A burner or stinger is a stinging or shocking sensation felt in the back of the neck or shoulder. It is caused when a nerve in the neck or shoulder is pinched by either the bones, muscles, or other neck tissues. This most often occurs when the head is turned quickly to one side and the opposite shoulder is forced downwards. Although the actual injury occurs in the neck, the symptoms can appear in the shoulder and down the arm depending on which nerves are pinched. The injury is common in football, although players in such sports as soccer, rugby and basketball are also at risk. The injury can cause complete or transient paralysis.

Signs and Symptoms

• Numbness, tingling, or burning in the neck, shoulder, or arm
• Feeling of being shocked or struck by a bolt of electricity
• Loss of sensation in the arm and/or hand on the injured side
• Slight weakness of the arm and/or hand on the injured side
• The athlete may have a history of having suffered a torsion injury to the neck

On-Site Management

Suspect the Worst. Immobilize the head and spine if sensation and strength do not return within 5 minutes.

ABC's. Stabilize any other injuries and treat for shock, if necessary. Monitor to ensure that the athlete's condition does not worsen.

Medical Referral. In all cases, refer the athlete to a physician, even with minor burners/ stingers. This can be done after competition if it only occurs once and goes away within 5 minutes. But, if it reoccurs or lasts longer than 5 minutes, immediate referral to physician is required.

Return to Activity

The athlete may return to activity if feeling and strength return to normal within 5 minutes. As well, the athlete should have no pain or signs of other injuries. However, even athletes with a temporary neck burner/stinger should be seen by a physician following the practice or game. Athletes who suffer repeated burners or stingers may be disqualified from contact sports, because permanent nerve damage can result.

Athletes recovering from a stinger are more susceptible to other shoulder injuries while the rotator cuff and deltoid muscles remain weak.

Prevention

• Require neck strengthening and stretching exercises for athletes playing contact sports.
• Football players prone to burners/stingers should wear a neck roll.
• Discourage the athlete from using their head for tackling or checking.

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