Cervical surgery relieves itchiness
Dear Doctors: A friend who surfs had to get one of his cervical discs replaced. His doctor said getting a new disc is why an itch along his right forearm went away. What’s the connection?
DEAR READER: You’re referring to a condition known as brachioradial pruritus. Pruritus is a fancy word for itchiness. Brachioradial refers to the source of the itch — a muscle located in the forearm. Known as the brachioradialis, it flexes the forearm at the elbow. Taken together, the term brachioradial pruritus refers to localized itching, tingling, burning or stinging sensations that run along the outer part of the forearm. It can affect one or both arms and, in rare cases, the itchiness can spread to the neck, shoulders and lower leg. The condition is more common in women, particularly those with lighter skin tones. It occurs most often between the ages of 45 and 65. Instead of irritants that directly affect the skin, the itchiness from this condition arises due to a nerve disorder. Scratching the area won’t alleviate the itch. Some people have reported that scratching makes the itchiness worse.
The exact cause of brachioradial pruritus isn’t clear. However, it’s generally understood to be related to spinal problems that affect nerves that animate the arm. Conditions such as osteoarthritis, in which the cartilage of the joints wears away, or a herniated disc, as in your friend’s case, can lead to brachioradial pruritus. Sun damage appears to play a role, as well. Prolonged exposure to UV light from the sun, which can damage nerve fibers in skin, may cause increasing sensitivity to sensations of pain and itch. Studies have indicated that people who take part in a lot of outdoor activities that expose them to the sun and, thus, ultraviolet light — may be at increased risk of developing the condition. Some theories suggest that brachioradial pruritus is caused by a combination of nerve damage and UV exposure.
Diagnosis includes a physical exam to pinpoint the location of the itching. This is usually followed by imaging tests, such as an MRI or an X-ray, to identify the presence of any spinal abnormalities. Treatments vary. Some people are helped by using ice packs on the affected areas. Topical products, such as cooling menthol creams or local anesthetic creams, may be prescribed. Physical therapy to stretch and strengthen the spine can also bring relief.
In your friend’s case, it appears that the herniated disc in his cervical spine had compressed a nerve. That, along with spending so much time in the sun while surfing, put him at risk for the condition. In the course of replacing the damaged disc, his surgeon was able to release the pinched nerve, which allowed the maddening itch of brachioradial pruritus to abate.