Cervical Sports Injuries: The Stinger

How stinger or burner injuries affect the neck and shoulder; symptoms, treatment, prevention.

Peer Reviewed

In the world of contact sports, such as football, hockey, soccer or basketball, a common cervical injury affecting the neck and upper body is the stinger. A stinger, sometimes called a burner, is an injury that occurs when the head or neck is hit to one side, causing the shoulder to be pulled in the opposite direction. While stingers/burners most often occur at the high school level, they can occur at all levels of play.

stinger burner neck injury from sideways whiplashAs a result of a forcible sideways blow to the head or a blow to the shoulder itself, brachial plexus nerves may become compressed, stretched, and irritated. Photo Source: 123RF.com.

How does a stinger or burner neck injury happen?

A stinger is caused by a stretching of the brachial plexus nerves. These are peripheral nerves that exit the spinal cord and run across the shoulders, under the collarbone, and into the arms. The brachial plexus nerves are responsible for giving the arms their strength and sensation. As a result of a forcible sideways blow to the head or a blow to the shoulder itself, these nerves may become compressed, stretched, and irritated.

brachial plexus nerves in the neckThe cervical nerves, specifically the brachial plexus can be injured during a forceful sideways movement of the head. Photo Source: 123RF.com.

What are the symptoms of a cervical stinger?

A sideways collision of this type causes immediate and intense pain, as well as tingling or burning sensations in the neck that run down the arm into the fingers. Weakness in the affected arm or hand is also common. The weakness, numbness, and/or tingling sensations may last as briefly as a few minutes or as long as a few weeks.

How is a burner or stinger injury treated?

  • Most stinger injuries resolve on their own with rest. Athletes are usually removed from the sport until symptoms are gone.
  • Ice packs on the neck or shoulders, anti-inflammatory medications, massage, and neck strengthening exercises are often part of the treatment plan.
  • Players can usually return to their sport once their pain is gone and they have regained full range of motion, strength, and normal sensation in the neck and arms.
  • Persistent or recurrent symptoms may indicate a more serious injury.
  • Cervical x-rays, a CT scan, or MRI may be necessary to rule out other serious conditions with similar symptoms.

Can stinger and burner types of neck and upper body pain be prevented?

Exercises that strengthen the neck muscles are an important way for athletes and novices to help prevent stingers/burners. Using good technique in contact sports and avoiding spearing (spear tackle, head down tackling) is also important. Safety equipment, such as neck rolls that limit backward movement of the neck, may also help.

Most importantly, players who experience stinger symptoms should immediately report them to their coaches or team physician, despite the risk of being removed from the game. Ignoring or playing through a stinger can lead to more serious injuries.

Commentary by Todd J Albert, MD

Dr. Subach's article is important, timely, and accurate. Year round, there are different types of organized sports (eg, soccer, football) that lend an opportunity for neck injury. Awareness is most important.The differential entity of radicular pain/weakness should only be entertained if the player's complaints are monoradicular (from a particular spinal nerve root). Otherwise, this global transient weakness is almost always a stinger aka burner. Congratulations to Dr. Subach on an excellent and concise review.

Updated on: 03/15/19
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Todd J. Albert, MD
Surgeon in Chief and Medical Director
Hospital for Special Surgery
Weill Cornell Medical College
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