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Brachial Plexus Neurapraxia

Brachial Plexus Neurapraxia, often call a "burner," is one of the more common cervical injuries. Burners are common in athletes who play contact sports. After an injury involving lateral flexion of the neck and depression of the shoulder, the athlete often feels sharp burning pain in the neck on the involved side. This pain is caused by traction to the brachial plexus or compression of the cervical nerve roots.

 

Signs and Symptoms

 

After an impact involving the head, neck and/or shoulder, the athlete experiences a sharp burning pain on the involved side. The burning pain may radiate into the shoulder and down the arm to the hand. There may also be associated numbness or tingling and weakness on the involved side, which can last several seconds to several minutes.

 

Prolonged numbness or tingling and weakness may be found in a small number of athletes who present with a burner. These athletes should be discouraged from returning to full participation until a clinical exam reveals a complete return of strength.

 

Other tests may be necessary to rule out a cervical injury.

 

Management and Treatment

 

Athletes whose numbness and tingling completely disappears, demonstrate full muscle strength of the shoulder and upper extremity (abduction, elbow flexion, external rotation and internal rotation) and have full pain-free cervical range of motion may return to their sport.

 

When returning to play, protective equipment such as a cowboy collar or a neck roll is recommended. This is to prevent extreme hyperextension and lateral bending of the cervical spine. A good neck and shoulder muscle strengthening program will aid in the prevention of further "burners."

 

References

 

DeLee, Jeesse C. MD, Drez, David Jr. MD, Miller, Mark D. MD. Orthopaedic Sports Medicine. Volume One 2003; 797 – 800.

 

Griffin, Letha Y. MD, PhD, American Orthopaedic Society for Sports Medicine, Orthopaedic Knowledge Update Sports Medicine. 1994; 174.