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Stingers That Don’t Get Better

90-95% of stingers resolve quickly. Only 5-10% stingers persist more than a few hours • Brachial plexus injuries and anatomic anomalies more common in younger (high school) athletes • Cervical spine level injuries (esp. disc herniation) more common in collegiate/pro athletes.

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 SplintER Series: A Temporary Pain in the Neck

A stinger typically resolves after several minutes. A thorough history and physical examination must be performed and documented, including a cervical and neurologic examination. If neurological symptoms remain present in the Emergency Department, an alternative diagnosis should be strongly considered.

Articles of Interest

Management of Recurrent Stingers

Debate exists whether a stinger is due to C5 or C6 nerve root injury or a brachial plexus injury. EMG studies have identified injuries to the cervical nerve roots, brachial plexus, and peripheral nerves in patients diagnosed with a stinger

Burners (Stingers) Syndrome

Burner’s syndrome is a common injury in contact sports and reflects an upper cervical root injury or a peripheral nerve dysfunction injury. It is a transient nerve injury which occurs following over-stretching of the upper trunk of the brachial plexus or compression of the C5/C6 nerve root, depending on the mechanism of injury.

Cervical Burners and Stingers (Brachial Plexus Injuries)

Another name for this type of nerve injury is brachial plexus injury. Football players are affected most often. Up to half of all college football players have had at least one burner or stinger. Many of these occurred during high school football. Fortunately, it’s not a serious neck injury.

How to Assess the Brachial Plexus “Stinger”

Stingers are a type of neurapraxia of the brachial plexus and/or cervical nerve roots that are a reversible peripheral nerve injury. It is typically characterised by the presence of burning pain radiating from the neck unilaterally into the hand/arm, lasting seconds to hours.

Stingers and Burners

Stingers/burners typically affect the C5 +/- C6 nerve roots or the upper trunk of the brachial plexus. Mild injury may result in neurapraxia and conduction block, leading to temporary sensory deficits and weakness that may last from minutes to weeks. More severe injury may result in axonotmesis or neurotmesis, which can lead to long-term sensorimotor deficits.

Stingers and Burners | Brachial Plexus

A brachial plexus stinger is an injury to the nerve bundle that results in transient paralysis and paresthesia (loss of sensation) of the entire arm. Although frightening for the athlete, the transient paralysis and paresthesia usually resolves quickly within minutes. However, more serious brachial plexus stingers can result in damage to the nerve itself with neurological deficits lasting up to one year.

Stingers: A Common Injury in Football

As a coach, I have watched many football injuries happen from the sidelines. But one injury that always seems to worry me is a “stinger” — also known as a “burner.”

Stingers: A Common Sports Injury

While the stinger is usually a spine injury, it is never a spinal cord injury. Both types of injuries commonly occur in contact and collision sports. The difference is that a spine injury does not result in paralysis of the arms and legs, like a spinal cord injury. Stingers also do not affect both arms at the same time, although each arm can be affected with different injuries.

Stingers: Be aware of the differential diagnosis

Sports injuries to the head and neck have taken on a higher profile in recent years. Attention has primarily centered on three pathologies: concussions, cord contusions and stingers, which are also referred to as burners.

The Neurological Phenomenon of Stinger or Burner Injuries

Because the symptoms of a stinger/burner are often self-limiting in nature, meaning they tend to "go away" on their own, athletes can sometimes think they're no big deal and shake them off without telling a coach, trainer or physician. As one can imagine, that's a mistake.

The “Burner”: A Common Nerve Injury in Contact Sports

A “burner” is a common nerve injury resulting from trauma to the neck and shoulder, usually during sports participation. The injury is most often caused by traction or compression of the upper trunk of the brachial plexus or the fifth or sixth cervical nerve roots. Burners are typically transient, but they can cause prolonged weakness resulting in time loss from athletic participation. Furthermore, they often recur.

Upper trunk brachial plexopathy. The stinger syndrome

This study demonstrated that a much more common mechanism of injury resulting in the stinger syndrome is probably compression of the fixed brachial plexus between the shoulder pad and the superior medial scapula when the pad is pushed into the area of Erb's point, where the brachial plexus is most superficial.