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
I apply Technu as a lotion to clean skin and it helps. I put it on in the early evening before the itch starts and it does help. I also think Vit D helps.July 8, 2016 - 12:29pm
Hello, I suffered from this for more that 2 years and i drove me mad. I went, on recommendation from a friend, to a "healer" and he just put his hands on my back (I was lying down) I went into a kind of sleepy or relaxing "trance". I have to say I had really weird half dreams and experiences during this session. I had a few sessions and the icing went away. I wasn't really sure what he did until my wife started getting in Bio Energetic Healing and through this, I realized this was what he was doing.June 12, 2016 - 10:20am
This was 3 years ago and since then my wife treated me but only a few times, and I haven't had a recurrence. But she treats me regularly for various things. She uses methods from, Frank Kinslow (QE), William Bengston ((Energy Healing), Ursula Fallet (ENKOMP), Touch For Health, Innerwise.
If you can find someone who practises Bio Energetic, give it a try. Another method is Cranialsacral.
I also found this link - https://www.drbaileyskincare.com/info/blog/post/a-new-explanation-for-intensely-itchy-arms
This has confirmed my original suspicion that it was connected with my back problems and aggravated by the sun.
I am so glad I found this article and site so I can read all the comments. I started getting severe itching, only to my left arm, about 4 years ago. It did start at my shoulder and now has worked its way down my arm. It commonly happens at night, and yes, wakes me. I do live in Florida as well. I scratch so hard that I have created small scabs. I am going to try all of the recommendations commented.June 11, 2016 - 6:15am
I have this when I'm exposed to sun for long time. I'm in Florida. Over the counter ointment does not work on me. What helped me big time, is Bactroban and Clovate N ointment. Look it up fellow sufferers, might help you.April 14, 2016 - 8:08pm
I have had this condition for almost 30 years after a honeymoon in Mexico and sun exposure. The itching is always between my wrist and elbow. Within the past 3 months, it is finally gone. How? I suffer from lower back pain and have been in traction to release the pressure on my spine. I have read in here how others have benefitted from traction, but to their neck, as the itch has something also to do with a compressed nerve in the spine. Unbelievably, the itch is now gone. I have also purchased an inversion table. I can finally sleep at night. Amazing is an understatement.March 28, 2016 - 2:28am
This incredible itching is between my forearm and elbow and there have been times when I could have sawn my arm off to stop it. I explain it by saying "it feels like my artery is itching". It started after a two week holiday in Australia (although I always use factor 50 sunblock in the sun and always have). Three doctors appointments so far - anti-biotics for cellulitis, didnt work. 4 different anti-histimines didnt work. Now prescribed 300mg aspirin daily - we shall see. Really happy to have stumbled on this site :)
I have a lime in the fridge and think I shall crack it open before bedtime. Thanks for the infoJanuary 7, 2016 - 11:40am
I've had this problem for about 5 years now. Only occurs in the fall & winter. I think both theories of causation are correct. When I explain it to other people I refer to it as an itch that won't be satisfied with scratching it. It seems to me that its a nerve problem because I did injure my spine, which also caused the top part my leg to go numb. I think its sun exposure as well because it's predominantly a left arm problem for me. Sarnia lotion has helped to provide some temporary relief but doesn't always work. I have noticed the condition gets worse after a hot shower. I'm going to hang upside down on my inversion chair, start taking cold showers year round, and try to use those Lidocaine 5% patches and or the aveeno - thanks to all who contributed.January 4, 2016 - 2:52pm
I have had this condition for a good number of years.. On my right arm, iam a Lorry driver in the uk and this always seems to flare up in summer it drives me nuts and have discovered that cold things are the only relief, iam 44 years old and do occasionally get neck pain, it's only my right arm that's affectedDecember 19, 2015 - 3:04pm
Cervical traction with a home device (used in a horizontal body position) seems to relieve some of the pressure on cervical nerves. In addition, Lidocaine 5% patches (manufactured by Watson/Actavis Pharmaceuticals) placed each evening on shoulders and arms provide significant, beneficial, and effective relief. Patches are worn for 12 hours and help the BRP sufferer to sleep at night. The benefits seem to carry over into the following day. Lastly, Aspercream with 4% Lidocaine provides on-the-spot short term relief. Effective hygiene includes cool or cold showers with only Cetaphil used on arms and shoulders.November 19, 2015 - 3:14am
I have just started getting the itch on my shoulders, it started up last night at around 3:00 for no reason. Its the middle of November and I live in Northern Wisconsin so it's usually cloudy or snowing.November 18, 2015 - 7:11am