A burner is an injury to the bundle of nerves in your neck. These nerves run from the back of your neck into your arm. The nerves leave the spine and form a group called the brachial plexus. The plexus extends into the upper shoulder. From here, the nerves split into individual strings. The nerve strings go to all the arm muscles. A burner may also be called a stinger.
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A burner may be caused by injury to the brachial plexus, such as:
Factors that increase your risk for a burner include:
Symptoms may include:
You will be asked about your symptoms and how the injury occurred. One of the most important questions is whether symptoms occur in one arm only or in both arms at the same time. Symptoms in more than one limb may be more serious. This may need more extensive evaluation.
The doctor will examine you for:
For serious burners, you may have an electromyogram (EMG). This is a test of the electrical activity of the muscle. It can help to determine the extent of the injury.
It is important to make sure symptoms are due to burners and not a more serious injury to the spinal cord. Early recognition of this condition can prevent reinjury and possible paralysis. Careful post-injury evaluation can help prevent permanent damage.
Some burners last only a few minutes. These will not need medical treatment.
Treatments options include:
If your burners last longer, it can cause muscle weakness. You may be referred to a physical therapist. The therapist will help you strengthen your muscles while the nerve heals.
The decision to return to a sport activity after a burner requires careful evaluation. It is important that the nerve has fully healed and there is a low chance of reinjury. AnMRI or EMG study may need to be done to confirm this. Multiple burner injuries in one season may be reason to restrict return to play. In this case, the player should consult an experienced sports medicine physician for evaluation.
Non-steroidal anti-inflammatory drugs, such as ibuprofen or naprosyn, may be used to reduce discomfort.
Icing the neck as needed may help to reduce discomfort.
To avoid burner, follow these guidelines:
American Academy of Orthopaedic Surgeons
American Orthopaedic Society for Sports Medicine
The College of Family Physicians of Canada
Burners. Am Fam Physician. 1999 Nov 1;60(7):2042. Available at: http://www.aafp.org/afp/1999/1101/p2042.html. Accessed September 9, 2014.
Burners and stingers. American Academy of Orthopedic surgeons website. Available at: http://orthoinfo.aaos.org/topic.cfm?topic=A00027. Updated May 2010. Accessed September 9, 2014.
Dimberg EL, Ted M. Burns TM. Management of common neurologic conditions in sports. Clinics in Sports Medicine. 2005;24(3).
Kasow DB, Curl WW. "Stingers" in adolescent athletes. Instr Course Lect. 2006;55:711-716.
Weinberg J, Rokito S, et al. Etiology, treatment, and prevention of athletic "stingers". Clin Sports Med. 2003 Jul;22(3):493-500, viii.
Last reviewed August 2014 by Brian Randall, MD
Please be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.
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