2024 FSA Podium and Poster Abstracts

P076: CERVICAL EPIDURAL STEROID INJECTION AS A POTENTIAL TREATMENT FOR CERVICAL COMPRESSIVE PRURITUS: A CASE REPORT
Helena Krogman; Bryan J Steves, MD; Hang Nguyen, MD; Caitlin Gray, MD; Rene Przkora, MD; Sandra Porsche, MD; University of Florida College of Medicine, Department of Anesthesiology

Cervical Epidural Steroid Injection (CESI) is commonly utilized as a primary intervention for managing cervical pain conditions. However, its potential beyond chronic pain management remains relatively unexplored. This case presents a distinctive instance of Cervical Compressive Pruritus (CCP) leading to Brachioradial Pruritus (BRP), effectively mitigated through CESI.

CCP is a condition characterized by persistent itching of the upper extremities, particularly the arms, attributed to nerve compression or irritation in the cervical spine. It often presents as Brachioradial Pruritus, a neuropathic dysesthesia causing itching along the dorsolateral forearm. The etiology of CCP remains multifactorial, with factors such as cervical spine pathology, including disc herniation, spinal stenosis, or other restrictive pathology contributing to nerve compression and thus altered sensory signaling. Management of CCP poses a challenge, with conventional therapies often providing limited relief. 

The patient's clinical trajectory highlights a CESI's potential efficacy in addressing mainly neuropathic pruritic symptoms linked to cervical compression, thereby broadening its utility in interventional management. This case study illuminates a promising frontier in pain medicine by introducing well known treatments as a novel therapeutic avenue for refractory BRP associated with CCP. 

By showcasing the correlation of various neuropathic pruritic symptoms to cervical compression, we broaden the scope of available treatments and emphasize the significance of employing conventional therapeutic methods for less common symptoms. This contribution adds valuable insights to the evolving landscape of multidisciplinary pain management, offering improved quality of life for patients contending with non-painful yet clinically burdensome barriers to symptom management.