Brachial Plexus Injury (Stinger/Burner)

What is a stinger?

A stinger or burner is an injury to the nerves that travel from your neck and down your arm.

There are seven bones in your neck called vertebrae. The vertebrae are held together by ligaments. Your spinal cord goes from the bottom of your brain through a canal in your vertebrae down to your lower back. Nerves come off the spinal cord that make your limbs and body move and have sensation. These are called peripheral nerves. A group of peripheral nerves called the brachial plexus leaves the spinal cord and travels between the vertebrae and into the shoulder, giving your arm its ability to function. These are the nerves that are injured when you have a stinger.

How does it occur?

A stinger is almost always seen in contact sports when the head and neck are forcibly moved or hit to one side, stretching the brachial plexus on the opposite side. Sometimes when the head and neck are forcibly pushed to one side there is compression of the nerves in the brachial plexus on the same side. The nerves become irritated as a result of being stretched or compressed.

What are the symptoms?

A stinger usually causes intense pain from the neck down to the arm. You may feel like your arm is on fire. You may have a "pins and needles" sensation. Your arm or hand may be weak. It is possible that you may not have any symptoms after a period of rest following your injury.

How is it diagnosed?

Your healthcare provider will ask about your symptoms and examine your head, neck, shoulder, arm, and hand. You may have a sensation of burning or tingling if he or she pushes down on your head or pushes your head to the side.

Your provider may do neck X-rays to be sure there is no damage to the vertebrae. If the injury is serious, he or she may do a CT (computerized tomography) scan or MRI (magnetic resonance imaging). Your provider may send you to a specialist for tests such as an electromyogram (EMG) or nerve conduction studies (NCS).

How is it treated?

Treatment may include:

• resting your neck and arms until the pain and symptoms are gone
• putting an ice pack on your neck and shoulders for 20 to 30 minutes every 3 to 4 hours for 2 to 3 days or until the pain goes away
• taking an anti-inflammatory medication
• doing exercises to strengthen your neck.

Chronic stiff neck muscles may be treated with heat, massage, or muscle stimulation.

When can I return to my normal activities?

Everyone recovers from an injury at a different rate. Return to your activities will be determined by how soon your nerves recover, not by how many days or weeks it has been since your injury has occurred. In general, the longer you have symptoms before you start treatment, the longer it will take to get better. The goal of rehabilitation is to return you to your normal activities as soon as is safely possible. If you return too soon you may worsen your injury.

How can I prevent a stinger?

A stinger is best prevented by keeping the muscles in your neck strong. It is important to use good technique in contact sports such as football and not to strike with your head when blocking or tackling.