Burners and Stingers

Burners and stingers are common injuries resulting from the stretching or compression of nerves in the neck and shoulder, often seen in contact or collision sports. These injuries are characterised by a sharp, burning, or stinging pain that radiates from the shoulder down to the hand, similar to an electric shock or lightning bolt.

Anatomy

Nerves act as electrical cables, transmitting signals between the brain and muscles. In the neck, these nerves branch out from the spinal canal and form a larger network known as the brachial plexus, which controls movement and sensation in the shoulder, arm, and hand. Burners and stingers specifically affect this brachial plexus.

Causes

Burners and stingers typically occur when the head is forcefully pushed sideways and downward, bending the neck and pinching the surrounding nerves. They are often caused by impacts such as a fall onto the head, wrestling takedowns, or football tackles, with defensive players and offensive linemen in American football being particularly prone to these injuries.

Risk Factors

• Contact Sports: Athletes participating in contact sports are at higher risk for burners and stingers. Activities like football and wrestling frequently lead to these injuries.
• Spinal Stenosis: A small spinal canal may increase the risk of these injuries. This condition can be congenital or degenerative, leading to a narrower spinal canal due to aging or wear and tear.

Symptoms

Symptoms of burners and stingers usually affect only one arm and can last from seconds to minutes, though they may persist for hours or longer. Common symptoms include:

• A burning or electric shock sensation
• Immediate arm numbness and weakness
• A warm feeling in the arm

Clinical 'Examination

To diagnose a burner or stinger, your doctor will review your symptoms and the circumstances of the injury. Imaging tests like X-rays, MRIs, or nerve studies are generally not required unless:

• Weakness lasts more than a few days
• There is persistent neck pain
• Symptoms affect both arms
• There is a history of recurrent stingers or burners

Treatment

Initial treatment involves removing the athlete from further activity and ensuring symptoms are completely resolved before resuming sports. Recovery time can range from minutes to several days. Athletes should not return to play if they experience weakness or neck pain.

If symptoms persist, working with a trainer or therapist to regain strength and mobility may be necessary. For those with recurrent stingers, special protective gear like a neck roll or elevated shoulder pads may be recommended. Options include "spider pads" worn under shoulder pads or a "cowboy collar" worn over them.