A stinger, also known as a burner, is a neurological injury that is common in high-contact sports such as ice hockey, rugby, American football, and wrestling). It is caused by restriction of the nerve supply to the upper extremity via the brachial plexus, which is formed by the anterior rami of the nerves at the 5th cervical level of the spinal cord all the way to the nerves at the 1st thoracic level of the spinal cord). The brachial plexus innervates the upper extremity as well as some muscles in the neck and shoulder. A stinger can fall into two different categories of peripheral nerve injury with physiological differences. Grade I is neurapraxia, which involves focal damage of the myelin fibers around the axon, with the axon and the connective tissue sheath remaining intact. The disruption of nerve function involves demyelination. Axonal integrity is preserved, and remyelination occurs within days or weeks).

The symptoms of a stinger include a stinging, tingling, or burning sensation down the arm into the hand, severe pain in the neck and shoulder, and arm numbness and weakness immediately following the injury. The affected athlete is allowed to return to play within a short time, but persistent symptoms will result in removal. Athletes are also advised to receive regular evaluations until symptoms have ceased, specifically, the restoration of pain-free mobility).

Stingers are best diagnosed by a medical professional who will assess the athletes pain, range of head and neck motion, arm numbness, and muscle strength). Imaging tests, such as X-rays, magnetic resonance imaging (MRI) scans, and nerve studies are not usually needed. A more extensive examination is needed if you have any of the following symptoms: weakness lasting more than several days, neck pain, symptoms in both arms, or a history of recurrent stingers/burners.

If you have had recurrent stingers, your doctor may recommend a special neck roll or elevated shoulder pads to wear during sports activities.