms for around 5 years now.l am 49 and thought it was to do with menopause as a lack of estrogen can cause bizarre itching.
Upping my biodentical estrogen does help a bit, but l feel this itching is more sinister than we are led to believe.
I often have strange sand grain things emerge from the wounds that l create from digging to relieve the itch.
After the crystalline like grains are released, l feel immediate relief until the cycle starts again.
I wonder if this is some type of Morgellons like disease?
Peppermint essential oil provides some relief, and numbing the area with ice.
It is a terrible thing we are all experiencing and the weeping holes on my arms are horrible, always round, with oozing liquid, sometimes with stringy threads and the granules, like my body is purging something foreign? Any thoughts on the Morgellons theory?

May 26, 2020 - 4:09pm
EmpowHER Guest
Anonymous

Hi,

I just want to back up the Eumovate cream (clobetasone butyrate) claim. It works for me too and it's the only thing that ever has. I've got to a stage where i only very rarely have to use the cream now, only when it flairs up (maybe once per year).

January 24, 2020 - 12:43am
EmpowHER Guest
Anonymous

My wife (now 44) and I was early in our dating that summer afternoon five years ago when standing on my back deck a wasp came out from under a bamboo tiki torch where it and several others had nested. It stung her on the forearm and we treated it as a minor sting that it was. However, over the next few days intense itching began and it has not relented. It starts every year just around the peak of the summer heat late July August and lasts into early winter. After several visits to primary care physician and dermatologist it was diagnosed as brachioradial-pruritus brought on by nerve damage from the wasp sting. It must had been a precision strike by a smart wasp. Needless to say, the sting was at just the right place to precipitate to anguish it has caused. She began using ice both day and night and nearly all of the over the counter topical itching products then a roll-on product called Icy-Hot which is now a must have. The itching is described exactly as I am reading from other comments on this forum. The scratching on her arms (at night being the worst) till they were raw and bleeding. Then even at work in a climate-controlled office building it’s just the same. At its worst it’s to the point of mind alternating madness simply because the itching simply won’t stop. She takes Benadryl as a last resort and it knocks her out. Needless to say, the quality of life is degraded by this intense ailment which seems to have no cure. It was only on her left arm but this year it has migrated to also the right arm. It comes and goes and when it hits, she is in constant itching and scratching mode and being distracted from a meaningful quality of life. One doctor suggested cervical nerve damage as the root cause but it doesn’t make sense to us knowing it all started with a simple wasp sting to the arm and she hasn’t been in any violent trauma. There seems to be little known about this ailment but I am going to ask the question anyway because we are so desperate. Is there not a brachioradial-pruritus specialist or nerve block option clinic in this country or another that can end the itching for good? We are like many other sufferers desperate for a permanent solution.

October 4, 2019 - 5:38am
HERWriter Guide (reply to Anonymous)

Hi Anon

I'm sorry to read how your wife is suffering so much - and how you are too, alongside her. 

Try this website - I don't know if it will help but I hope so:

https://www.aocd.org/page/BrachioradialPruritu

 

Best,

Susan

October 4, 2019 - 11:27am
EmpowHER Guest
Anonymous

I have had this issue for the last five years. It is painful like a burning sensation and comes to the surface of my skin as itch but is a signal for pain. I sleep with ice packs to relieve the itch and wake up constantly. I scratch till I bleed all over the sheets and the ice is the only thing that helps. I live in Florida. It used to start always in August so I thought it was poison Ivy because every year end of July I was in Colorado and going through trails that had warning signs of poison ivy. It wasn't that. I have had 3 doctors and 2 dermatologists look at it. One took a biopsy and found nothing. The other said I had BP and to get a steroid cream immediately to clear up the horrible secondary issue I had caused by scratching my arms (at night being the worst) till they were raw. He also said to stop using the naturopathic oils like melaleuca (tea trea oil) or vitamin E, arnica and that my skin was reacting in a more inflamed way. He said I had a pinched nerve in my C3/4 and to get to a chiropractor to alleviate this pain. I feel like that helped for a few months but then it came back. It was only on my right arm but the last month went to my left arm and now is on both. It comes and goes and I am in constant pain. I had an antihistamine shot to the hip (very strong) and was given strong antihistamine tablets by prescription only. I've used creams and lotions of all kinds. I now have schedules to see an acupuncturist and to have a food allergy testing. I already have cut out so many things that I think could cause ellergic reactions. Gluten, milk and milk products, soy and soybean products and now all corn. One thing that has helped just a bit is CBD oil that I put directly on the scratches but it doesn't help after an hour or two. I thought it was shingles, but it is only on my arms so can't be that...and though it sometimes looks like a small blister like chicken pox, I was actually hopeful that was iwhat it was so I could take that vaccine they give for shingles. BTW, I am a triathlete and very healthy but this started right as I was turning 50 so my acupuncturist is checking my hormones now and my lower digestive track to make sure that is not causing my nerves to react in my arms. So much to consider!!! But the fact remains that it's painful, unattractive, & could be an auto immune disorder and I will do anything to cure it! I still do the chiropractic exercises because I do believe it is nerve related and am thankful you all were writing about this on this site. May this review help and may we find an answer to what we are all experiencing.

July 1, 2019 - 12:19pm
EmpowHER Guest
Anonymous (reply to Anonymous)

I have the same problem and the only relief I can get is using bengay. It numbs my nerves but it really works

July 23, 2019 - 7:58am
Guide (reply to Anonymous)

Anon,

Thank you for sharing this. You are correct in that it could be related to an autoimmune disorder. Tests can be taken to find out.

We hope you feel better soon. Keep us updated.

best.

Helena

July 1, 2019 - 12:43pm
EmpowHER Guest
Anonymous

I used to have a problem with extremely itchy arms, but it also affected my legs, especially around my ankles. I finally mentioned it to my doctor. I showed him how I was scratching my arms so raw it looked like a rash but wasn't, just the scratches. I told him I was using baby oil after showers. He said that was my problem. According to him the mineral oil was leaching vitamin E out of my skin causing a vitamin E deficiency. He recommended I get some pure vitamin E oil for my skin and avoid all mineral oil. It worked, the itching ended immediately and this treatment has worked for 30 years. Pure vitamin E oil used to be hard to find 30 years ago, there was one pharmacy that carried bottles of it. Nowadays it is easily available and there are many more mainstream brands. But beware if you are going to try this, just because the front of the bottle says vitamin E you need to check the ingredients to make sure mineral oil isn't in there as a cheap filler. Vitamin E oils and lotions will be plant based, ie: safflower, sunflower, olive, castor, walnut, or other plants/seeds. Cheap enough to try to see if it relieves the itching.

January 10, 2019 - 3:06pm
EmpowHER Guest
Anonymous

Your Response:
I had this condition for 2 years - it drove me mad as aswell, usually only at night. Onset early evening and felt like pin pricks,
Very itchy around elbow usually on one side - no rash. I found the issue by changing my diet - I found I had a LACTOSE INTOLERANCE.
I stopped all diary products for a week and for me at least this was the cause. It’s worth a try. I’m dairy and itch free now and take lactase tablets when I want banoffee pie or deserts!

October 21, 2018 - 11:15am
EmpowHER Guest
Anonymous (reply to Anonymous)

I drink milk all day, & right before I go to bed,, I sleep with ice bottles on my arms, just so I dont wake up with bloody arms from scratching all night!

January 14, 2019 - 5:46pm
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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.