brachioradial pruritis and neck problemsBrachioradial Pruritus and Neck Problems

In part 1 of this series we had discussed a rare condition called Brachioradial Pruritis (BRP) and how NUCCA Spinal Care was able to get to the underlying cause of the condition and eliminate it by correcting problems in the neck.

BRP is an enigmatic condition with a controversial cause; some authors consider BRP to be a photodermatosis (sensitivity to sunlight leads to changes in the skin) whereas other authors attribute BRP to compression of cervical nerve roots (nerves in the neck).

Several dermatologists have done research into this condition that makes sense with what doctors are seeing in upper cervical chiropractic offices.  They sought to investigate the presence of neuropathy (nerve related problem) in patients with BRP.  They performed studies of the median, ulnar, and radial nerves (nerves leaving the lower portion of the neck that go into the arm) in consecutive patients with BRP, including measurement of sensory and motor function.

Included in the study were 7 patients, 5 men and 2 women, with an average age of 58.3 years (range: 42-72 years). Of the patients, 4 (57%) had abnormal responses on testing that were diagnostic for cervical radiculopathy, and 3 of these patients had prolonged distal latencies of the nerves tested, which may be interpreted as sensory motor neuropathy secondary to chronic radiculopathy.  The fourth patient had polyneuropathy secondary to diabetes mellitus.

They authors concuded that BRP may be attributed to a neuropathy, such as chronic cervical radiculopathy. The possibility of an underlying neuropathy should be considered in the evaluation and treatment of all patients with BRP.

In another study the Medical charts of patients with BRP seen in the Division of Dermatology of the University of Massachusetts Medical Center between the years of 1993 and 2000 were retrospectively analyzed. On the basis of clinical index of suspicion, some patients had undergone radiography of the spine.  Of the 22 patients with BRP, 11 had cervical spine x-rays. The x-rays showed cervical spine problems that could be correlated with the location of pruritus in each of these 11 patients.  All 11 showed the connection!

The authors concluded:

"The main cause of brachioradial pruritus (BRP) is not known but there is evidence to suggest that BRP may arise in the nervous system. Cervical spine disease may be an important contributing factor."

NUCCA Spinal Care is focused on correcting structural problems with the alignment of the head, neck and spinal column.  When the spine is misaligned it will cause degeneration of the spine and interference with the function of the nerve system.  Frequently in our office looking at the x-rays of hundreds of patients with upper cervical misalignments we will see that a majority of the degeneration is in the lower cervical bones...C5, C6 & C7.  This is the area where the nerves leave the spine and go into the arm and hand.  By correcting the alignment of the spine the pressure can be relieved and the degeneration and nerve irritation can be stopped.

If you have itching or burning in your arms or have been diagnosed with Brachioradial Pruritis than an upper cervical evaluation is warranted.  To find an upper cervical specialist in your area go to www.nucca.org or www.upcspine.com or if you are in the Redwood City, California area to schedule your NUCCA evaluation, click here.

Want to hear from people like you? Check out our reviews here.

Dr. Pete Tsiglieris of Advanced Spinal Care in Redwood City, California is an Upper Cervical Specialist trained by the National Upper Cervical Chiropractic Association (NUCCA). His upper cervical clinic also serves San Mateo, Palo Alto, Menlo Park, San Carlos, and Sunnyvale. They are uniquely trained to correct problems in the upper cervical spine (upper neck). This vital area is intimately connected to the central nervous system and problems in this area have been shown to be an underlying cause of a variety of different health problems, including migraines and other headaches, carpal tunnel syndrome, neck pain, back pain and shoulder pain and weakness. More information can be found on our website at https://bayareanuccacare.com/

References:

J Am Acad Dermatol. 2003 Jun;48(6):825-8.

J Am Acad Dermatol 2003 Apr;48(4):521-4

Why do my arms itch and burn?Brachioradial Pruritus

Are your arms itching and burning?

Is the only relief an ice pack applied to the area?

Does it get worse at night?

Do you have a history of head or neck injuries?  Car accidents?  Falls?  Other Traumas?

You may have a condition known as Brachioradial Pruritus.  According to Medscape, Brachioradial pruritus is a nerve related itch syndrome of the upper extremities. It is typically localized to the skin on the forearm, but involvement of the upper arms and shoulders is also common.  It may be one sided or both sided. Scratching reportedly only makes the discomfort worse, and most patients discover that application of cold packs is often the only therapy that provides symptomatic relief.

This was the case for a 37 year old patient with BRP, Jennifer.  She would sit up all night with ice packs on her arms in order to get some relief.  This case was published as a Case Study in the Journal of Upper Cervical Chiropractic Research on the resolution of her condition utilizing Upper Cervical Chiropractic for the correction of structural misalignments in the neck.  This particular patient had a fall on a staircase where she hit her head about 8 years before the symptoms began.  As a nurse she was able to diagnose herself as having Brachioradial Pruritis a somewhat rare condition that Dermatologists typically see and have little answers for.

Jennifer went the Dermatologist route at first and had no results.  She just continued to suffer until the cause was identified and then she was on the path to recovery.

Dermatologists are frequently baffled by this condition and maybe for good reason, much of the research available points to the neck as a probable cause (see references below).  So if you go to a skin expert and they see itching skin then they will frequently prescribe some sort of topical cream or other medication to no avail.  But if the problem is being caused by an underlying neck condition as it was in Jennifer's case, a skin expert is going to have a hard time properly diagnosing or treating such a condition.

If the cause is pressure on the nerves as they leave the neck and travel into the arm then covering up the sensation with Benadryl or even ice packs are at best a temporary solution.

In the next blog we will look at additional research that is pointing BRP sufferers to the neck.

If you have been diagnosed with Brachioradial Pruritis or if you just have the symptoms described above then a structural evaluation of your neck would be appropriate.  Now the problem is not all neck evaluations are created equal.  Without a thorough understanding of the misalignments in the neck the problem could be unchanged or made worse.

So make sure that you go to an upper cervical specialist that will take the time and the effort to understand the misalignments with precise upper cervical x-rays and a thorough evaluation.

Many excellent upper cervical specialists can be found at www.nucca.org or www.upcspine.com  or if you are in the Redwood City, California area to schedule your evaluation, click here.

Want to hear from people like you? Check out our reviews here.

Dr. Pete Tsiglieris of Advanced Spinal Care in Redwood City, California is an Upper Cervical Specialist trained by the National Upper Cervical Chiropractic Association (NUCCA). His upper cervical clinic also serves San Mateo, Palo Alto, Menlo Park, San Carlos, and Sunnyvale. They are uniquely trained to correct problems in the upper cervical spine (upper neck). This vital area is intimately connected to the central nervous system and problems in this area have been shown to be an underlying cause of a variety of different health problems, including migraines and other headaches, carpal tunnel syndrome, neck pain, back pain and shoulder pain and weakness. More information can be found on our website at https://bayareanuccacare.com/

References:

Heyl T. Brachioradial pruritus. Arch Dermatol. Feb 1983;119(2):115-6.

Tait CP, Grigg E, Quirk CJ. Brachioradial pruritus and cervical spine manipulation. Australas J Dermatol. Aug 1998;39(3):168-70.

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