Stingray Envenomation Resulting in Neuropathy and Complex Regional Pain Syndrome Treated With Peripheral Nerve Stimulation - A Case Report

Sep 28, 2026

Stingray stings often cause severe but temporary pain and can occasionally lead to major complications, including peripheral nerve injuries and complex regional pain syndrome (CRPS). CRPS presents with persistent, debilitating pain and functional impairment, commonly after nerve injury. Conservative management may be inadequate, requiring escalated strategies. A 19-year-old developed radial neuropathy and CRPS after a stingray sting; despite conservative care and orthopedic surgery, symptoms worsened until a 60-day SPRINT peripheral nerve stimulation system produced marked pain reduction, improved function, and sustained benefit after device removal.

LanguageEnglish

CategoryHealthcare

FormatPDF

Pages5

Reading Time13 min

AccessFree to download

Introduction

Stingray venom effects and complications

CRPS features and mechanisms

Management approaches for neuropathic pain and CRPS

Case Presentation

Injury circumstances and initial findings

Treatment and Outcomes

Decision for temporary peripheral nerve stimulation

Pain, function, and follow-up response

Review began 10/15/2025 Review ended 11/24/2025 Published 12/01/2025 © Copyright 2025 Scott et al. This is an open access article distributed under the terms of the Creative Commons Attribution License CC-BY 4.0. , which permits unrestricted use , distribution , and reproduction in any medium , provided the original author and source are credited. DOI: 10.7759/cureus.98242 Open Access Case Report Stingray Envenomation Resulting in Neuropathy and Complex Regional Pain Syndrome Treated With Peripheral Nerve Stimulation: A Case Report Ryan M. Scott 1 , Brian C. McLean 2 1. Anesthesiology/Pain Medicine, Naval Medical Center San Diego, San Diego, USA 2. Anesthesiology/Pain Medicine, Pain Management Center, Naval Medical Center San Diego, San Diego, USA Corresponding author: Ryan M. Scott, [ryanmondayscott@gmail.com](ryanmondayscott@gmail.com) Abstract Stingray stings frequently result in severe but temporary pain; they can occasionally result in significant complications, including peripheral nerve injuries and complex regional pain syndrome (CRPS) . CRPS is characterized by severe, persistent pain and functional impairment, often following a nerve injury. Conservative treatments may be insufficient, necessitating advanced management strategies. A 19-year-old patient presented with radial neuropathy and CRPS following a stingray sting. Despite conservative treatment and orthopedic surgery, the patient 's condition progressed, resulting in debilitating pain and functional limitations. The decision was made to place a SPRINT peripheral nerve stimulation (PNS) system (SPR, Cleveland, OH, US) . Sixty days of right radial nerve stimulation resulted in a significant reduction in pain, improved function, and enhanced quality of life. The patient experienced sustained pain relief and functional improvement over the follow-up period after removal of the device. While implanted spinal cord stimulators and permanent peripheral nerve stimulators have been used in the management of the pain from complex regional pain syndrome for many years, and this system is likely being used in the treatment of CRPS currently, this report adds to the literature evidence that use of a 60 day temporary PNS system early in the disease course may resolve the condition before it can become chronic. This case highlights the potential of PNS in managing complex pain syndromes and suggests that further research is needed to confirm its broader applicability and long-term benefits. Categories: Therapeutics, Pain Management Keywords: chronic and acute pain management, complex regional pain syndrome stages, mono-neuropathy, peripheral nerve stimulator, toxicology and envenomation Introduction Stingray stings are a common marine injury, especially in Southern California, and can lead to a variety of complications due to the venomous nature of the sting and physical trauma inflicted by the stingray 's barbed tail [1] . Stingray venom is composed of a complex mixture of proteins, enzymes, and other bioactive compounds that can cause intense pain, local tissue necrosis, and systemic reactions. Common immediate effects include severe pain, erythema, and edema [2] . Long-term complications can include chronic pain, infections, and, in rare cases, neurological damage due to direct trauma or envenomation effects [1] . The intense pain exhibited by stingray envenomation may be largely due to the presence of serotonin as well as two enzymes, 5-nucleotidase and phosphodiesterase [3] . Neurological complications from stingray stings can manifest as peripheral nerve injuries, which may result in complex regional pain syndrome (CRPS), previously known as reflex sympathetic dystrophy (RSD) [3] . CRPS is a debilitating condition characterized by persistent pain, usually following an injury. Symptoms include severe pain, swelling, changes in skin color and temperature, and functional impairment. The exact mechanisms ofthe pathophysiology

FAQs

What complications can follow a stingray sting?

Stingray stings can result in severe pain and, in some cases, peripheral nerve injuries and complex regional pain syndrome (CRPS). Long-term complications may include chronic pain, infections, and rare neurological damage.

How was CRPS managed when conservative treatment and surgery were insufficient?

After progression despite conservative treatment and orthopedic surgery, a temporary SPRINT peripheral nerve stimulation (PNS) system was implanted to deliver therapy for up to 60 days.

What were the outcomes after temporary peripheral nerve stimulation?

Sixty days of right radial nerve stimulation led to significant pain reduction, improved function, and enhanced quality of life, with sustained benefits after removal during follow-up.

Sep 28, 2026

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