Itch, Itch…Scratch, Scratch…Itch, Itch…Scratch, Scratch
Uncontrollable itching with no apparent cause
Does this sound or feel familiar? Uncontrollable itching with no apparent reason or cause; no rash, no swelling, no insect bites, no dry skin, no allergic reaction, just plain old itching sensations on your skin. After years of dealing with an affliction for which no doctor or Internet search ever provided me with a diagnosis, a change in my life alleviating stress and anxiety dramatically reduced the incidences of this nasty itchy condition.
I can’t itch and dissect a frog at the same time
My first memory of the prolonged itching sensation on my arms and neck was during a summer school biology course when I was 14 years old. The distraction of constantly wanting to scratch while trying to focus on cutting up a frog was pure torture. This seemingly random condition, for which no other friend or family member suffered, would follow me through young adulthood and on into middle age.
The mystery itch
The remedies to stop the itchy condition were numerous. I went through various creams, solutions, soaps, alcohol (applied and ingested), antihistamines, pain killers, cold showers and ice packs. Except for the welts and scratch marks I inflicted on myself in an effort to halt the itching sensation, there has never been a visible sign on my arms or neck of irritation; either from underneath the skin or on top. Maybe mystery solved for some. See section on Brachioradial pruritus below.
You can feel the tingling sensation of the nerves
Just as dreams come into our psyche at night, episodes of uncontrollable itching would also descend upon me during sleep. There were nights when it wasn’t uncommon for me to arise two and three times to apply some remedy to quell the maddening sensation to itch my arm or neck. As I sat in a darkened room in the middle of the night, exhausted from the lack of sleep from itching, I would stare at my arm and actually feel the nerve endings tingling. It is as if there was a feather under my skin tickling me from inside.
Hydrocortisone to the rescue
Over the course of the years I have developed a three step approach to numb the nerve endings from tingling uncontrollably. The first step was one or two applications of 1% hydrocortisone cream. Next was popping some aspirin or other pain reliever. If the combination steroid cream and pain killer didn’t douse the burning itch under my skin I resorted to an ice pack. It may be no coincidence that cortisol or hydrocortisone is produced by the body to stimulate anti-stress and anti-inflammatory pathways. Through all this late night torture I became all too familiar with BBC murder mysteries repeatedly broadcast on our local PBS channel in the middle of the night.
The ancient cure of ice
Aside from bad late night TV infomercials I had to watched, the only recurring cause for my incidents of itching that I could pin point was heat. My itching rages most often occur during the hot summer months in California but tingling nerve endings will also blossom during the cool of winter. Even if I’m snow skiing and have bundled up against the cold too much my arms or neck will flare up screaming to be itched. On occasion, not wanting to ski naked, I would actually grab some snow and hold it to my neck to dampen the itch sensation.
I never leave home without a tube of cream
Since I never know when my appendages might start screaming to be itched I have numerous tubes of hydrocortisone creamed stashed about the house, car and back pack. It would not be uncommon for me to use two to three tubes of the steroid cream a month. So far, I haven’t experienced any side effects from my excessive use of hydrocortisone cream that I. that I, that I – know of. Unfortunately for the manufacturers of hydrocortisone cream a change in my approach to life seems to have substantially reduced my consumption of their product that acts like throwing a wet blanket on the red hot itchy fire on my arms or neck.
Mid-life crisis creates cure for the itch
Perhaps this is part of the mid-life crisis with an upside. Last year I gave up on life as I had tried to structure it. I threw in the towel. I called it quits. I wrote a blog piece called My Days As A Salesman Are Over. Instead of trying to conform to society and its expectations of what I should have done and where I should be, I decided to conform to what I wanted to be. In short, I decided to follow what I could do and what I enjoyed. Money? I place my faith in the belief that if you are producing something out of love, everything else will follow. ( I hope I’m right.)
