Burner Syndrome, often known as Stinger syndrome, is an injury related to athletes and sports (1). It is a burning of stinging sensation that can be felt travelling from the neck or shoulder down the arm to the hand. When the nerves in the neck are stretched or compressed due to trauma, it may lead to burner syndrome. The pain may typically subside within minutes, hours, or a few days, but the condition is recurring and may cause trouble repeatedly.

Symptoms

Burner syndrome is typically felt by a sudden, sharp, burning or stinging pain that travels from the neck or shoulder down to the arm and into the hand (1). This sensation may feel like an electric shock.

Other common symptoms include:

• Numbness: The affected area may feel tingly or numb
• Transient limb weakness or heaviness: The affected area may feel weak or heavy in severe cases
• Limited range of motion: The shoulder and neck might face a decreased range or motion or difficulty in movement in some cases
• Pain: The pain, although not a major symptom, may range from mild to severe in different cases, based on the intensity of injury.
• Warmth: The affected area may feel warm in some cases

The symptoms are not permanent; they may resolve in minutes, however, in severe cases the symptoms may last for hours or a few days. In such cases, it is advised to consult your doctor or physiotherapist.

Causes

Burner syndrome is a common brachial plexus injury in contact athletes (2). The injury is typically classified as grade 1 or grade 2.

• Grade 1 injury: demyelination or disruption of the nerve function. It is also known as Neuropraxia
• Grade 2 injury: Axonal damage and Wallerian Degeneration, also known as axonotmesis

The major cause of the injury could be:

• Depression of shoulder or lateral flexion of neck to the contralateral side due to a forceful blow.
• Percussive injury caused due to direct blow to Erb’s point
• Compression of the nerve roots or brachial plexus occurs when the head is forcefully pushed into hyperextension and side flexion toward the side of the injury.

Burner syndrome is commonly experienced by players in collision or contact sports such as American football, ice hockey, and rugby (2, 3).

Risk Factors

Burner or stinger syndrome most commonly affects athletes who participate in contact sports like football, rugby, and wrestling, where intense physical collisions are frequent.

Risk factors include (2, 3):

• A prior history of stinger injuries.
• Limited neck strength or flexibility
• Poor tackling form.

Congenital issues, such as cervical spinal stenosis, can also increase susceptibility. Athletes with poor posture or ill-fitting protective equipment face greater risk as well. Movements that forcefully bend the neck backward or to the side can compress nerves, triggering symptoms. Additionally, repeated injuries without sufficient recovery time may lead to chronic nerve irritation or recurring episodes of the condition (3).

Diagnosis

The diagnosis of the syndrome is typically done with clinical examination. A neurological examination is done often consistent with unilateral tingling in arm and transient weakness in the affected muscles, mainly C5 and C6 which are the deltoids and biceps (3).

While clinical diagnosis is accurate, in cases of recurrent or bilateral symptoms, imaging (MRI, CT myelogram) may be needed to rule out cervical stenosis or disc pathology.

Electromyography (EMG) is occasionally useful for assessing persistent weakness (3).

Treatment

Although burner syndrome can be cured on its own by proper rest, sometimes conservative treatment is suggested by the doctor. The treatment majorly focuses on inflammation reduction, managing pain, and restoring the lost range of motion. In some severe cases, the doctor may suggest physiotherapy (3).

Some treatments may include

• Anti-inflammatory medicines: The doctor may suggest ibuprofen or acetaminophen, which help in managing pain and inflammation
• Physical therapy: If the symptoms don’t go away for long, the doctor may suggest physical therapy and guide the patient to strengthen the neck and shoulder muscles
• Protective Gear: In certain cases of repeated stingers, the doctor may advise customised special gear such as shoulder pads and neck rolls.

Conclusion

Although Burner Stinger Syndrome is typically short-lived and often resolves on its own, it should not be dismissed, especially in athletes who experience it repeatedly. While the discomfort and nerve-related symptoms may fade within minutes or days, ongoing episodes can result in lasting complications if not properly addressed. Recognizing the signs, understanding the causes, and following appropriate treatment plans are key to early management and prevention. With timely medical attention, targeted physiotherapy, and the use of protective equipment, most individuals can make a full recovery and safely return to their sport. Always pay attention to persistent symptoms and consult a healthcare professional to protect long-term nerve function and athletic ability (1-3).

Reference
1. Hakkaku T, Nakazato K, Koyama K, Kouzaki K, Hiranuma K. Cervical Intervertebral Disc Degeneration and Low Cervical Extension Independently Associated With a History of Stinger Syndrome. Orthop J Sports Med. 2017 Nov 2;5(11):2325967117735830. doi: 10.1177/2325967117735830. PMID: 29147669; PMCID: PMC5672996.
2. Feinberg JH. Burners and stingers. Phys Med Rehabil Clin N Am. 2000 Nov;11(4):771-84. PMID: 11092018.
3. Safran MR. Nerve injury about the shoulder in athletes, part 2: long thoracic nerve, spinal accessory nerve, burners/stingers, thoracic outlet syndrome. Am J Sports Med. 2004 Jun;32(4):1063-76. doi: 10.1177/0363546504265193. PMID: 15150060.