Brachioradial Pruritus

[peterb]

  Garth

A warm welcome to the forum, hope you enjoy your time here, a great bunch of people here.

[Fishs]

 

  Hi there Garth

 Welcome along to the forum.

feel free to rant and ask questions .. Hope you enjoy your stay here ..

fish

[Gobe]

Gobe: again, thanks.


Garth

P.S.: Is that a Scottish flag I detect in your avatar image?   ;-)

Aye!  

[kcluvzmle]

Hi & welcome, Garth...

Ive been dealing with my ...affliction for 8 or 9 months now, Im 47. At first we thought it was BP (i saw a GP) then later (August) I was officially dx'd by derm & biopsy to have Lichen Simplex.

Anyway, well good luck with appt tomorrow, hope you get some answers. And, it was actually my GP who put me on Doxepin which has helped me a lot. Otherwise, little else ever helped except Aloe Vero Gel w Lidocaine, very temporary of course.

Ill check back in tomorrow... tired now! zzzz.....

KC

[CKINCS]

I was told by my dr. a couple of days ago that I have brachioradial pruritis.  Interesting thing is that my sister (7 yrs. older) and my mother have both suffered with this condition on and off for a number of years.  The dr. prescribed Zonalon cream, but I haven't filled it because an internet search revealed it is not very effective.  Has anyone tried elavil?  I read that it worked in at least one case - not sure even what it is.  What about accupuncture?  I'm willing to try anything at this point.  I have no known cervical spine problems.  I was wondering if I could have done nerve damage while carrying my kids with my right arm.  Not sure.  I have had relief during the day with 3 ibuprofen tablets, but the itching wakes me up at night so ibuprofen doesn't cut it at that time.  Right now I'm using ice on the area and I'm waiting for the Benedryl to kick in.  My sister uses a double dose of Benedryl and even that has become ineffective in stopping the itch.  Please respond with effective remedies.  Thank you!

[peterb]

  CKINCS

Welcome along to the forum.  I suffer from Psoriasis and when mine is very itchy, I find that Piriton works for me, and also plenty of moisturiser.  Have a look around the boards there is other info on your condition, and later others will offer some advice.

[peterb]

Here are some good links for you

PRESS HERE FOR LINK

And here is another interesting article -----------

Grenz Rays

Grenz rays have been used by dermatologists since the 1920's. At one time, it was an important treatment tool, but with all the recent medical advances it is rarely used today. It is used to calm down inflammation of the skin and will not cause damage as seen with prolonged use of cortisone creams. It is occasionally very helpful for conditions that fail to fully respond to other treatments. Grenz treatments are not a replacement for other treatments but are added to them to get a more complete result.

Grenz rays are a form of black light. Similar to ultraviolet light, x-rays, and gamma rays, these are all composed of photons, which are packets of electro-magnetic energy traveling at the speed of light. Grenz rays are produced at low kilovoltages giving them a very low penetration power. Half their energy is absorbed within the first half millimeter of tissue, which means that they do not penetrate beneath the skin.

Due to its very limited level of penetration, Grenz rays are classified as ultrasoft radiation. They do not carry the risks of other forms of radiation when proper radiation safety measures are followed. Grenz ray treatments should not be confused with the "superficial radiation therapy" or "superficial X-Ray" which were used for everything from acne to eczema back 30 to 40 years ago, and are still used in the treatment of malignant skin cancers today.

The usual course of Grenz treatment consists of weekly or bi-weekly treatments over three or four sessions. Treatments giving over 200 Rads will cause a mild sunburn reaction at the site. A persistent dark, tan may linger for several months afterwards. Hair loss does not occur. Subsequent treatments may be repeated two or three times yearly, if needed.

Uses of Grenz therapy include treatment of the last lingering spots of mycosis fungoides, atopic dermatitis, contact dermatitis, psoriasis, Haily-Haily disease, lichen simplex chronicus, hand eczema, and anogenital itching including pruritus ani.  

http://www.aocd.org/skin/dermatologic_diseases/grenz_rays.html

[Gobe]

 

Welcome to Skincell CKINCS!

 

[Garth Wood]

CKINCS:

Hi there.  Hope being here helps.

Elavil is a brand name for Amitriptyline, which is a tricyclic anti-depressant normally taken in pill form.  Another antidepressant that is sometimes prescribed is gabapentin, also in pill form.  The theory behind taking these is that they depress the activity of the central nervous system sufficiently to stop (or at least moderate) the nerve impulses from the damaged nerves which give rise to the itching sensation in the first place.  This assumes that the origin of the symptoms truly is nerve damage in the C5 to C7 area of the cervical spinal column (lower part of your neck).  Not everyone agrees that this is the etiology of BRP.

