Brachial Plexus Injury (Burner or Stinger)

Overview

What Are Burners?

Burners (or stingers) are injuries to the nerve network that provides feeling and muscle control in the shoulder, arm, forearm, hand, and fingers. The medical term for burners is brachial plexus injuries. They’re common in sports. Most go away pretty quickly.

What Happens in a Burner?

The brachial plexus nerve network begins with nerve roots at the spinal cord in the neck and reaches to the armpit. Nerves branch out from there and continue down the arm to the forearm, hand, and fingers.

When a strong force increases the angle between the neck and shoulders, the brachial plexus nerves might stretch or tear. The injury may also pull the nerve roots of the brachial plexus from the spinal cord. Damaged nerves carry sensation poorly and make muscle movements weak.

Top Things to Know

• A burner (or stinger) is an injury to the nerves that control the shoulder, arm, and hand.
• Symptoms may include pain, numbness, weakness, or a burning feeling.
• Many burners go away in minutes, but some kids may need ice, pain medicine, or recommended exercises.
• Safe playing techniques, proper stretching, and strengthening the neck and shoulder muscles may help prevent burners.

Signs & Symptoms

What Are the Signs & Symptoms of a Burner?

Kids with a burner may have:

• pain or an electric shock shooting down the arm
• numbness in the arm or fingers
• clumsiness or weakness in the hand or arm
• a warm sensation in the affected area

A severe injury may cause paralysis (loss of movement) of the arm and a loss of sensation.

Causes & Prevention

Who Gets Burners?

Football players are most at risk for burners. But they also can happen in kids and teens who participate in:

• rugby
• hockey
• wrestling
• gymnastics

Burners can also happen in an accident (like a fall from a bike or a motor vehicle crash) when the head is forcefully pushed to one side or something hits the neck and shoulder.

Less common are brachial plexus injuries in newborns. These can happen if something complicates the birth, such as a breech (bottom-first) delivery or a large baby with shoulders too wide to fit through the birth canal.

Can Burners Be Prevented?

To make burners less likely, kids who play contact sports should:

• Keep their neck and shoulder muscles as strong and flexible as possible.
• Gently stretch the neck muscles before any athletic activity.
• Use protective gear (like a football neck collar or specially designed shoulder pads).
• Use proper sports technique (never leading with their head during a football game, etc.).

Diagnosis

How Are Burners Diagnosed?

A doctor will usually recognize a burner from the child or teen’s symptoms and a physical exam. The doctor may check arm strength, reflexes, and range of motion in the arm.

Imaging tests — like X-rays or an MRI — might be ordered if a child has:

• a history of burners
• neck pain or decreased range of motion in the neck
• symptoms in both arms
• weakness lasting more than a few days
• problems with thinking, speech, or memory

The tests can help doctors see the extent of the injury and rule out a more serious condition, such as a spine fracture.

Treatment & Care

How Are Burners Treated?

Treatment depends on how severe a burner is. Many mild injuries need no treatment because feeling and muscle control return within a few minutes.

Kids with a lasting burner might need:

• Ice applied to the affected area. Use an ice bag or a cold compress for 20 minutes every two to three hours for the first couple of days to ease any swelling.
• Anti-inflammatory medicines. Pain relievers (such as ibuprofen or acetaminophen) can help ease pain and inflammation in the neck and shoulder.
• Range of motion exercises. To keep the neck, shoulder, arm, and hand limber and flexible while the nerves heal, the doctor may recommend some exercises. These can also help ease muscle spasms.

What Else Should I Know?

Most burners go away on their own. Kids with a more serious injury might work with a physical therapist or trainer to keep the muscles strong during healing.

A burner should heal completely before kids return to sports.