Jeffrey R. Carlson, MD
In the spring, young men across America get mopey, starry-eyed and stare off into space, dreamily thinking of only one thing…WHEN is football season going to start? Well, sports fans, August is almost here and the pre-season NFL games will be starting soon, as will college games. With the advent of another season, we will see more news reports of pro and collegiate players who have neck injuries. In this article, I will discuss the infamous Stinger, how it occurs, and how it is treated.
Ah, the “stinger” or “burner”. Many football players know that searing pain, tingling and loss of feeling down one arm after a collision with another player or the ground. Many people think of this as a shoulder or arm injury, when it is, in fact, caused by a nerve root in the cervical spine being stretched to the point of injury. Other neck injuries often happen at the same time as a stinger. This can be a minor and temporary trauma, lasting only a few minutes or it can be a career ending tragedy, depending on the severity of the damage done to the nerves/and or discs and vertebrae.
Players want to get back into the game and will minimize the pain they are feeling from a stinger, which can make it difficult to fully diagnose and treat until later, when the game is over. Research shows that having one stinger will make a player more susceptible to having another. A repeat stinger can also occur in the different arm. Permanent nerve damage, weakness, numbness or tingling may result from having multiple stingers in a player’s career.
If minor and symptoms resolve quickly (2 minutes – 24 hours), no treatment will be necessary, although it is always a good idea to have the player checked out for cervical strain or injury. A pain-free, full range of motion in the neck should be seen after the stinger occurs. There should be no muscle weakness and the arm and hand should be fully utilized.
If not, an Orthopaedic spine physician should be consulted. X-rays may initially be taken to rule out a fracture. Conservative treatment includes rest, ice, anti-inflammatory medications, muscle relaxants and Physical Therapy. The player should be pain free, with full range of motion and no muscle weakness before returning to the field. It can take several weeks for the player to recover to this point.
With continued symptoms, further medical examination of the injured player must take place to rule out an acute cervical disc herniation, fracture, spinal cord injury, ligament damage or other nerve impingement issues. A nerve conduction study or MRI may be used to assess the level of injury. Epidural steroid injections may be used to dampen nerve inflammation.
If symptoms persist and a ruptured cervical disc is the cause, surgery may be needed to free the nerve root from impingement. Fractures may require surgical intervention or may be allowed to heal without surgery. Soft tissue injury may take months to heal. Recovery from these more severe injuries may be slow and take several months to a year for full function to return.
A fellowship trained Spine Specialist can treat players who have sustained more severe stingers and the concurrent spine injuries that present. With the appropriate treatment, the goal is to get you back on the field and in the game as soon as possible.