What Is Brachioradial Pruritus?

Brachioradial pruritus is a nerve disorder that causes itching of the skin that covers the brachioradialis muscle. The brachioradialis muscle is located in the outer side of your forearm and works with other muscles to help your elbow flex.

Although it is rarely a serious problem, the symptoms can be uncomfortable and hard to treat. That's partly because it's not completely clear what causes it.

This article looks at brachioradial pruritus and the kinds of symptoms you might experience with it. It discusses the possible causes and explains how your healthcare provider might treat it.

What Is Brachioradial Pruritus?

Brachioradial pruritus is itching that specifically occurs on the skin on the side of the outer side of your forearm. The intense itching happens along the affected arm or, in some cases, both arms. Itchiness might also be felt in other parts of the body, including the neck or legs, though this is rare.

Brachioradial pruritus is not something you can catch or give to someone else. Rather, it stems from nerve irritation or injury.

Brachioradial Pruritus Symptoms

Itching is the classic symptom of brachioradial pruritis. Sometimes there is pain as well as itching. This is because the same nerves send both the pain and itch signals to the brain.

If you scratch the itchy part of your arm, you may not actually get any relief. In fact, the area may become even itchier. This leads to more scratching and is called the itch-scratch cycle. In some cases, the itching can be very distracting and uncomfortable, especially when you are trying to sleep.

Other symptoms of brachioradial pruritus may include:

• Tingling in the arms
• A burning sensation in the arms
• Itching of the shoulder and upper back
  

The symptoms may be worse after sun exposure. Brachioradial pruritis does not cause a rash.

Causes of Brachioradial Pruritus

The exact reason for this type of itching is unknown. Nerve damage and sun exposure are the two main causes that have been linked to brachioradial pruritus, and it's quite possible that it may be due to a combination of both.

Nerve Damage

Degenerative spine diseases are those in which part of the structure of the spine breaks down. These changes in the spine's stability may place pressure on nearby nerves that connect to the arms. This can cause nerve damage that can lead to brachioradial pruritus.

One such example is spinal stenosis. It is caused when the center of your spine narrows and presses down on the spinal cord and nerves.

Another is called cervical spondylosis. With this condition, the nerves that exit the spinal cord at the neck are compressed and damaged.

Sun Exposure

Chronic exposure to ultraviolet (UV) radiation can lead to damage of the nerve fibers in the skin.

It can make the nerves more sensitive to the pain and itchiness of brachioradial pruritus. This may be what actually triggers the symptoms in people with cervical spine disease.

Who Gets Brachioradial Pruritus?

Brachioradial pruritus happens more than twice as often in women as it does in men. It can happen at any age, but is more common in middle age.

Because brachioradial pruritus is often associated with sun exposure, people living in warmer climates may be more at risk. That's also the case for people whose lifestyles include lots of outdoor activities, like gardening or swimming.

Diagnosing Brachioradial Pruritus

This condition is often diagnosed by a skin specialist called a dermatologist. They usually identify it based on your symptoms and where on the body the itching is reported.

Your doctor may begin by working to eliminate other possible causes of your itching. For example, if you have a rash that goes along with your itchy skin, it is unlikely you have brachioradial pruritis. Unfortunately, it's harder to diagnose itchy skin when there is no rash. Brachioradial pruritus may be suspected when anti-itch medications have failed to provide relief.

A healthcare provider may use several diagnostic tools to form a brachioradial pruritus diagnosis:

• Ice pack test: Many people with brachioradial pruritus notice that ice packs applied to the affected skin are the only things that give them relief. A provider may apply ice packs to the skin during an evaluation to see if this is true in your case. This often leads to a definitive diagnosis.
• X-ray: An X-ray of the cervical spine may also be ordered to make sure there is nothing placing pressure on the nerve roots to the arm. Images may show degenerative disc disease or osteoarthritis, additional conditions that may point to brachioradial pruritus.
  

Brachioradial Pruritus Treatment

The symptoms of brachioradial pruritus can be hard to treat successfully. Oral antihistamines like Zyrtec (cetirizine), hydrocortisone, and other corticosteroids that are applied to the skin often do nothing or very little to ease discomfort.

Heat doesn't help either. People who have tried a heating pad or a soak in a hot bath often find that the heat just makes their itching worse.

Quite a few other treatments have been tried for brachioradial pruritus. Still, the success rate remains mixed. These include:

• Capsaicin cream, which suppresses a chemical produced in nerve endings
• Pramoxine cream, which numbs sensory nerve impulses in the skin
• Doxepin cream, an antihistamine known to reduce a chemical that causes itching
  
• Ketamine cream, an anesthetic that also provides pain relief

Some other drugs may help to relieve the symptoms of brachioradial pruritis. They include:

• Gabapentin, a seizure drug that may offer relief from the itching
• Carbamazepine, a seizure drug often used to treat nerve pain
• Lamotrigine, another seizure drug used to treat the itching
• Amitriptyline an antidepressant that can be used for pain relief

Apart from drugs, some people report they find relief through acupuncture or cervical spine treatment provided by a chiropractor.

It's important to remember that sun exposure is a known trigger for brachioradial pruritis. Any treatment plan must include sun protection measures. This can include using sunscreen, wearing clothes to protect the skin, and staying out of the sun altogether at peak times.

Summary

Brachioradial pruritus is a disorder likely linked to spinal nerve damage and sun exposure. It causes itching of the skin over the outside of the forearm that is not relieved by scratching. Over-the-counter creams, allergy medications, and heat application typically don't help and may make matters worse.

A healthcare provider can diagnose brachioradial pruritus by reviewing your symptoms, seeing if ice packs relieve the itching, and taking X-ray images to look for spinal issues.

Treatment can be difficult, but some people have found success with creams applied to the skin or alternative therapies like acupuncture.