Stingers and Burners JOI has the answer
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What is a Stinger and Burner?
A injury to the nerves of the neck and shoulder that cause a burning or stinging feeling down the neck or arm are called stingers or burners. Another name common name for this type of nerve injury is called a brachial plexus injury.
This injury is very common in American football and other contact sports which is caused by nerve compression from sudden impact to the neck and shoulder area.
This can cause a sting or burn sensation that can spread from the shoulder, down the arm, as far as the hand/fingers.
What Are the Symptoms of Stingers and Burners?
The most common symptoms of stingers and burners are a burning or electric shock sensation which may be felt from the neck down to the hand which occurs after a compression type force or a traumatic impact to the neck / shoulder area.
Image of a man in shoulder pain The feeling usually lasts about seconds or even minutes but on very rare occasions it can be much longer. The patient may describe a warm feeling in the arm and there may be some clinical signs of weakness or numbness after the initial injury.
How are Stingers and Burners Diagnosed?
To determine whether your injury is a stinger or burner, your doctor will discuss your symptoms and how the injury occurred. Imaging tests, such as x-rays, magnetic resonance imaging (MRI) scans, and nerve studies are not usually needed but maybe prescribed.
A further examination is needed if you have any of the following symptoms:
- Weakness lasting more than several days
- Neck pain
- Symptoms in both arms
- History of recurrent stingers and burners
To Learn More about the Anatomy of the Spine, watch this VIDEO.
How are Stingers and Burner treated?
The primary treatment for a stinger or burner injury is rest, in order to allow the damaged nerves to heal.
Since this is most likely a sporting injury, the individual must refrain from sports activity until all feeling and strength has returned to the neck, shoulder, and arm; the range of motion of the neck, shoulder, and arm is normal; and reflexes are regular.
If the injury s mild, the athlete may be able to return to sports after a few moments. In other cases he or she may have to wait a few hours, a few days, or even longer to play sports.
- Along with rest, ice should be applied for as long as is comfortable, several times a day, for the first 48 hours. Heat could be applied to the neck and shoulder in order to promote greater blood flow to the injured area as well as assist with decreasing tightness.
- NSAIDs such as ibuprofen (Advil), naproxen (Aleve) or aspirin can be taken, to relieve swelling and pain. If muscle spasms are present, a muscle relaxant may be prescribed by your MD.
- A cervical collar may be used to prevent the brachial plexus nerves being further damaged. Cervical traction may be performed by a physical therapist which can relieve pressure on the nerve root.
- Physical therapy might be prescribed by your MD which might include exercises to strengthen and stabilize the neck and shoulder muscles, and to promote full range of motion to the neck and shoulders.
- If symptoms do not decrease with time and the treatments described above, your MD might order a corticosteroid injection into the damaged nerve root area. This is known as a nerve root block and can significantly reduce inflammation of the nerve.
- Surgery is rarely necessary. It might be done if a bulging vertebral disc or a bone spur is compressing the nerve root. Following surgery, physical therapy might be prescribed to restore range of motion and strength, and correct any postural abnormalities that might contribute to further injury to both the shoulders and neck.
Image of neck nerve anatomy
Exercises for Individuals That Have Had a Stinger or Burner
The following exercises may be performed when your have been cleared to perform exercises. It should be understood that you do not do any exercises that make your neck or shoulders hurt more.
Isometric neck flexion: Sit tall, eyes straight ahead, and chin level. Place your palm against your forehead and gently push your forehead into your palm.
Isometric neck extension: Sit tall, eyes straight ahead, and chin level. Clasp your hands together and place them behind your head. Press the back of your head into your palms.
Isometric neck side bend: Sit tall, eyes straight ahead, and chin level. Place the palm of your hand at the side of your head and press your head into the palm of your hand.
Head lift with neck curl: Lie on your back with your knees bent and your feet flat on the floor. Tuck your chin and lift your head about 3 inches off the floor, keeping your shoulders flat on the floor.
Shoulder shrug: Stand with your head directly over your shoulders, with your spine straight. Shrug your shoulders up and then relax.
Shoulder abduction: Stand with your arms at your sides. Bring your arms up, out to the side, and toward the ceiling making sure the thumbs are pointing up.
These are just a few exercises that might be prescribed by your physical therapist or athletic trainer. Progression will be based on symptoms and tolerance to each activity.
The Jacksonville Orthopedic Institute has many other articles about the shoulder which may be interesting to you. This s a link to one of them HERE.
To schedule an appointment for physical therapy at JOI Rehab, please call 904-858-7045.
By: Matt Paulus ATC, Site Coordinator
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