Erb’s palsy is a medical condition characterized by paralysis of the arm. The severity of paralysis varies from patient to patient, ranging from mild weakness and loss of motion to total paralysis of the arm. This paralysis is due to damage to the brachial plexus.

The brachial plexus is a network of nerves near the neck that provide movement and feeling to the shoulder, arm, hand and fingers.

These nerves act kind of like a fiber-optic cable. Just like fiber-optics, the nerves in the brachial plexus send information from one location to another – from the brain, down the arm and into your hands and fingers. This is how your brain controls the movement of your muscles.

If this cable is cut or crushed, information cannot be properly sent across it. If the damage is severe enough, information can’t be sent across it at all. The same principle applies to the brachial plexus.

If your child was injured in this way, the connection between their brain and the muscles in their arm (or arms) becomes damaged, and they can lose the ability to use those muscles.

Erb’s palsy can occur in both infants and adults, however it is more common in infants.

In infants, it is typically caused by a physical injury during delivery, such as shoulder dystocia. During a shoulder dystocia, after the delivery of the infant’s head, the shoulders become stuck behind the mother’s pubic bone.

The neck and shoulders of your baby contain bundles of complex, sensitive nerves, known as the brachial plexus. Damage to a specific set of nerves – the “upper trunk” C5-C6 nerves – can cause Erb’s Palsy.

The reason Erb’s palsy is most prevalent in infants is because of the high risk of shoulder dystocia during childbirth, coupled with the fragility of an infant’s body.

Adults are stronger and more durable than babies (and generally don’t cram themselves through spaces that are too small for them to fit in). Because of this, a very strong force has to come downward on the shoulder to damage the brachial plexus like this, or it has to be severed during an injury to the shoulder.

The symptoms of Erb’s palsy may vary depending on the type and severity of the injury. The most common symptoms include:

• Weakness in one arm
• Holding one arm against the body with a bent elbow
• Lack of, or decreased grip strength in affected hand
• Numbness in the arm or hand
• Impaired muscular, circulatory, or nervous development
• Paralysis in affected arm (partial or total)
• Pain on affected side

There is no “cure” for Erb’s Palsy, although there are treatments.

Thankfully, the vast majority of infants diagnosed with Erb’s palsy fully recover, usually with treatment. Some babies with mild Erb’s palsy can heal completely without any intervention at all.

Erb’s palsy is rarely permanent, especially in mild cases. A doctor can help you determine how serious your child’s case may be, and the types of treatment that may be necessary.

Treatments differ depending on the severity of the injury.

Mild Injuries:

Most mild stretch or tear injuries will heal on their own without much, if any, medical intervention. In most cases, mild injuries heal within three to six months.

Moderate to Severe Injuries:

More serious injuries may not heal without assistance.

These injuries may require interventions, such as:

• Physical therapy: Improves mobility and movement, reduces pain, and increases strength
• Occupational therapy: Improves strength and coordination. Occupational therapy is a very helpful method of improving a child’s ability to function in day-to-day activities, such as holding items, playing, and exercising.
• Surgery: The most severe cases of Erb’s palsy may require surgical intervention. Surgery is done to repair nerves and restore as much function as possible. When surgery is necessary, it is best to perform the procedure as soon as possible to improve outcomes.