Burners or Stingers, Brachial Plexus Stretch Injury

Burners or stingers are injuries which commonly happen in football or any other injury that stretches or injures the nerves from the neck to your arm. The nerves which come out of your neck and supply the arm and hand on both sides are called the brachial plexus. These nerves come from the spinal cord and wind down through the neck and under the collarbone and end as the nerves in your arms. They carry messages to and from the arm and hand. They allow you to move your arm and to also have feeling in your arms and hands.

SYMPTOMS

  • The main problem is a burning pain that starts in the neck and shoots into the arm.

  • There may be numbness, weakness or brief paralysis of the arm.

  • There may be needles and pins feelings which run from the neck and down the arm.

  • The type of problem depends on which nerves are damaged.

  • Shoulder weakness and muscle tenderness of the neck may occur from hours up to days after the injury or sometimes not at all.

DIAGNOSIS

  • Your caregiver can usually diagnose this based on the history of injury, symptoms, and a physical examination.

  • Electromyography and nerve conduction tests may be helpful. These are tests to tell how well your nerves are working. (Your nerves are like the wires carrying electricity in your house).

  • Specialized x-rays may be done to make sure there is not an injury to the cervical spine (neck) or shoulder.

HOME CARE INSTRUCTIONS

  • Apply ice to the shoulder and axilla (armpit) for 15-20 minutes, 03-04 times per day while awake for the first 2 days. Put the ice in a plastic bag and place a towel between the bag of ice and your skin.

  • Only take over-the-counter or prescription medicines for pain, discomfort, or fever as directed by your caregiver.

  • If you were given a splint or sling, wear them as instructed. You may remove them to shower.

  • An elastic bandage wrap may be useful for shoulder or upper-arm swelling.

RETURNING TO ACTIVITIES

  • You will not be able to return to activities in a contact sport until full strength and range of motion of the upper extremity and neck returns to normal, and EMG studies are negative. This means the injured nerves do not show continual problems. This can take more than 6 months. There should be no residual pain.

  • You can maintain your cardiovascular fitness by continuing to work out your lower extremities.

PREVENTION

  • Prevention measures include strengthening exercises of the neck and shoulder muscles and protective devices for your neck before starting sports again if that was the cause.

  • More than half of these injuries will happen again. It is very important to do the strengthening exercises recommended.

  • Wear neck and shoulder pads that are well fitted to prevent re-injury.

Sometimes it is impossible to tell the difference between an injury to the nerves that supply the arm and the spinal cord. If there is injury to the spinal cord your symptoms may worsen. It is important to pay attention to your condition. If there is any worsening of your condition, or if your condition does not improve, contact your caregiver or go to an emergency department.

SEEK IMMEDIATE MEDICAL CARE IF:

  • You develop severe neck pain.

  • You lose control of your urine or stool.

  • You develop weakness in your arms or legs.

MAKE SURE YOU:

  • Understand these instructions.

  • Will watch your condition.

  • Will get help right away if you are not doing well or get worse.