To heck with climbing the corporate ladder
As a result of drastically changing my outlook and approach to life there were some immediate consequences. My angry outbursts melted away. Depression, a constant companion revealed in my blog post My Confession of Depression, has been a scarce visitor. I’ve found myself sleeping through the night. My uncontrollable itching has subsided to a minor annoyance. Most notably, the stress and anxiety of my life are at historically new low levels.
Equilibrium in the brain
My journey to equilibrium in my life where happiness and joy is more evenly balanced against stress and anxiety has not been easy. There were times when the midnight itching sessions were preferable to the struggle of letting go of the psychological drives to conform and be successful in life. The annoying itching has not completely stopped. The heat of this summer coupled with the rational stress of paying bills and being a good family member still cause me to itch. How much of the itching is due purely from heat and how much is from stress and anxiety, I have no way to measure.
Stress + Anxiety = Itching
As far as I am concerned, there is a direct correlation between the level of stress and anxiety in my life and the uncontrollable tingling of the nerve endings on my arms and neck. Stress and anxiety are forms of mental energy which is often times unwanted. As stress and anxiety build up in our closed psychological system of a brain it has to be dissipated in order to maintain balance or equilibrium within the system. I have concluded, in the absence of any other scholarly explanation, that my uncontrollable itching was a manifestation of this dissipation of this mental energy.
I’m no doctor or physicist
My diagnosis and conclusions are oddly similar to the definition of entropy which is concerned with potential energy in a closed system or state of matter. All systems and matter want to reach the lowest energy state. A mountain wants to erode to a plane and water wants to fall to the lowest level.
Entropy:
1. a measure of the unavailable energy in a closed thermodynamic system that is also usually considered to be a measure of the system’s disorder, that is a property of the system’s state, and that varies directly with any reversible change in heat in the system and inversely with the temperature of the system; broadly : the degree of disorder or uncertainty in a system
2 a : the degradation of the matter and energy in the universe to an ultimate state of inert uniformity
b : a process of degradation or running down or a trend to disorder
I have not achieved nirvana just nervenda
We are all trying to reach a mental state of perpetual calmness. Life constantly adds energy into our brains that we need to deal with. Some of us are unable to dissipate or metabolize the energy of stress and anxiety easily. Everyone has different ways of dealing with the additional stress, mine has been to itch uncontrollably. Now that I have limited the build up of stress and anxiety, my body doesn’t have to release this energy by the obnoxious itchy impulses into my arms and neck.
Is the answer blowing in the wind
I have no medical, psychological or engineering background to validate my hypothesis that stress and anxiety are converted into midnight nerve tinglings across my body. I also don’t want to leave you with the idea that the only way to stop your uncontrollable itching is to throw your life to the wind in the manner that I have done. If there are a few nuggets of wisdom in my thoughts you might be able to apply to your own life that helps alleviate this stupid urge to scratch at our bodies like a dog with fleas, may you go forward and scratch no more.
April 7, 2015 Update
As I’ve mentioned to folks in comments, I have been relatively successful in quelling my uncontrollable itching by reducing stress and anxiety in my life. At least that is what I attribute the decreased incidence of the annoying itching. This has been loosely validated by a nasty itch episode I had the other night.
Recently, two separate and unconnected events have occurred in my life. First, as a volunteer for a group I’m involved with I had to break the bad news to a fellow volunteer that his work just wasn’t up to par. I was dreading the meeting because the man had done a tremendous amount of work on the project and I personally like him. But I had to tell him all his time and effort just wasn’t producing a product that was acceptable. Second, I had been offered a position that sounds very good, but there are some draw backs that make me hesitant to accept it. I’m going to have to tell the person that has made the generous offer, that I really should accept, that I will have to decline.
