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Archive for the ‘Brachioradial Pruritis’ Category

A hand scraching at a pruritus on arm

Image via Wikipedia

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?

Recently we have published a Case Study in the Journal of Upper Cervical Chiropractic Research on the resolution of a condition called Brachioradial Pruritis  in a 37 year old female 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.

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.

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.

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 San Diego County area than come into to our office and we will evaluate you.  You can find us at www.nuccawellness.com

Dr. William R. Davis Jr., D.C. is a Vista Chiropractor and Upper Cervical Specialist. He is in private practice in Southern California in the city of Vista. He specializes in correcting 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. More information can be found on his website at http://www.nuccawellness.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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I have previously talked about a rare condition called Brachioradial Pruritis (BRP) on this blog 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 (see https://nuccadoctordavis.wordpress.com/2010/03/05/nucca-and-brachioradial-pruritis/ for more info). 

The Journal of Dermatology describes Brachioradial pruritus (BRP) as a localized itching or burning sensation of the arm. 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 I am seeing in my office.  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 my office looking at the x-rays of hundreds of patients with upper cervical misalignments I 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.  If you are in the San Diego CA area than go to our website at www.nuccawellness.com to find out about our evaluation special.  If you are not in the area go to www.nucca.org or www.upcspine.com to find a doctor in your area today!

Dr. William R. Davis Jr., D.C. is a Oceanside Chiropractor and Upper Cervical Specialist. He is in private practice in Southern California in the city of Vista. He specializes in correcting 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. More information can be found on his website at http://www.nuccawellness.com
References:

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

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

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Today we are going to discuss a rare and debilitating condition that few doctors have even heard of, let alone have any clue what the cause is….

“According to Wikipedia…Brachioradial pruritis (sometimes abbreviated BRP) is an intense itching sensation of the arm usually between the shoulder and elbow of either or both arms.  The itch can be so intense that sufferers will scratch their own skin to a bleeding condition. The cause is not known, although there are a few lines of thought on what causes it. No cure has been found. Many different medications and types of topical creams have been experimented with, but none seem to make any difference. The only thing that seems to help most sufferers is the application of ice to the area until the itch is diminished.”

So imagine that your arms itch all the time and it gets worse at night.  Keeping you awake and creating fatigue and other problems that are severely affecting your work and family life.  You go to the medical doctor and he says it must be some kind of dermatitis.  He refers you to a Dermatologist.  They give you creams and antihistamines trying to control some kind of allergic reaction.  But you have no improvement the only thing that helps is putting ice on your arms.  So you stay up half the night with ice on your arms wondering what is happening with you?!  Is it all in your head?  Are you imagining these sensations?

In the literature one possible cause is compression of the cervical nerve roots.  The most common treatments medication for pain, allergy pills and creams!?  What!?  If the probable cause is compression or irritation of the nerves that come out of the neck…why don’t we take the pressure off?  Get to the cause and allow the nerves to heal?

Again from Wikipedia…”The main cause of 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.”

Look at the neck!!!  Why do we cover up symptoms rather than finding the cause?  If you struggle with Brachioradial Pruritis…there is hope…upper cervical care may be the answer.  If you can realign the neck and take pressure off of the nerves and keep it that way…not through manipulation where it works for a little while and then comes right back…but through truly realigning the spinal column you can get your life back!!!

Here is Jennifer’s story from our office…

“When I first came to the office I was looking for relief from severe burning and itching in my arms.  I also had muscle tightness and spasms in my upper back and neck.  I was unable to sleep for more than 4 hours at a time due to the itching.  I had tried multiple treatments including Benadryl, topical ointments and creams with no results.

 Since beginning care I had almost instant relief of the burning and itching in my arms.  My neck and upper back feel much better.  The muscle spasms and tenderness are much less.  And I can sleep through the night again.

 The care at Breath of Life is thorough and complete…no surprises.  Dr. Davis and staff are very informative, pleasant and accommodating!                Jen E., Encinitas CA

Dr. William R. Davis Jr., D.C. is a Oceanside Chiropractor and Upper Cervical Specialist. He is in private practice in Southern California in the city of Vista. He specializes in correcting 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. More information can be found on his website at http://www.nuccawellness.com

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