What’s the difference between a stinger/burner and a neuropraxia? Our 17-year-old son is in with the high school team physician being examined to determine which one he has. We’d like to get a jump up on the information so we know what questions to ask and what kind of treatment to expect.

The term neuropraxia describes symptoms of bilateral (affecting both sides) burning, numbness, loss of sensation, and muscle weakness of the arms and hands. The symptoms are caused by pressure on the spinal cord in the cervical spine (neck). It is like having a concussion to the spinal cord (instead of to the brain). The symptoms can last minutes up to hours.

With burners or stingers, the spinal cord nerve root coming off the spinal cord (not the spinal cord itself) is pinched or compressed. The player experiences the same symptoms of burning, numbness, loss of sensation and/or weakness but in just one arm, not both arms.

Whether it’s burners, stingers, or neuropraxia, full recovery is expected — if the player doesn’t go back on the field and experience another high-energy contact injury to the head and/or neck. And if there isn’t an undetected fracture of the vertebra or damage to the disc. Only an examination and X-ray, MRI, or CT scan to rule out this type of trauma will answer that question.

It sounds like that’s where your son is in the process.

An expert panel of spine surgeons, neurologists, and orthopedic surgeons who specialize in trauma have suggested the following guidelines:

  • X-rays (or other imaging techniques) are required for high-
    energy contact sports injuries before a return-to-play determination can be made

  • Players with transient (temporary) neuropraxia without
    stenosis (narrowing of the spinal canal) can return to full sports participation

  • Players with transient neuropraxia (symptoms go away) but with stenosis should not be allowed to return to their sport until treatment has resolved the problem.
  • Return to full participation for players with neuropraxia and stenosis may require surgical decompression (taking pressure off the spinal cord). The procedure to decompress the spinal cord is usually fusion of the spine at the level of the compression.
  • There are situations when players must be advised not to return to sports. This occurs when there are repeated episodes of neuropraxia, persistent stenosis, and of course, permanent disability.

    In all cases, players should not be approved to return to their sport until and unless they have normal neurologic function and pain free (and full) motion.

    Imaging studies should confirm that there is plenty of room in the spinal canal for the spinal cord (i.e., no more stenosis). And the spine should be stable with no signs of subluxation, dislocation, or hypermobile (excess) motion.

    Hopefully this information will arm you with enough information and details to understand the problem and work with the physician to determine the best possible solution.