Upper trunk brachial plexopathy

Abstract

This study was designed to determine the cause of upper trunk brachial plexopathy, which is referred to as a "stinger" or a "burner." This injury often has been thought to occur secondary to traction when an athlete sustains a lateral flexion injury of the neck. At the United States Military Academy, a 4-phase study was begun with 261 tackle football players (236 intramural- and 25 varsity-level players) to investigate this injury. Electromyography and nerve root stimulation studies were used to delineate the lesion, which was found in a total of 32 players who continued throughout the study. This study demonstrated that a much more common mechanism of injury resulting in the stinger syndrome is probably compression of the fixed brachial plexus between the shoulder pad and the superior medial scapula when the pad is pushed into the area of Erb's point, where the brachial plexus is most superficial. An orthosis was designed to protect the brachial plexus from the compressive force of the shoulder pad. In preliminary trials, this orthosis had been very effective in decreasing the number of episodes in which stinger injuries occurred.

Sports and peripheral nerve injuries: Report of 190 injuries evaluated in a single electromyography laboratory

“…The EDX findings in athletes with these lesions were consistent with the diagnosis of either a C5-C6 radiculopathy or an upper trunk brachial plexus lesion. Controversy exists as to whether burners are primarily upper trunk brachial plexopathies 3,5,8,11,13 or cervical radiculopathies. 7,10 Typically, only those athletes with persistent neurologic abnormalities are referred for EDX evaluation.…”

The effects of a rugby playing season on cervical range of motion

“…For the backs, left side flexion and flexion/ extension declined the most (À15.4%, À6.6%, and À14.6% respectively), which reflects a decline from 1028 to 918 for the entire flexion/extension range of motion. As most rugby injuries are caused during the tackle (Bathgate et al, 2002;Quarrie & Hopkins, 2008), which can give rise to ''stingers and burners'' causing transient neuropraxia (Kuhlman & McKeag, 1999;Marley, Di Benedetto, & Curl, 1993), it is not surprising side-flexion is significantly compromised in both forwards and backs. The right side in particular may be affected in forwards because of right hand dominance, but further work is needed to support this theory.…”

Brachial Plexus Lesions after Backpack Carriage in Young Adults

“…For example, recall information of the damage mechanism separates compression neuropathy from the stinger/burner syndrome, a short-lasting burning pain and paresthesia occurring in subjects playing contact sports after lateral flexion of the neck or fixed brachial plexus compression between the shoulder pad and superior scapula. 10 The thoracic outlet syndrome produces symptoms from the lower plexus region, and is characterized by pain and paresthesias in the ulnar region of the arm. Sporadic 4 or hereditary 1 neuralgic amyotrophies (plexus neuritis) or multifocal motor neuropathy may create a clinical picture resembling brachial plexus paresis at disease onset.…”