Tips for Preventing and Recovering from a Stinger, a Common, but Painful, Sports Injury

Dear Sports Doc,

My son got a stinger during his last football game. He made a tackle, immediately had a jolt of pain and then his whole arm went numb. The symptoms went away almost as quickly as they came on and he recovered completely in a minute or two. After the medical staff checked him out, they even let him back in the game. Is this normal?

When a section of the brachial plexus or a nerve root gets forcefully stretched or pinched, it can cause severe pain and numbness that shoots down the arm.

What Is a Stinger?

The nerves that go into your arm begin as branches of the spinal cord in the neck. The first branches (called nerve roots) form a complicated series of connections as they travel. They join together and divide into new branches, forming a web-like bundle of nerves called the brachial plexus.

When a section of the brachial plexus or a nerve root gets forcefully stretched or pinched, it can cause severe pain and numbness that shoots down the arm. This is called a stinger; it is also sometimes called a burner.

How Do the Nerves Get Stretched or Pinched?

There are three scenarios that can cause a stinger:

  1. The shoulder is pulled down, and the neck is forced in the opposite direction. For example, the right shoulder gets pulled down, and the head is pushed to the left. This overstretches the nerves.
  2. The neck is forced backward and to one side. For example, the head gets pushed all the way back and all the way to the right, which pinches the nerves.
  3. A direct blow just above the collarbone, which injures the brachial plexus.

How Is a Stinger Diagnosed? Do You Need Any Tests?

Stingers can usually be diagnosed by the details of how the injury happened and an examination by a medical professional. X-rays and other tests are not necessary in most cases.

If the injury is severe, if symptoms do not go away within a few hours or if an individual has had multiple stingers, then further testing may be recommended. Also, if it is not clear whether an injury other than a stinger is present, tests may be needed to identify or rule out other injuries.

How Do You Treat a Stinger?

A stinger itself does not usually need treatment because symptoms often go away very quickly and the nerve recovers. If pain or weakness lasts for more than a few hours, then physical therapy may be helpful to regain motion and strength over time.

When Is It Safe to Start Playing Sports Again After a Stinger?

A full recovery is required before returning to any activity that could risk making the injury worse. It is safe to return to sports when:

1. The pain is completely gone.

2. Full strength has returned.

3. Neck and shoulder motion are normal.

Some stingers last only a few seconds to a couple of minutes. When this is the case, return to play on the same day may be possible. For such a quick return, it is recommended that a medical professional perform an evaluation to help assess safety.

Can Stingers Be Prevented?

Several things can decrease the risk of getting a stinger. One is to stretch and strengthen your neck and shoulder. A stiff or weak neck or shoulder is more likely to be injured during rigorous activity. Guidance from a physical therapist can be helpful to create a management plan that’s right for you.

It is also important to focus on the basics. Good posture, with head high and chest out, takes pressure off the neck and nerves, reducing the chances of an injury. Proper sport technique, such as heads-up tackling and avoiding spear tackling, lets you perform your best without unnecessary risks.

Finally, protect yourself. Well-fitting protective equipment is key to safety. Each sport is different, but in football, for example, the use of elevated shoulder pads, neck rolls and other interventions has been linked to a decreased chance of getting a stinger.

If I Get a Stinger, Do I Need to See a Doctor?

It’s probably a good idea. Although stingers are typically mild injuries that get better without medicine, nerve injuries in general can cause serious problems and are often difficult to treat.

A doctor can help ensure your injury is not a more serious one and can help you decide what strategies for recovery and injury prevention are best for you.

About Dr. Josh Berkowitz 2 Articles
Dr. Josh Berkowitz is an assistant professor of Orthopaedics, Internal Medicine and Pediatrics who specializes in Sports Medicine at the UNC School of Medicine. He works as a Team Physician for the UNC Tar Heels and serves as an associate director of the combined Internal Medicine-Pediatrics Residency Program at UNC. He enjoys working with athletes of all ages and ability levels, providing care for community events all the way up through professional and international competitions. Locally, he also works with Chapel Hill High School and the Raleigh Flyers.

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