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Burners (stingers): Acute brachial plexus injury in the athlete

Geoffrey Kuhlman, MD, CAQSM, FAAFP
Section Editors
Jeremy M Shefner, MD, PhD
Karl B Fields, MD
Deputy Editor
John F Dashe, MD, PhD


Upper extremity nerve injury commonly results from impact to the neck and shoulder. One such injury, a burner (also called a stinger), generally results from traction or compression of the upper trunk of the brachial plexus or of cervical nerve roots 5 or 6. Burners are typically transient, but they can cause prolonged weakness resulting in time lost from athletic participation. They commonly recur, leading to further disability. Returning to sports activity requires restoration of pain-free motion, complete recovery of strength, full functional status, and addressing predisposing factors.


A burner is caused by trauma to the neck and shoulder and signifies peripheral nerve dysfunction or injury. In most cases, it is a brachial plexopathy involving the upper trunk (figure 1). However, several authors also describe cervical nerve root lesions [1-5]. (See "Brachial plexus syndromes", section on 'Traumatic plexopathies'.)

Three mechanisms of burners are known:

The first is traction injury to the brachial plexus, which occurs when the shoulder is depressed and the neck is forced laterally away from the involved side, stretching the brachial plexus [1,6,7].

The second is a direct blow to the supraclavicular fossa, which causes a percussive injury to the upper trunk of the brachial plexus [4,5,7].

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Literature review current through: Nov 2017. | This topic last updated: Aug 20, 2017.
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