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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

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

Risk Factors

Factors that increase your chance of a burner include:

Symptoms

Symptoms may include:

Diagnosis

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:
Serious burners can be evaluated with an electromyogram (EMG). This is a test of the electrical activity of the muscle. It 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

Some burners last only a few minutes. These will not need medical treatment.
Treatments options include:

Physical Therapy

Burners can cause muscle weakness. You may be referred to a physical therapist. The therapist will help you strengthen your muscles 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 EMG 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, such as ibuprofen or naproxen, may be used to reduce discomfort.

Ice

Icing the neck as needed may help to reduce discomfort.

Prevention

To help reduce your chance of a burner:

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

Health Canada http://www.hc-sc.gc.ca

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

References

Burners. Am Fam Physician. 1999;60(7):2042.

Burners and stingers. American Academy of Orthopedic Surgeons Ortho Info website. Available at: http://orthoinfo.aaos.org/topic.cfm?topic=A00027. Updated May 2010. Accessed September 2, 2015.

Dimberg EL, Burns TM. Management of common neurologic conditions in sports. Clin Sports Med. 2005;24(3)637-662.

Kasow DB, Curl WW. "Stingers" in adolescent athletes. Instr Course Lect. 2006;55:711-716.

Weinberg J, Rokito S, Silber JS. Etiology, treatment, and prevention of athletic "stingers". Clin Sports Med. 2003;22(3):493-500.

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