Neck Burners and Stingers: Getting to the Nerve Root of the ProblemMany football players and wrestlers are familiar with the terms burner and stinger. They describe how nerve pain can "zing" down one arm from a hard hit to the head and neck. This intense sensation of burning pain is thought to be from a pinching of the nerve root where it comes out of the spinal column of the neck.
The area between the bones of the spine where the nerve comes out is called the foramen. When the head is bent back and then compressed, as can happen in a football tackle, the foramen becomes narrower, and the nerve can get pinched. The authors wanted to see if athletes who had problems with burners tended to have a smaller foramen, a condition called stenosis. Researchers came up with a formula to quickly and accurately size the foramen by measuring the height of the foramen and the spinal bone below it on an X-ray image.
Researchers looked at neck X-rays of 64 athletes between the ages of 15 and 18 who reported having had a burner. Comparisons were made to another group of athletes in the same age range who reported having a neck injury in the past but no burner.
Two calculations were used. The first measured the spinal canal. The second was the formula designed by the authors for measuring the size of the foramen. They discovered that athletes who had a burner in the past had smaller spinal canals and smaller foramen. It is likely these athletes were at risk for a burner because a hit to the head and neck, especially with the head tilted back, tends to close the foramen down and pinch the nerve root.
Athletes who keep having problems with burners or who show signs of stenosis on X-ray might benefit from safety features to keep their necks from bending into unsafe positions and from being compressed from impact. These measures, according to the authors, could include neck rolls, special collars, and tips on how to tackle without putting the neck at risk.
John D. Kelly IV, MD, et al. Association of Burners with Cervical Canal and Foraminal Stenosis. In The American Journal of Sports Medicine. March/April 2000. Vol. 28. No. 2. Pp. 214-217.
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