A burner is an injury to the bundle of nerves in your neck. These nerves run from the back of your neck into your arm. The nerves leave the spine and form a group called the brachial plexus. The plexus extends into the upper shoulder. From here, the nerves split into individual strings. The nerve strings go to all the arm muscles, supplying sensation to the arm. A burner may also be called a stinger.
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A burner may be caused by injury to the brachial plexus, such as:
- Overstretching—can be caused by your shoulder being pushed down while your head is forced to the other side
- Pinching—can happen if your head is moved quickly to one side
- Bruising—can happen when the area above your collarbone is hit directly or pressure on the top of your head compresses the brachial plexus nerves against bone
Factors that increase your chance of a burner include:
- Playing American football—increased chance of receiving direct blows to the head, neck, and shoulders
- Participating in other contact sports
Symptoms may include:
- Numbness, tingling, or weakness in the shoulder or arm
- Burning or stinging feeling in one arm
- Burning or stinging feeling between your neck and shoulder
You will be asked about your symptoms and how the injury occurred. One of the most important questions is whether symptoms occur in one arm only, in both arms, or in either leg at the same time. Symptoms in more than one limb may be more serious, suggesting injury to the spine or spinal cord. This may need more extensive evaluation.
The doctor will examine you for:
- Pain or tenderness
- Neck and arm range of motion
- Strength in the arm and hand
- Arm reflexes
- Sensation in the shoulder and hand
Serious burners can be evaluated with an electromyogram (EMG). This is a test of the electrical activity of the muscle. It can help to determine the extent of the injury.
It is important to make sure symptoms are due to burners and not a more serious injury to the spine or spinal cord. Early recognition of this condition can prevent possible paralysis. Careful post-injury evaluation can help prevent permanent damage or reinjury.
Some burners last only a few minutes. These will not need medical treatment.
Treatments options include:
Burners can cause muscle weakness. You may be referred to a physical therapist. The therapist will help you strengthen your muscles while the nerve heals.
The decision to return to a sport activity after a burner requires careful evaluation. It is important that the nerve has fully healed and there is a low chance of reinjury. AnMRI scan or EMG study may need to be done to confirm this. Multiple burner injuries in one season may be reason to restrict return to play. In this case, the player should consult an experienced sports medicine physician for evaluation.
Nonsteroidal anti-inflammatory drugs, such as ibuprofen or naproxen, may be used to reduce discomfort.
Icing the neck as needed may help to reduce discomfort.
To help reduce your chance of a burner:
- Keep the muscles around your neck and shoulders strong and flexible to help you withstand the stress of a direct blow.
- Learn safe sport techniques.
- Avoid using your helmet as a contact point when tackling and blocking in football.
- Always make sure to wear the proper safety equipment for your sport.
- Pads and other modifications of athletic gear have been proposed in an effort to reduce the incidence of burners. These may be especially useful for players who have previously suffered injury.
- James Cornell, MD
- Reviewed: 09/2015
- Updated: 09/02/2015
Please note, not all procedures included in this resource library are available at Allegiance Health or performed by Allegiance Health physicians.
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