Brachioradial Pruritus

Overview

What is brachioradial pruritus?

The brachioradialis is the muscle in the lower part of the arm that helps the arm bend at the elbow. Brachioradial pruritus is a nerve disorder that causes itching, stinging, or tingling sensations in this area of the outer forearm.

Brachioradial pruritus usually affects both arms, but it can occur in only one arm. In rare cases, the urge to scratch spreads to other parts of the body, including the shoulders, neck, and lower legs. This condition is not contagious.

Who is affected by brachioradial pruritus?

Brachioradial pruritus occurs three times more often in women than men. It is most common in women with light skin tones ages 45-65. In some studies, people who play tennis or sail or engage in other outdoor activities are more prone to developing pruritus of this type.

Symptoms and Causes

What causes brachioradial pruritus?

Irritation or injury to nerve roots causes brachioradial pruritus. Doctors have found links between the disorder and two factors:

  • Sun exposure: Brachioradial pruritus occurs more often in people who have frequent exposure to ultraviolet (UV) radiation from the sun.
  • Spinal problems: Spinal problems that compress (put pressure on) nerves affecting the arms can lead to brachioradial pruritus. Conditions that can cause spinal compression include a herniated disk (damage to the tissue separating the bones of the spine) and osteoarthritis (the wearing down of joint cartilage, the connective tissue in the joint).

What are the symptoms of brachioradial pruritus?

If you have brachioradial pruritus, you may feel an intense urge to scratch your forearms. You may also notice burning, stinging, or tingling sensations in your arms. The symptoms of this disorder are often worse after exposure to the sun.

Diagnosis and Tests

How is brachioradial pruritus diagnosed?

Doctors use a medical history and several tests to confirm a diagnosis of brachioradial pruritus. These tests include:

  • Ice-pack test: A doctor places an ice pack on the affected area to see if symptoms stop when you apply the ice pack and return when you remove it.
  • Imaging tests: Tests such as X-ray or MRI help doctors identify spine abnormalities. Osteoarthritis or a herniated disk in the spine may cause a compressed nerve.
  • Physical exam: During a physical exam, a doctor looks at and feels the skin on the affected area of the arm.

Management and Treatment

What are the treatments for brachioradial pruritus?

Treatment for brachioradial pruritus may include:

  • Ice packs: Many people with brachioradial pruritus find relief from symptoms by applying ice packs to the affected areas.
  • Physical therapy: For some people, exercises to stretch and strengthen the spine ease symptoms of brachioradial pruritus.
  • Surgery: In rare cases, doctors perform surgery to correct a spinal problem causing brachioradial pruritus.

Medications

Your care provider might also suggest medications or topical products, many of them over-the-counter, which you apply right to your skin. Topical products might include creams like:

  • Menthol (cooling) cream that may bring relief if ice packs also help.
  • Capsaicin cream to reduce the chemical transmitters in nerve endings, so that you gradually experience less pain.
  • Local anesthetic creams (pain relievers) to reduce pain in the area, including one made from ketamine and amitriptyline.

Your doctor may prescribe medicines including:

  • Antihistamines: These drugs manage chemicals in the body that cause itching.
  • Anesthetics: Specific medications numb nerve impulses in the skin.
  • Anticonvulsants: Drugs such as gabapentin and pregabalin treat seizures and pain.

What are the complications associated with brachioradial pruritus?

Some people with brachioradial pruritus experience skin complications due to excessive scratching. They include:

  • Eczema (inflamed and rough patches of skin).
  • Hypopigmentation (loss of skin color).
  • Nodules (hard lumps).
  • Sores or scarring.
  • Thickening or darkening of the skin.

Prevention

How can you prevent brachioradial pruritus?

You cannot prevent brachioradial pruritus. You can reduce your risk of the disorder by protecting your skin from exposure to sunlight.

Protect your skin by wearing protective clothing when you go outside. Always use sunscreen with a sun protection factor (SPF) of at least 30.

Who is at risk of developing brachioradial pruritus?

You may have a higher risk for brachioradial pruritus if you:

  • Are a middle-aged woman with light or fair skin.
  • Experience frequent exposure to the sun.
  • Have a back or neck problem that causes compressed nerves such as a herniated disk.

Outlook / Prognosis

What is the prognosis (outlook) for people with brachioradial pruritus?

For many people with brachioradial pruritus, symptoms go away in a few weeks to a few months after taking medication and reducing exposure to sunlight.

For some people, the itching and burning sensations come and go for the rest of their lives. In many cases, doctors can successfully manage these flare-ups.

Many people with brachioradial pruritus find that symptoms improve during winter months.

Living With

When should I see a healthcare provider about brachioradial pruritus?

Contact your healthcare provider if you feel a constant urge to scratch your arms or experience other signs of brachioradial pruritus.

What questions should I ask my healthcare provider about brachoradial pruritus?

If you have brachioradial pruritus, you may want to ask:

  • What is causing my itchy arms?
  • What type of treatment is best for me?
  • What can I do to avoid complications from scratching?

Last reviewed by a Cleveland Clinic medical professional on 01/07/2020.

References

  • DermNet NZ. Brachioradial pruritus. Accessed 1/14/2020.
  • Yosipovitch G, Patel TS. Chapter 103. Pathophysiology and Clinical Aspects of Pruritus. In: Goldsmith LA, Katz SI, Gilchrest BA, Paller AS, Leffell DJ, Wolff K. eds. Fitzpatrick’s Dermatology in General Medicine, 8e New Yor, NY: McGraw-Hill; 2012.
  • Beuscher L, Reeves G. Brachial radial pruritus: approach to the patient with engimatic forearm pruritus. J Nurs Pract, 8 (9) (2012), pp. 736-741
  • Robbins BA, Schmieder GJ. Brachioradial Pruritus. StatPearls Publishing; 2019 Jan. Accessed 1/14/2020.
  • Australasian College of Dermatologists. Brachioradial pruritus. Accessed 1/14/2020.
  • Poterucha TJ, Murphy SL, Davis MD, et al. Topical amitriptyline-ketamine for the treatment of brachioradial pruritus. JAMA Dermatol. 2013;149(2):148-50.

Cleveland Clinic is a non-profit academic medical center. Advertising on our site helps support our mission. We do not endorse non-Cleveland Clinic products or services. Policy

Cleveland Clinic is a non-profit academic medical center. Advertising on our site helps support our mission. We do not endorse non-Cleveland Clinic products or services. Policy

Cleveland Clinic is a non-profit academic medical center. Advertising on our site helps support our mission. We do not endorse non-Cleveland Clinic products or services. Policy