Continued Itching of the Forearm and Bend of Elbow

Brachioradial pruritus is a nerve disorder that causes itching on the skin on the outer side of your forearm. This part of your arm covers the brachioradialis muscle, which works with other muscles to help you flex your elbow.

While it's not usually a serious health problem, a flare-up of brachioradialis pruritis symptoms can be uncomfortable and hard to treat—partly because experts are not completely sure why it happens.

This article goes over the possible causes of brachioradialis pruritis, what the symptoms are, how it is diagnosed, and how it can be treated.

BSIP / UIG / Getty Images

Brachioradial Pruritus Symptoms

Itching is the classic symptom of brachioradial pruritis. It specifically affects the outer side of the forearm or, sometimes, both forearms. Though rare, the intense itchiness may also be felt elsewhere on the body, like the neck or legs.

If you scratch the itchy part of your arm, you may not actually get any relief. In fact, the area may feel even itchier. The scratching that causes more itching is called the itch-scratch cycle.

In some cases, the itching from brachioradialis pruritus can be very distracting and uncomfortable—especially when you are trying to sleep. The symptoms can also be worse after sun exposure.

Pain may come along with the itching because the same nerves send itching and pain signals to the brain.

Other symptoms of brachioradial pruritus include:

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

While you might expect to see changes on your skin where it itches, brachioradial pruritis does not cause a rash.

Causes of Brachioradial Pruritus

Brachioradiali pruritus is caused by nerve irritation or injury. It's not clear exactly why brachioradial pruitus results from these.

However, nerve damage and sun exposure are the two main causes that have been considered. It's possible that both are involved.

Brachioradial pruitus is not contagious.

Nerve Damage

One theory is that brachioradial pruritus can happen to people with degenerative spine diseases. These conditions happen when part of the structure of the spine breaks down. The changes in the spine's stability can place pressure on nearby nerves that connect to the arms.

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

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

The nerve damage from these conditions may lead to symptoms of brachioradial pruritus.

Sun Exposure

It's also been considered that sunlight might play a role in brachioradial pruritus. Chronic exposure to ultraviolet (UV) radiation can damage the nerve fibers in the skin.

Once they're damaged, the nerves can be more sensitive to the pain and itching from brachioradial pruritus. It's thought that this could be what actually triggers the symptoms in people with cervical spine disease.

Who Gets Brachioradial Pruritus?

Brachioradial pruritus happens twice as often to women as it does to men. While it can start at any age, it's more common in middle age.

Since brachioradial pruritus is often associated with sun exposure, people living in warmer climates might be more at risk for it. That's also why people whose lifestyles include lots of outdoor activities, like gardening or swimming, might be more likely to get it.

Diagnosing Brachioradial Pruritus

Brachioradial pruritus is usually diagnosed by a skin specialist called a dermatologist. They can identify the condition based on your symptoms and where on your body you have itching.

Your provider will need to first rule out other possible causes of your itching. For example, if you have a rash and itching, it would be very unlikely that you have brachioradial pruritis. Unfortunately, it's harder to diagnose itchy skin when there is no rash.

A diagnosis of brachioradial pruritus might be considered if anti-itch medications have not helped with your symptoms.

A provider can use several diagnostic tools to determine if you have brachioradial pruritus, including:

• Ice pack test: Many people with brachioradial pruritus notice that putting ice packs on the affected skin is the only thing that gives them relief. A provider may apply ice packs to your skin during an evaluation to see if it helps. If it does, it can make them more sure about the diagnosis.
• X-ray: An X-ray of the cervical spine can be done to make sure there is nothing placing pressure on the nerve roots to the arm. The mages may show degenerative disc disease or osteoarthritis, which are conditions that can point to brachioradial pruritus.
  

Brachioradial Pruritus Treatment

A flare-up 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 also does not help brachioradial pruritus symptoms. People who have tried a heating pad or a soak in a hot bath often find that the heat just makes the itching worse.

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

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

Some other drugs may help relieve the symptoms of brachioradial pruritis, such as:

• Gabapentin (a seizure drug that may offer relief from the itching)
• Carbamazepine (a seizure drug often used to treat nerve pain)
• Lamotrigine (a seizure drug used to treat 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 also important to remember that sun exposure is a known trigger for brachioradial pruritis. Any treatment plan should include sun protection measures, like applying sunscreen, wearing clothes to protect your skin, and staying out of the sun at peak times.

Summary

Brachioradial pruritus is a disorder that is thought to be 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.

A healthcare provider can diagnose brachioradial pruritus by talking to you about your symptoms, seeing if ice packs relieve the itching, and taking X-rays to look for problems with your spine.

Treatment for brachioradial pruritus can be challenging. Some people have found success with creams applied to the skin or alternative therapies like acupuncture.

Frequently Asked Questions

• Does brachioradial pruritus get worse after exercise?

  Working out by itself is not a trigger, but you might notice the itching gets worse if you've exercised outside (due to sun exposure).

• Does brachioradial pruritus get worse at night?

  The itching from brachioradial pruritus can disrupt your sleep. Using ice packs at night can help relieve the symptoms.

• How can you treat brachioradial pruritus at home?

  Try applying ice packs to help relieve the symptoms. If ice works for you, another strategy might be using a cooling cream with menthol to ease the itching.

• What other conditions can cause itchy forearms?

  There are many conditions that can make your forearms itch, like dry skin, bug bites, folliculitis, atopic dermatitis, and psoriasis. If you have itching that does not go away or is getting worse, talk to your healthcare provider.

Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.

1. American Osteopathic College of Dermatoloy. Brachioradial Pruritis.

2. Australasian College of Dermatologists. Brachioradial Pruritus.

3. Carvalho S, Sanches M, Alves R, Selores M. Brachioradial pruritus in a patient with cervical disc herniation and Parsonage-Turner syndrome. An Bras Dermatol. 2015; 90(3):401-2. doi: 10.1590/abd1806-4841.20153059

4. Lavery MJ, Kinney MO, Mochizuki H, Craig J, Yosipovitch G. Pruritus: an overview. What drives people to scratch an itch?Ulster Med J. 2016;85(3):164–173.

5. Lipman ZM, Magnolo N, Golpanian RS, et al. Comparison of itch characteristics and sleep in patients with brachioradial pruritus and notalgia paresthetica: A retrospective analysis from 2 itch centers.JAAD International. 2021;2:96-97. doi: 10.1016/j.jdin.2020.12.001

6. Bernhard JD, Bordeaux JS. Medical pearl: the ice-pack sign in brachioradial pruritus. J Am Acad Dermatol. 2005;52(6):1073. doi:10.1016/j.jaad.2005.02.056

7. Wachholz PA, Masuda PY, Pinto ACVD, Martelli ACC. Impact of drug therapy on brachioradial pruritus.An Bras Dermatol. 2017;92(2):281–282. doi:10.1590/abd1806-4841.20175321

8. Cleveland Clinic. Brachioradial pruritus.

By Daniel More, MD
Daniel More, MD, is a board-certified allergist and clinical immunologist. He is an assistant clinical professor at the University of California, San Francisco School of Medicine and currently practices at Central Coast Allergy and Asthma in Salinas, California.

Thanks for your feedback!

mcdonaldseneiver.blogspot.com

Source: https://www.verywellhealth.com/brachioradial-pruritus-83220

Share this post