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Burner

(Stinger)

Definition

A burner is an injury to the bundle of nerves in your neck. These nerves run from the back of your neck into your arm. The nerves leave the spine and form a group called the brachial plexus. The plexus extends into the upper shoulder. From here, the nerves split into individual strings. The nerve strings go to all the arm muscles, supplying sensation to the arm. A burner may also be called a stinger.

Brachial Plexus

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Causes    TOP

A burner may be caused by injury to the brachial plexus, such as:

  • Overstretching—can be caused by your shoulder being pushed down while your head is forced to the other side
  • Pinching—can happen if your head is moved quickly to one side
  • Bruising—can happen when the area above your collarbone is hit directly or pressure on the top of your head compresses the brachial plexus nerves against bone

Risk Factors    TOP

Factors that increase your chance of a burner include:

  • Playing American football—increased chance of receiving direct blows to the head, neck, and shoulders
  • Participating in other contact sports
  • Having a small spinal canal

Symptoms    TOP

Symptoms may include:

  • Numbness, tingling, or weakness in the shoulder or arm
  • Burning or stinging feeling in one arm
  • Burning or stinging feeling between your neck and shoulder
  • A warm sensation in your shoulder area

Diagnosis    TOP

You will be asked about your symptoms and how the injury occurred. One of the most important questions is whether symptoms occur in one arm only, in both arms, or in either leg at the same time. Symptoms in more than one limb may be more serious, suggesting injury to the spine or spinal cord. This may need more extensive evaluation.

The doctor will examine you for:

  • Pain or tenderness
  • Neck and arm range of motion
  • Strength in the arm and hand
  • Arm reflexes
  • Sensation in the shoulder and hand

Serious burners can be evaluated with a electrodiagnostic studies. These are tests of the electrical activity of the nerve. They can help to determine the extent of the injury.

It is important to make sure symptoms are due to burners and not a more serious injury to the spine or spinal cord. Early recognition of this condition can prevent possible paralysis. Careful post-injury evaluation can help prevent permanent damage or reinjury.

Treatment    TOP

Some burners last only a few minutes. These will not need medical treatment.

Treatments options for persistent symptoms include:

Physical Therapy

Burners can cause muscle weakness. A referral to a physical therapist may be needed. The therapist will focus on muscle strengthening while the nerve heals.

The decision to return to a sport activity after a burner requires careful evaluation. It is important that the nerve has fully healed and there is a low chance of reinjury. AnMRI scan or nerve study may need to be done to confirm this. Multiple burner injuries in one season may be reason to restrict return to play. In this case, the player should consult an experienced sports medicine physician for evaluation.

Medication

Nonsteroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen or naproxen, may be used to reduce discomfort.

Ice    TOP

Icing the neck as needed may help to reduce discomfort.

Prevention    TOP

To help reduce your chance of a burner:

  • Keep the muscles around your neck and shoulders strong and flexible to help you withstand the stress of a direct blow.
  • Learn safe sport techniques.
  • Avoid using your helmet as a contact point when tackling and blocking in football.
  • Always make sure to wear the proper safety equipment for your sport.
  • Pads and other modifications of athletic gear have been proposed in an effort to reduce the incidence of burners. These may be especially useful for players who have previously suffered injury.

RESOURCES:

Ortho Info—American Academy of Orthopaedic Surgeons
http://orthoinfo.org
Sports Med—American Orthopaedic Society for Sports Medicine
http://www.sportsmed.org

CANADIAN RESOURCES:

The College of Family Physicians of Canada
http://www.cfpc.ca

References:

Burner (Stinger). Kids Health—Nemours Foundation website. Available at:
...(Click grey area to select URL)
Updated October 2014. Accessed August 23, 2017.
Burners and stingers. American Academy of Orthopedic Surgeons Ortho Info website. Available at:
...(Click grey area to select URL)
Updated May 2010. Accessed August 23, 2017.
Burners. Family Doctor website. Available at: https://familydoctor.org/condition/burners/. Updated une 2017. Accessed August 23, 2017.
Burners and stingers. EBSCO DynaMed Plus website. Available at: http://www.dynamed.... Updated December 15, 2015. Accessed August 23, 2017.
Dimberg EL, Burns TM. Management of common neurologic conditions in sports. Clin Sports Med. 2005;24(3)637-662.
Last reviewed September 2017 by EBSCO Medical Review Board Michael Woods, MD, FAAP
Last Updated: 9/2/2015

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