I've been to the dermatologist, who basically said "There's nothing we can do for you."  I'm getting *tired* of hearing med professionals say that.  I've now got a referral to a neurologist.  Three months down the road.  Yippeee.  Meanwhile, I'm going to assume that it's nerve damage complications arising from cervical radiculopathy (pinched nerve in the neck).  One of the most conservative (and reasonably effective!) treatments for this is neck traction, so I'm going to start a manipulation regimen with my chiropractor and get him to also prescribe a home-use neck traction device, to see if I can get some relief that way.  He's already taken X-rays of my cervical spine, and I'm talking to him about what he can see at 1:00 P.M. today.

I'd rather manage this myself than wait for some medical pudknocker.  It's ******* ( Ed Bot! ) me off.


Garth

P.S.:  I've received temporary relief by using Lanacaine extra strength, which has as its two active ingredients 20% benzocaine (a topical anesthetic) and 3% resorcinol (a phenol derivative).  I have to be careful to use this stuff only when the itching is really bad, because the resorcinol in particular can cause allergic reactions, and it's also possible to "overdose" on resorcinol.  If your skin starts to ache when you put resorcinol on, you've probably got phenol poisoning -- you can short-circuit it by using isopropyl alcohol ("rubbing alcohol") on the skin where it aches.  Isopropryl alcohol knocks out phenol poisoning.

P.P.S.: There is some evidence that acupuncture can help with BRP as well.  That's my next step if I can't deal with the cervical issues myself.  There are several acupuncturists here in Edmonton who have training in both Western and non-Western medical traditions.

[Garth Wood]

Well, just to reply to myself:  

Been to the chiropractor, who now has the films of my cervical spine.  There is mild degeneration between C5 and C7 (essentially age-related), but no abnormal growths or actual pinching of the nerves through the exit foramina, no fractures, no destructive lesions.

Meanwhile, back at the ranch...

I've been surfing the NIH abstracts database for BRP-related studies.  There are three that might be of interest to others suffering from BRP:

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=9737043&dopt=Abstract
http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=12664013&dopt=Abstract
http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=12789170&dopt=Abstract

Interestingly enough, one of the article abstracts notes that "specific manipulation" of the cervical portion of the spine offered substantial relief (and in a couple of cases, complete resolution) of the symptoms of BRP.  Can you say "Go forth and find yourselves a well-trained chiropractor"?  Mine has also recommended at-home traction twice a day and glucosamine supplements.

You can bet I'm not waiting around for the neurologist.  Three months is too long to be sitting on my thumbs while the itching threatens to drive me bananas.  I'll report back on my own progress as it occurs (or doesn't, I guess).  I'm gonna hit the local medical library for details on the specific cervical manipulation that was used in the one reported study.  Hope this info helps others.


Garth

[Garth Wood]

An update:

The dermatologist I saw suddenly realized that I wouldn't be able to see a neurologist for almost three months, and filled a prescription for me for gabapentin (also known by the trade name Neurontin).  It helps reduce the itching sensation almost to nil, but I've only been on it for a day and a half, and I'm pretty "doped out."  I sure hope I don't have to take this stuff all the time if the condition turns out to be chronic...  It also gives me the munchies, and one of the listed side-effects is "water gain."  Great.  Lessee now, intense itching or turning into a blimp?  Hmmmm...

Neck traction also appears to be helping, in two ways -- the itching seems to be less afterwards, and it's making it easier for my chiropractor to do neck adjustments (everything's "looser").  I'm awaiting the neurologist visit with some trepidation, since in a very small number of cases, BRP's actually caused by tumors in the neck.  *That* would be just my luck!

Anyways, sleeping more comfortably now.  Again, hope this info helps others.


Garth

[morgan]

oh my god i can't believe i found this.  I came onto this site with hopes that i would find out what was wrong with me.  I've told my doctors about this but they can't see anything. I've tried all types of creams and lotions even precriptions ant nothing works.  Gold Bond lotion is the only thing that comes close.  It is making me insane.  It started about 3 years ago and would happen occassionally.  It has gotten worse this year.  The first half of the year it was on my left arm for about six months then it moved to my right arm.  Feels like there are some type of insects chewing at my skin from the inside yuck but its torture.  it hurts to scratch and doesn' relieve anything, just causes the itch to increase and the arm to hurt.  I've started to get the little red blister like marks that seem to follow a line down my arm, and the small purple bruising like marks.  My arms hurt to touch during these episodes.  Icing my arm is the only thing that seems to help.  I've suspected that it was being cause by pinched nerves because it seem like nerve sensation.  I do have back problems herniated disc L5 but i also have cervical problems my neck curves in the wrong direction and i was advise a couple of years ago that i was getting sperring on C 5. I haven't seen my latest x rays taken by my chiro but maybe it is arthritis on C5. Anyhow i'm so glad i found this site please let me know if anyone gets an answer to this.  Until then try ice compresses on your arms it does help.  Also Gold Bond Lotion.

