Burners (Stingers) Syndrome

Introduction

This Wiki page aims to provide readers with a background understanding of Burner’s syndrome (also known as Stinger’s syndrome), why the young athletic population are more at risk and give an insight into the different management options which are available. We will discuss the various treatment options supported by research evidence, with a focus on the efficacy of each treatment options in returning the athlete to the sport and preventing future recurrence and potentially more serious neurological developments.

What is Burner’s Syndrome?

Burner’s syndrome is a common injury in contact sports and reflects an upper cervical root injury or a peripheral nerve dysfunction injury. It is a transient nerve injury which occurs following over-stretching of the upper trunk of the brachial plexus or compression of the C5/C6 nerve root, depending on the mechanism of injury. Recurrences are common and can lead to permanent neurologic deficits. Burner’s syndrome tends to be a grade I or grade II nerve injury.

Classification of Peripheral Nerve Injuries

Grade I- Neuropraxia; a disruption of nerve function involving demyelination (Warren et al., 1989; Hershman, 1990). Axonal integrity is preserved, and remyelination follows within three weeks (Warren et al., 1989).

Grade II- Axonotmesis; in which axonal damage (Warren et al., 1989) and Wallerian degeneration occur (Hershman, 1990).

Grade III- Neurotmesis;  complete nerve transection (neurotmesis), or permanent nerve damage (Warren et al., 1989).

https://www.physio-pedia.com/Classification_of_Peripheral_Nerve_Injury

Aetiology and Epidemiology

Burners’ may be the most common upper extremity nerve injury seen in competitive athletes. (Dimbergand Burns, 2005; Krivickas and Wilbourn, 1998).

There are three main mechanisms of injury which may cause Burner’s syndrome:

1. A forceful blow causing depression of the shoulder and lateral flexion of the neck to the contralateral side, leading to traction of the upper roots of the brachial plexus (Sallis et al., 1992; Hershman, 1990; Nicholas, Hershman and Posner, 1995).
2. A direct blow to supraclavicular fossa or Erb’s point causing a percussive injury (Di Benedetto and Markey 1984; Markey, Di Benedetto and Curl 1993; Nicholas, Hershman and Posner, 1995).
3. Compression of nerve roots or brachial plexus when the head is forced into hyperextension and ipsilateral side flexion towards the side of trauma (Watkins, 1986).