Cervical Spine Injuries: The Stinger
Shawndra Davis
Hughston Athletic Training Fellowship
In contact sports such as hockey, basketball and especially football, a common cervical spine injury to the brachial plexus nerve group is known as a burner or stinger. The brachial plexus is a network of nerves exiting the spinal cord at the bottom of your brain. The nerves come from the spine out to different parts of the body which gives you the ability to have sensation. The particular group of nerves that is affected from having a stinger is called peripheral nerves. These nerves run across the shoulders, under the collarbone, and down into the arms giving them the ability to function.
Several mechanisms account for brachial plexus injuries. The most common is nerve root compression or stretch. This happens when the head and neck (cervical spine) is hit and forced to one side causing the brachial plexus to stretch on the other side. Along with the stretching of the brachial plexus, compression of those same nerves on the other side may sometimes occur, also. This mechanism is almost always seen in contact sports.
A stinger usually causes intense pain from the neck down into the arm and hand of the affected side. Many times when an athlete gets a stinger, the athlete may come running of the field with the affected arm dangling by their side. This sign is due to the loss of strength and the increased pain. The athlete may report the arm feeling like it is on fire and or having a “pins and needles” type sensation ranging from the neck down into the hands.
In order to properly diagnose a brachial plexus injury a thorough examination of the cervical spine must be completed. During this evaluation, the health care provider may check for complaints of burning and a “pins and needles” type sensation especially when the neck is pushed down or to the side. Also, check for weakness in the arms and hands. These signs and symptoms may go away within a matter of time depending upon the severity of the injury to the nerves. If the injury is suspected to be severe, seek further medical attention. Your physician may require an x-ray, computerized tomography (CT) scan, or magnetic resonance imaging (MRI) of the neck to check for secondary injuries to the vertebrae as well as the severity of the nerve damage. An electromyogram (EMG) or nerve conduction studies (NCS) are two other special tests that may be needed to further evaluate the cervical injury.
Treatment of this injury consists of resting the neck and arms until the pain and symptoms are gone. Apply an ice pack to the neck and shoulders for up to 20 minutes every three to four hours for two to three days or until the signs and symptoms go away. Some brachial plexus injuries may heal without treatment. Exercises that focus on strengthening the neck are beneficial. Chronic brachial plexus injuries may be treated with heat, massage, or muscle stimulation. In some cases, surgery may be recommended.
Getting back to normal activity will rely on how soon the nerves recover. Each individual recover at different rates but the longer you have the symptoms before you start treatment the longer it will take to recover. Recovering quickly and safely is the standard goal. Returning too soon increases the chances of worsening the injury. Stingers may occur to anyone. To those who are at a higher risk, keep your neck strong. Use good technique such as not striking with the head creating helmet to helmet especially in contact sports. This way you decrease the chance of getting a stinger.
References:
“Brachial Plexus Injury.” http://www.emedicine.com/sports/topic13.htm
“Brachial Plexus Injury (Stinger/Burner)” http://www.med.umich.edu/1libr/sma/sma_stinger_sma.htm
Prentice W E. (2003). Arnheim’s Principles of Athletic Training. McGraw Hill 2003 NY: New York.
| Shawndra Davis was a participant in the Hughston Athletic Training Fellowship Program, Columbus, Georgia, from 2007-2008. She received her Bachelors of Science Degree in Athletic Training from the University of West Alabama in May of 2007. While attending UWA her responsibilities included football, volleyball, tennis, rodeo, softball, baseball, basketball, cross country, and a rotation at Rush Hospital. She was also a member of the UWA Sports Medicine Club. In July of 2006, Shawndra completed an internship with the Community Relations Department of Hughston Orthopedic Hospital. She is an active member of the National Athletic Trainers Association (NATA), Southeast Athletic Trainers Association (SEATA), and the Alabama Athletic Trainers Association (ALATA) and has served as a student athletic trainer for the Alabama/ Mississippi High School All Star Football Game, as well as Varsity cheerleading and dance camps. She has been assigned to and is responsible for the overall healthcare of the athletes at Shaw High School. |
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