UMEM Educational Pearls

Title: Stingers

Category: Orthopedics

Posted: 12/28/2024 by Brian Corwell, MD (Updated: 1/21/2025)
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A stinger is a short lived neuropraxia to the upper brachial plexus

Named for the temporary sensation that radiates from the shoulder to the hand

Can occur though 3 common mechanisms

Most commonly from direct traumatic or tractional injury

Common in American Football

Occurs in almost 50% of players over a 4-year college career

Most commonly to running backs and linebackers in one NFL study

Symptoms: Unilateral burning pain and tingling in the arm with transient weakness

Symptoms NOT confined to a single dermatome.

Usually in C5, C6 innervated muscles (deltoid and biceps).

Symptoms are transient usually resolving in approximately 2 minutes

If asked to examine someone for this at a sporting event

Evaluate patient for:

C spine tenderness

Full cervical range of motion

UNILATERAL weakness in shoulder Abductors and external rotators

UNILATERAL weakness in biceps

UNILATERAL weakness in forearm pronation

UNILATERAL weakness in triceps extension

Consider evaluation for concussion symptoms if appropriate

Majority of patients in college and profession sports return to play in game when exam returns to normal