[Gobe]

 

Welcome to Skincell Morgan!

 

[peterb]

  Morgan

A big welcome to Skincell.

[Garth Wood]

Morgan:

Welcome.  And get your GP or family doc to get you on gabapentin (AKA "Neurontin") RIGHT NOW -- it's "quieted" my itching sensations to virtually nil.  The dosage I'm receiving is 300 mg, 3 times per day, spaced eight hours apart.  It's working (though it's only a temporary fix).  Start 'em on Friday night if you can -- I was really dopey for the first few days, but my body's adapting to it now (and the itching sensation's a mere shadow of its former self, thank God).

Good luck.


Garth

P.S.:  I stated in an earlier post that gabapentin was an antidepressant.  This is wrong -- it's actually a new class of drug which appears to inhibit certain nerve impulses (particularly the ones associated with itching sensations).  It's "on-label" use is as a preventative for partial epileptic seizures, and it has about a dozen "off-label" uses.

[Monika]

Hi Morgan, welcome

[CKINCS]

Hi all,

Garth, thanks for all of your research and postings!  I am still suffering terribly with this itchy burning crap and it's driving me batty.  I will call my derm tomorrow.  Any knowledge of long-term effects of Gabapentin?  So the doped out feeling was only temporary?  I couldn't tolerate that permanently.  Thanks,

CKINCS

[Garth Wood]

CKINCS:

Well, if I'm anything to go by (and most people go by me pretty quickly if they can help it   ), I'd say somewhere between two to four days.  The first day was the worst -- I didn't trust myself to drive or do anything with sharp objects.  Day Two was still fairly "disconnected" (felt like someone had inflated my head and separated it from my shoulders by about 6 inches), and by Day Three, things were starting to get back to normal.  I did a lot of napping the first few days (which was fine -- I'd been losing sleep from the itching, so I was just catching up).

Gabapentin has surprisingly few drug interactions noted, but booze intensified the "dopey" effect, and it also seemed to speed up my liver's processing of the gabapentin (while at my brother-in-law's, I had several beers and the itching sensation started to return prior to the time for my next dose).  So I'd say "avoid alcohol if you can" while on gabapentin.  I have noted that the equivalent of a single beer doesn't seem to bring the itchiness back -- probably not enough liver involvement with that little alcohol.

As for long-term effects, there's little info that I can find -- it's been studied in small clinical trials since the mid 80s, but has only been available for general prescribing for the past five years or so.  As always, there's lawsuits over the stuff in the States, but I don't pay much attention to those -- too much noise swamping the data, if you get my drift.

Oh yeah, one other thing: gabapentin competes for receptor sites with magnesium and its salts, so if you take Rolaids, Milk of Magnesia or other OTC meds with magnesium in it, you're interfering with gabapentin's ability to "do its thing."  Make sure you read the label on any OTC med before trying it -- if it's got magnesium, it's probably gonna interfere with the gabapentin.  Tums oughta be OK (uses calcium carbonate [chalk!] as its active ingredient, rather than a magnesium salt), but I'm not sure about vitamin/mineral supplements containing magnesium -- I'd probably try taking the supplement several hours after (or before) a dose of gabapentin.  Folic acid and Vitamin B6 also seem to interfere with gabapentin's activity to some extent.  Talk to your pharmacist about the interactions -- she/he may have some advice for you.

Hope this helps.


Garth

[Garth Wood]

A friend of mine who is a medical librarian just received the full text of an article on cervical manipulations which were implicated in the relief of BRP.  She's mailing it to me (snail mail, unfortunately) even as I type this.  I should have the full text within the next few days, and even though I'm not allowed to reproduce it (copyright issues), I'll abstract the relevant info and post it here.

'Til then,

Garth

[Val]

Eeek!! How have I missed this topic.

Firstly, welcome to  RosemaryH, Sleeves, lauriecca, Garth Wood, Ckincs and morgan.
 
Sorry I'm so late in welcoming you all.

This deep itching that a lot of you are experiencing on you arms, and that it seems to be connected with the cervical spine. Well I get that in my legs, and I have arthritis (3 types) of many joints but also in my lower spine.

I also have pustular psoriasis which itches like mad, but the itch in the legs is nothing like that itch at all. When the legs decide to play up the itch is really deep inside, one of you said like a crawling insect deep within (sorry I can't remember who said that now), which explains it perfectly. My GP and Rhuemy told me that this was caused by the spinal damage. I was put on a very low dose of Amitriptyline to be taken at night only, plus some pain gel, which I also use at night. I must say that these 2 things have both helped greatly with this deep, night-time itch.

When I was first told it was due to the arthritis I thought they were nuts, or that I was. Now reading your stories maybe not.  It sounds as if it's the cervical spine it affects the arms and if it's the lower spine it affects the legs.