STINGER OR BURNER
|Definition||Tingling, Burning or Numbing of an arm or hand, typically after a collision in football.|
|Details||A stinger is a transient stretching of the nerves that run from the neck to the arm. It results in pain and numbing in the arm or hand that usually spontaneously resolves.|
|Causes||A blow to the shoulder with stretching of the neck is the usual cause. This pulling the shoulder in the opposite
direction of the neck puts traction on the nerves that come out of the spinal cord in the neck and results in the
symptoms of a stinger. Narrowing of the bones protecting the spinal cord in the neck is one known risk factor for
stingers. Football is by far the most common sport associated with stingers.
Relative risk of stinger by football position
|Diagnosis||Stingers are diagnosed by a history of a collision and subsequent minor neurologic symptoms (such as Tingling, Burning and Numbing) that resolve spontaneously. Stingers MUST be distinguished from more seriously neurologic injuries such as cervical spine fractures.|
|Treatment||Rest and removal from the game until the symptoms resolve is the initial treatment for stingers. If there is any persistent or progressive neurologic symptoms, immediate transfer to a hospital for evaluation is warranted. Recurrent stingers require further investigation by a qualified physician.|
Outlawing spearing (head down tackling) and protective neck rolls that limit backward bending of the neck have
helped reduce severe injuries. Also, screening of players with narrowing of the space available for the spinal
cord in the neck with xrays may be useful.