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.
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.
3) Thoughts about brachioradial pruritus. The Online Journal of Community and Person-Centered Dermatology (OJCPCD). Retrieved August 13, 2016.
Add a Comment130 Comments
My upper arms have been itching for 15 months. I have been to the allergist and the dermatologist and they both shrugged and said 'eczema'. It is NOT eczema! I found this tonight and would be deliriously happy if my arms weren't itching so badly! Thanks for the info about lime juice! Icy Hot works for me on normal nights. (Tonight it is really bad) I will also try the capsaicin and the max stuff someone else suggested. I DID find acupuncture to be helpful!! I've just been working a lot lately (I travel) and have not had consistent appointments. I will share this article with my acupuncturist and find a chiropractor- cover all my bases. Thanks everyone!!!October 13, 2015 - 8:08pm
i put pure coconut oil on it which seems to help a little bit. Next i will try the lime juice. I'll put the lime with the coconut and hope it feels better.September 19, 2015 - 3:58pm
I have had this problem just for the past two nights. I have snacked on peanuts before bedtime and tonight i'm going to avoid peanuts. I'm wondering if i've developed a slight allergy to them.September 3, 2015 - 10:43am
I've experienced intense itching on my shoulders and upper arms for the past 11 years every August through March. I do not know what causes it and some years are better than others. It is usually at night, so I do not sleep much. It causes me great anxiety since I do not know why this happens. There is no rash or bumps, just a prickly itching feeling. I've seen every type of doctor and no one can help me. I've tried everything and would try anything if it would help. I'd so much rather be in pain.August 28, 2015 - 9:27pm
Just as an FYI some itching can be caused by anxiety. I would recommend looking into that aspect.September 27, 2015 - 11:39am
I'm visiting my sister in law. I've been having this arm itching on and off now for awhile. She said to put lime juice on it. And surprisingly enough it worked . Tonight is my second night here . Trying to go to sleep and bam.. The itching started up again. Just put on line juice again. It seems to actually be helping. Weird right ? I'm using the lime juice in the little container . I also took benydryl . However I've been doing benydryl for awhile and haven't had much relief . I have no idea why the line juice is helping . Fingers crossed it works again this evening .September 13, 2015 - 10:26pm
Just be careful not to expose the skin with lime juice on it to UV light, or you will have a whole other awful problem in the form of a chemical burn..September 27, 2015 - 11:40am
Ok seriously THANK YOU Anonymous! I have been suffering, sleepless and frustrated with this itching. I randomly googled it and up came this web site. I have a neurological disease so all this info was not shocking - and made sense! (also happy it wasn't "all in my head" lol) I read your post and tried the lime juice after the itch creams that I had purchased did not help. THE LIME JUICE WORKS!!!!! I have used it all week applying a couple of times before I go to bed each night and I can not believe how it takes away the itch. THANK YOU so much for posting!September 18, 2015 - 9:38am
Hey that's awesome !!! It worked for me a couple nights . Then tried icy hot . Bit itching like crazy tonite..!!! Arg!!October 4, 2015 - 1:55am
Vanicream is over the counter moisturizer. I have been washing my arm with the soap they also have and then adding the moisturizer to my arm every morning afternoon and night. It's over the counter. Sarna is also an anti itch cream I use when the lotion is not enough. I have been suffering with this for a few years, and finally went to a. Doctor. He put me on this plan and I was weary of him knowing how to help me in this area but I have been pain free for almost a week now. I still get the itch/burning early morning but I immediately put on my creams and it is almost instantly that the pain goes away. Hope this helps you!September 13, 2015 - 9:07pm