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The 'Burner' a Common Nerve Injury in Contact Sport Athletes

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WebMD Health News

Nov. 26, 1999 (Atlanta) -- A 'burner,' also called a 'stinger,' is a common nerve injury resulting from trauma to the neck and shoulder, according to an article published in the Nov. 1 issue of American Family Physician. The primary symptom is a burning pain that travels down one arm and is often accompanied by numbness and weakness. This injury is most commonly seen in athletes participating in contact sports like football, wrestling, and hockey or in sports where the upper body may suffer collisions or pulls, such as gymnastics.

Symptoms of burners are usually short-lived -- seconds to minutes -- but severe injuries can take weeks or months to heal. Frequently, burners recur and sometimes lead to a chronic syndrome.

"Although burners are common injuries, their true incidence is unknown. This void is largely due to underreporting by athletes," write Geoffrey S. Kuhlman, MD, and Douglas B. McKeag, MD, in the study. A survey of college football players found that 65% of players had at least one burner in their college careers, but 70% of these athletes did not report the injury to anyone. Kuhlman is director of sports medicine at the Hinsdale Family Practice Residency in Illinois, and McKeag is professor of family practice and orthopedics at the University of Pittsburgh School of Medicine.

A burner usually involves the nerves coming out of the spinal cord and going into the arm. Sometimes they also affect nerves in the neck. Usually, the symptoms disappear within minutes, but they may reappear hours or days later. In some cases, the pain persists for weeks or even months.

If the pain persists for more than three weeks, doctors can use a variety of tests on the muscles to diagnose the condition, but Kuhlman warns that in typical cases of burners, tests used to diagnose the injury play a limited role. Rarely, sophisticated imaging techniques can be used to rule out other conditions. Some serious conditions like fractures of the neck and injuries to the spinal cord may mimic burners, according to Kuhlman.

"Athletes can return to contact sports once they have regained full range of motion and strength," says Kuhlman. He recommends using protective equipment in those most at risk of developing burners. "A neck roll or a cowboy collar are the most practical and easily accessible options," he says. These protective pieces are typically sold in sporting goods stores and stocked in athletic teams' equipment rooms.

But recommending or requiring every football player, for instance, to wear equipment to protect from burners would be impractical, according to Kuhlman. "Players at the skill positions like wide receiver or quarterback generally desire greater rotational motion of the neck to see the ball, to observe opponents, and to play their positions. Wearing a neck roll or cowboy collar will limit some of that rotational motion and feel cumbersome," he tells WebMD. "The players at positions most at risk for this injury -- namely those who block and tackle the most -- should consider wearing this type of equipment, even in the absence of identified risk factors."

In addition to using the proper protective gear, the authors caution that flexibility and strength of the neck, shoulder, and arms are very important in determining the severity of the condition. They recommend stretching exercises and a 'chest-out' posture along with muscle-building exercises to minimize the chances of this injury.

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