Objective: Brachioradial pruritus (BRP) is a localized neuropathic dysesthesia of the upper extremities caused by a cervical radiculopathy combined with ultraviolet radiation (UVR) exposure. Typical treatment focuses on targeting the pruritus rather than the underlying cervical lesion. This paper documents the successful resolution of BRP using Orthospinology upper cervical chiropractic adjusting and Pierce C5 spinal adjusting in a patient who earlier did not respond to her medical interventions.
Clinical Features: A 42-year-old athletic female had a 3-year history of intense itching and erythema of the right upper arm and neck stiffness. She received a diagnosis of BRP and failed topical treatments, gabapentin, antihistamine, physical therapy, and acupuncture. Her chiropractic examination revealed noticeable erythema and scarring over the right dorsolateral extremity, postural abnormalities, cervical palpatory pain, absent deep tendon reflexes, and positive x-ray findings.
Intervention and Outcome: The patient was treated 12 times over 3 months with Orthospinology upper cervical chiropractic adjusting, Pierce technique high-velocity low-amplitude adjustment to the C5 vertebra on the initial visit, and instrument-assisted vibration to the C5 vertebra on all subsequent visits. Her pruritus and erythema were exacerbated after the initial treatment; however, the neck stiffness resolved. After one week since the initial treatment, the patient’s erythema had resolved, and the pruritus had substantially improved. After 30 days, the pruritus had resolved, and the scarring had begun to heal. After 60 days, besides faint potentially permanent scarring, the patient returned to pre-condition status. She remains in pre-condition status 2 years after initial treatment.
Conclusion: By treating the underlying cervical lesions, the patient was able to receive a successful, long-term result. These interventions were safe, cost-effective, and beneficial. Further studies should assess the management of the cervical spine in BRP outcomes at a higher level and evaluate for direct causative links between cervical lesions and BRP.
Author keywords: Chiropractic; Pruritis; Brachioradialis
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