Stingers are a sudden burning pain or numbness in the arm often accompanied by weakness of the upper arm or shoulder muscles after an injury, most commonly associated with competition in contact sports. Stingers are also known as burners. A stinger typically resolves within minutes and the weakness increases at the same time as the pain. Stingers are thought be caused by trauma to the brachial plexus, which is a bundle of nerves in the shoulder, or trauma to a nerve as it comes out of the spine. Stingers are a frequent injury in athletes, reported in up to 65% of college players, but most are never reported as symptoms, because the symptoms are short-lived or they fear being removed from play.
Here are a few things you should know about stinger:
- There is an increased risk of stingers with a history of cervical stenosis (tightness around the spinal cord in the neck) or foraminal stenosis (tightness around the nerve as it leaves the spine) and these athletes often have repeat stingers or chronic symptoms.
- The severity of stingers is determined by how long the symptoms last. Grade 1 is full recovery within two weeks. Grade 2 is symptoms for more than two weeks and sometimes not complete recovery. Grade 3 is symptoms for at least one year and little to no recovery.
- The treatment for stinger is to remove from competition and rest the arm until the symptoms resolve. If it is the first stinger, then the athlete can return to play when the symptoms resolve. If it is not the first stinger, then the athlete can return to play when the symptoms completely resolve if the athlete had less than three previous stingers that lasted less than 24 hours. The athlete may need further testing if the symptoms last longer than 24 hours or there has been more than three previous stingers.
- Consider other causes when the symptoms are most prominent in the pinky and ring finger, symptoms in both arms, symptoms in the legs, or localized neck pain and stiffness.
- There are several ways to prevent stingers by including more protective neck rolls and pads to equipment, high riding shoulder pads, proper tackling techniques with avoidance of dropping shoulder and maintaining an upright position, and strengthening and maintaining range of motion in the neck through physical therapy.
Dr. Erin Manning is an Assistant Attending Neurologist at Hospital for Special Surgery. She specializes in the treatment of neuromuscular disorders, including neuropathy, myopathy, spine disorders, and autoimmune diseases.