At about 11 PM while I was laying in bed asleep my neck lit up like a 100 watt light bulb with the itch. I had fallen asleep thinking about these two situations that I had to confront in the very near future. The itch was as strong as it had been years earlier when I faced similar stressful and anxiety filled decision. Two different sessions of slathering hydrocortisone cream on my neck and popping an ibuprofen 200 mg later, I was able to get the itch to subside so I could get back to sleep.
For me, this episode is one of the strongest indicators that stress and anxiety are strongly correlated with this itch that seems to have no other internal or external cause.
Brachioradial pruritus: a pain in the neck
June 30, 2015
Praise to a reader, Shelley, who left a comment that her uncontrollable itching was diagnosed as Brachioradial pruritus. In short, Brachioradial pruritus is an itching sensation on the forearms. While there is not a definitive cause, speculation centers on sun exposure or nerve problems emanating from the neck.
First, some definitions are in order if you go on to read some of cited literature in the links-
Brachioradialis: The brachioradialis is a muscle of the forearm that flexes the forearm at the elbow.
Pruritus: Itch (Latin: pruritus) is a sensation that causes the desire or reflex to scratch.
Brachioradial pruritus: (sometimes abbreviated BRP) is an intense itching sensation of the arm usually between the wrist and elbow of either or both arms.
Radiculopathy: refers to a set of conditions in which one or more nerves are affected and do not work properly (a neuropathy).
Hyperalgesia: ‘hyper’ from Greek ὑπέρ (huper, “over”), ‘-algesia’ from Greek algos, ἄλγος (pain)) is an increased sensitivity to pain, which may be caused by damage to nociceptors or peripheral nerves.
Cervical vertebrae: cervical vertebrae (singular: vertebra) are those vertebrae immediately below the skull or neck often designated as C1 – C7.
The overview, discussion and treatment is in this Medscape article Brachioradial Pruritus. The authors detail how numerous people report uncontrollable itching on their forearms for no apparent reason. Research indicates that the sensation maybe as much an itch as an indicator of pain. The seemingly best remedy, as many of us have found, are ice packs. Interestingly, ice packs are the first line of defense to reduce swelling and pain from an injury.
There does seem to be a connection to the area of intense itching and sun damage or over exposure to sun. Data suggested that Americans, whose driver side seat in on the left side of the car, experienced more itching on their left arms while people in countries where the driver’s seat in on the right side had more right forearm itching. Those arms are most exposed to the sun as one drives in their respective left or right side driver seat automobiles.
Other evidence suggests a connection between diseases affecting the neck. There was an increase of the itching or Brachioradial pruritus in patients with arthritis, osteochondrosis, spondylolytic changes.
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. [9] – Medscape http://emedicine.medscape.com/article/1355312-overview#a5
They noted that steroid injections (hydrocortisone?) between neck vertebra C6 and C7 alleviated the itch in those patients.
My epidemiology
I realized years ago that heat and sun light would trigger the itching. Sunscreen prevents a sunburn, but not the itch. Consequently, I usually hike with a long-sleeved light weight shirt and hat to keep the sun off me. However, I can still start itching if I get too hot either outside or in the car, especially under the seat belt.
The nerves and associated neck problems was new and interesting potential cause of the itch to me. For years I have fought pain in my neck. A chiropractor said I didn’t have enough curvature in my neck. Leaning on my left elbow while I work at a desk also makes my neck hurt. I would get neck spasms, think cramp or Charlie horse, that created excruciating pain until it subsided. Last year I tried acupuncture and got real relief for the first time in years. (My trip to the acupuncturist for neck pain). But my worst bouts of itching had already subsided before the acupuncture sessions.
It’s possible that a variety of actions I’ve taken over the years has reduced the severity of the uncontrollable itching I’ve suffered from: lifestyle change, reduce anxiety, reduced sun exposure, acupuncture, better posture (sometimes), and regular exercise to keep my neck loose. The best part is that for some of us there is name or diagnosis to this itching called Brachioradial pruritus.
Associated blog post: Hiker’ Rash: red rash between knee and ankle after hiking