Stingers and Burners- what they are and how physio can help?
Have you or a team-mate come off a little worse for wear after a tackle, with shooting pain down your arm and/or pins and needles into your hand? This is a type of neural traction injury, commonly referred to as a stinger or a burner.
In the neck and arm, the most common cause for a stinger is where the neck is forcefully bent to one side at the same time as the shoulder is depressed towards the ground. This causes a stretch or traction injury to the brachial plexus, which comprises nerves that run from the neck through the shoulder.
Nerve injury can cause symptoms such as a burning pain, numbness and pins and needles. These symptoms can be momentary, but can also last for a couple of months.
The goals of physio treatment for stingers are:
- Return normal range of motion for neck and shoulder joints
- Reduce the sensitivity of the injured nerve
- Facilitate nerve healing
- Advise on return to play options
Treatment will involve a combination of hands on therapy, soft tissue massage and specific exercises to target and facilitate healing of the injured nerve. It is generally recommended that you don't return to play until your symptoms have resolved as an incidence of one stinger predisposes to further injury. This is especially important in contact sports such as AFL and rugby where the risk of injury is higher.
- Jeyamohan S, Harrop JS, Vaccaro A, Sharan AD. Athletes returning to play after cervical spine or neurobrachial injury. Current Reviews in Musculoskeletal Medicine. 2008;1(3-4):175-9.
- Nee RJ, Vicenzino B, Jull GA, Cleland JA, Coppieters MW. Neural tissue management provides immediate clinically relevant benefits without harmful effects for patients with nerve-related neck and arm pain: a randomised trial. Journal of Physiotherapy. 2012;58(1):23-3
- da Silva JT, Santos FM, Giardini AC, Martins Dde O, de Oliveira ME, Ciena AP, et al. Neural mobilization promotes nerve regeneration by nerve growth factor and myelin protein zero increased after sciatic nerve injury. Growth factors (Chur, Switzerland). 2015;33(1):8-13.