Stinger (medicine)

In medicine, a stinger, also called a burner or nerve pinch injury, is a minor neurological injury suffered by athletes, mostly in high-contact sports such as rugby, American football, wrestling, and roller derby. The injury is always a spine injury as opposed to more serious spinal cord injuries, which can lead to partial or total paralysis. It is characterized by a shooting or stinging pain that travels down one arm, followed by numbness and weakness. Many athletes in contact sports have suffered stingers, but they are often unreported to medical professionals due to their minor symptoms and high frequency in sports.

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Mechanism

The injury usually involves nerves traveling from the spinal cord to the arm, but sometimes involves nerves in the neck. This happens in one of two ways: either the head and neck are forced toward the shoulder, compressing the nerves that lead from the spinal cord to that arm, or the head and neck are forced away from the shoulder, stretching those nerves. It is for this reason that stingers do not affect both arms simultaneously, however it is possible for both arms to accrue injuries. Symptoms often disappear within minutes and usually within hours, however, repeated nerve trauma can cause recurring stingers, chronic pain, and muscle weakness.

Diagnosis and treatment

Stingers are best diagnosed by a medical professional. This person will assess the athlete's pain, range of head and neck motion, arm numbness, and muscle strength. Often, the affected athlete is allowed to return to play within a short time, but persistent symptoms will result in removal. Athletes are also advised to receive regular evaluations until symptoms have ceased. If they have not after two weeks, or increase, additional tests such as magnetic resonance imaging (MRI) can be performed to detect a more serious injury, such as a herniated disc.

The order of treatments applied depends on whether the athlete's main complaint is pain or weakness. Both can be treated with an analgesic, anti-inflammatory medication, ice and heat, restriction of movement, and if necessary, cervical collar or traction. Surgery is only necessary in the most severe cases.

Prevention

Stingers can be prevented by wearing gear, such as butterfly restrictors, designed to protect the head and neck from being forced into unnatural positions. This equipment is more feasible in positions where unrestricted head and neck movement is not required, such as American football lineman, than in positions like quarterback, where such movement is integral. Regardless of equipment, it is important to report even minor symptoms to a trainer or team physician, and to allow appropriate recovery time.