Stingers—A Review of Current Understanding and Management

A stinger is the transient sensory and motor loss of one upper extremity caused by a stretch or compression injury to the brachial plexus or the exiting cervical nerve roots. Athletes from contact sports like American football, rugby, wrestling, and horseback riding are most affected. Given today’s competitive athletic culture and recent advancements in sports medicine, understanding the clinical, diagnostic, and therapeutic aspects of stingers is crucial. Thus, this narrative review highlights current knowledge of pathology, clinical features, diagnostic modalities, radiologic measurements, management, rehabilitation, and return-to-play protocols. Recent and prominent English publications on adult athletes revealed that the brachial plexus upper roots (C5 and C6) are most affected. Stingers accounted for 62.2% of neck injuries in National Football League athletes and affected up to 50.3% of football players. Grading is based on injury severity to the nerves. Most stingers are mild, lasting a few seconds to minutes. Return-to-play protocols remain controversial; however, stingers have promising prognoses and can mostly be resolved with conservative treatment and rehabilitation. Severe injuries require surgical intervention but rarely occur in athletics. In conclusion, many recent developments in the evaluation and treatment of stingers impact current treatment plans, return-to-play decisions, and the future of athletes.