We’re not talking about a bee’s defence mechanism, but you may have heard this injury referenced when watching your favourite sports team play, usually after a high impact knock or where a player gets twisted and contorted awkwardly. The injury will often look serious and with a high level of pain associated …. But what actually is it?
The medical term of a stinger is a ‘nerve plexus injury’ most commonly the brachial plexus (upper chest/shoulder), this is where the nerves quite literally get stretched to the point of damage, but also can be caused by a direct blow to the point of the shoulder, hence why the patient will get a strong stinging, burning or pins and needles type pain.
This particular injury can be caused from a heavy head knock (or upper body) where the head bends sideways rapidly, not too dissimilar to a whiplash injury. Or it can also be stretched from the other end of the nerve; if the hand/shoulder gets rapidly pulled (ie tackle/fall) it will cause the same stretching injury.
There are a number of nerve roots that can be affected with a stinger, all with unique patterns of the sting/burn, C5 and C6 are the most commonly affected nerves, however here is a commonly accepted mapping of the brachial nerve plexus
Less commonly this can occur in the lower back with similar mechanisms, the leg gets pulled or contorted (ie splits) causing a traction injury to the sciatic nerve with pain shooting down the legs.
What makes this injury quite unique is the often have very quick recovery times for the amount of pain caused, if the stretch is minor a player could come off the ground in agony but with the right stretching and movement patterns the pain can settle down and the player will finish off the game, with more severe injuries even the next week is possible.
The pain can last 1-2 minutes or a few days.
Common Symptoms
- Burning/stinging pain
- The limb can go completely limp
- Can get spasms and cramps
- Muscle weakness
- Usually only one sided
What makes this tricky is the nerve pain can also be symptomatic of a neck injury, so when in doubt, don’t take the risk of returning to the game. The player should definitely not return whilst there are signs of weakness and nerve pain
- A red flag of this can be those symptoms occurring on both sides of the body, this indicates that the site of the injury could be at the spinal cord, the person should be immobilised and ambulance called.
In very severe cases the injury becomes less of a ‘stinger’ and more of a chronic nerve problem, this can occur after repeated injuries across time (gradually weakening the structure with each injury) or in very extreme incidence (including vehicle accidents) this can cause tearing of the nerves resulting in months or years of nerve pain
Treatment
So what do you do in the case of a stinger? – Immediate rest, hopefully with some time on the sidelines or resting at home the symptoms will go away within minutes-hours. Should this be prolonged be sure to book in with a practitioner to assess for potentially more serious pathologies and then ongoing management.
If not contraindicated; anti – inflammatories can help reduce the painful sensation and aid in relaxing of surrounding musculature
