The nerves that give feeling to the arms and hands originate from the cervical (neck) spinal cord. As these nerves leave the neck, the separate nerves come together in the upper shoulder to form a bundle of nerves called the Brachial Plexus. From here the nerves separate, and go to all the arm muscles, ending in the hand and fingers.
Burners and Stingers are neck injuries that cause acute pain that feels like a burning, pinching, or shock running from the base of the skull to the shoulder or along the neck. Usually this pain is quite intense, but subsides quickly. In addition to an acute pain and shock from the shoulder down into the arm and fingers, there may be numbness, burning, or weakness in the arm, hand, and fingers. Usually this acute pain lasts only a minute or two and goes away completely.
Burners and Stingers are diagnosed by a history of a collision and subsequent minor neurologic symptoms (such as tingling, burning and numbness) that resolve spontaneously.
Burners and Stingers must be distinguished from more serious neurologic injuries such as cervical spine fractures.
Rest and removal from the game until the symptoms resolve, is the initial treatment for stingers. If there are any persistent or progressive neurologic symptoms, immediate transfer to a hospital for evaluation is warranted. Recurrent Burners and Stingers require further investigation by a qualified physician.
Burners and Stingers are caused by a quick movement of the neck and shoulder, which suddenly causes the neck to bend towards the opposite shoulder. This sudden and forceful bending of the neck away from the injury, causes the compression, pinching, or stretching of the bundle of nerves (brachial plexus) that run from the back of the neck into the arm. This often occurs from a twisting of the neck and head, or an impact from the side as may occur during a football tackle or with a whiplash injury.
Initial treatment consists of:
- Rest from the involved activity.
- Icing every two to three hours for 20 minutes for the first 72 hours.
- Anti-inflammatory medications to help reduce inflammation and pain. (Always check with your physician before taking these medications as they may cause G.I. problems or interfere with other medications you may be taking).
The nerves usually spontaneously recover within seconds, but may take up to 6 months. Maintaining shoulder, elbow, wrist, and hand range of motion while waiting for nerve recovery is very important. Referral to a physical therapist or an athletic trainer may be recommended for further treatment. Returning to play before the injury has completely recovered (normal examination and no symptoms) increases the risk of recurrent injury, increased severity of injury, and permanent injury.
Preventing Burners and Stingers
- Use protective gear (a collar for football) and proper sports technique. (EXAMPLE: Avoid using your helmet as a contact point when tackling and blocking in football).
- Avoid awkward positions of the head an neck.
- Stretch your neck muscles prior to activity.
- Strengthen your neck, back, and shoulder muscles. Keeping the muscles around your neck and shoulders strong and flexible will help you withstand the stress of a direct blow.
- Return to activity slowly after sustaining a burner or stinger.
- See a physician if you experience recurrent burners and stingers
People with shoulder pain have also found these products to be effective: