What is evidence supporting the cervicogenic hypothesis of the pathogenesis of brachioradial pruritus?

Updated: Oct 05, 2020
  • Author: Julianne Mann, MD; Chief Editor: Dirk M Elston, MD  more...
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Answer

Several authors have reported a higher prevalence of cervical spine disease (eg, arthritis, osteochondrosis, spondylolytic changes) among patients with brachioradial pruritus. [1, 9, 22, 23] Marziniak et al performed magnetic resonance tomography of the cervical spine in 41 patients with brachioradial pruritus. [24] Thirty-three of 41 of these patients had stenosis of the intervertebral foramen or protrusions of the cervical disk, leading to nerve compression.

Cervical disk herniation with compression of the C6 nerve root has been reported in association with brachioradial pruritus, with rapid resolution of symptoms after ventral C5-C6 discectomy, C5-C6 vertebral fusion, and C6 nerve root decompression. [11]

Treatment of cervical spine arthritis has been reported to provide relief in patients with brachioradial pruritus. [1, 25] Epidural cervical steroid injections at the C6-7 level were reported to lead to disappearance of itch in a patient with brachioradial pruritus. [14]

Cervical spine tumors, [26] cervical ribs, hypertrophic cervical transverse processes, [27] and cervical osteophytes [28] have all been reported in case series to cause upper extremity pruritus.

Electrophysiological studies on patients with brachioradial pruritus have shown bilateral delay of F responses of median and ulnar nerves. [29]


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