Anatomy & Background
The neck or cervical spine is composed of seven vertebral levels C1-C7. In the spine, there are areas where the intervertebral disc and facet joints join two cervical vertebral bodies. Where this occurs, it forms two canals on either side of the spine, called intervertebral foramina. At each level the cervical spinal nerves exit the spinal cord through the intervertebral foramen. The spinal nerves are the electrical wires of the body. The size or diameter of the spinal foramina can vary from person to person. Any compromise or encroachment of the canal may put pressure on the exiting nerve producing symptoms varying from pain, tingling, numbness or even weakness
What is a Stinger?
“Stinger,” is also called a burner or nerve pinch, and is a common athletic injury in which the head and neck are forced toward the shoulder compressing nerves in this area, or the head and neck are forced away from the shoulder stretching nerves in this area. Symptoms typically occur on one side of the body, affecting the nerves in the cervical spine down to the arm.
Anything that encroaches on, or presses on a nerve disrupting its function at can be considered a cause of stinger. Commons causes of stinger include:
- Contact sports like hockey, basketball, rugby, football, or wrestling.
- Sudden trauma like an accident that puts excess force on the head and neck.
Symptoms of Stingers
The symptoms experienced as a result of stinger will be located along the same path that the affected nerve travels.
- Pain, which can start in the neck and travel to the shoulder, and arm.
- Numbness tingling may be experienced from the neck to the shoulder, and arm.
- Muscle weakness may occur on any muscle that is innervated by the affected nerve. Long term pressure on the nerve can produce atrophy or wasting of that particular muscle.
- Pain and tenderness localized at the level of the involved nerve.
- Muscle spasm and changes in posture in response to the injury.
- Pain on one side of the body.
Treatment of stinger will depend on the severity of the condition. When treating acute back problems:
- Rest. Avoid the activities that produce the pain (bending, lifting, twisting, turning, bending backwards, etc).
- Anti-inflammatory drugs and pain medications.
- Apply ice in acute cases to the thoracic spine to help reduce pain and associated muscle spasm. Apply it right away and then at intervals for about 20 minutes at a time. Do not apply directly to the skin.
- An exercise regiment designed specifically to address the cause of the symptoms associated with pinched nerve and improve joint mobility, spinal alignment, posture, and range of motion.
- Steroidal medication to reduce inflammation in moderate to severe conditions.
- Physical therapy to reduce inflammation, restore joint function, improve motion, and help the return of full function.
In mild cases many patients found that rest, ice and medication were enough to reduce the pain. Physical therapy is recommended to develop a series of postural, stretching and strengthening exercises to prevent re-occurrence of the injury. Return to activity should be gradual to prevent a return of symptoms.
Moderate to Severe Cases
If the problem persists, consult with your health care provider. Your physician should perform a thorough evaluation to determine the possible cause of your symptoms, the structures involved, the severity of the condition, and the best course of treatment.
In addition to performing a thorough examination your physician may order the following tests to make a more concise diagnosis:
- X-ray to determine if there is any joint degeneration, fractures, bony malformations, arthritis, tumors or infection present.
- MRI to determine any soft tissue involvement, including visualization of the discs, spinal cord and nerve roots.
- CT scans, which can give a cross section view of the spinal structures.
Medications to consider
Your physician may recommend several medication options individually or in combination to reduce the pain, inflammation and muscle spasms that may be associated with stinger.
- Over the counter medications for mild to moderate pain.
- If over the counter medications are not effective your physician may prescribe stronger pain medication.
- Anti-inflammatory drugs or prescription NSAIDS (non-steroidal anti-inflammatory drugs) to reduce inflammation following acute injury.
- Muscle relaxers to reduce acute muscle spasm.
- Injections like facet injections, nerve blocks or an epidural. These may involve the injection of corticosteroids to a specific structure to reduce local inflammation.