Stingers/Brachial Plexus Injuries

The spinal cord extends from the base of the brain down the neck; large nerves branch off the spinal cord along its course. When one or more of these nerves are stretched or pinched, this mild injury to the nerves causes tingling and numbness in the arm and fingers; some athletes notice weakness in their arm as well.

The terms “stinger” and “burner” are two terms sometimes used to describe this stretched or pinched condition. It can get stretched by pulling his head away from his shoulder.  The nerves can get pinched when the head is forced towards the shoulder. These injuries are fairly common especially in football players, wrestlers and divers.

Symptoms

Symptoms of a stinger include:

  • A sensation of ‘electricity,’ warmth, discomfort and/or numbness.
  • Arm weakness.

Symptoms are brief, lasting seconds to minutes. With serious injuries, however, symptoms can last hours, or even days and weeks.

Diagnosis

Identifying a stinger is usually based on the description of injury, since the problem is often resolved before seeing a doctor. A physical exam helps evaluate the extent of injury. If you have experienced more than one stinger, you should be evaluated with X-rays and an MRI to check for more significant problems.

Treatment

Treatment in most patients is not necessary since they will feel fine after a few minutes. In patients with symptoms lasting more than a few hours, rest and anti-inflammatory medications can speed recovery.  Patients with frequent stingers may need further evaluation to rule out the possibility of underlying spinal column narrowing which could make return to contact sports unsafe.

No athlete should return to activity until the initial symptoms have resolved and arm strength has returned. If symptoms are very brief and arm strength is normal, athletes can often return to competition very quickly. However, if symptoms persist, as they do in 5 to 10 percent of cases, the athlete will need further evaluation prior to returning to sports. Football players with recurrent stingers may benefit from the use of high shoulder pads or a “cowboy collar,” which prevents the nerves from being stretched.