Erb’s Palsy Symptoms

Fact-Checked and Medically Reviewed by:
Katie Lavender, RN Registered Nurse
Quick Answer

Erb’s palsy is muscular and nerve condition that causes weakness or paralysis in the shoulder, arm, wrist, hands and fingers. It is important to detect Erb’s palsy as quickly as possible, as earlier detection increases the odds of a full recovery. Parents should look for symptoms such as a limp or paralyzed arm, as well as a lack of muscle control or feeling in the arm or shoulder.

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Common Symptoms of Erb’s Palsy

Erb’s palsy is often caused by damage to the head, shoulders or neck of an infant during birth. The result is muscle weakness or paralysis in the arm, shoulder, wrist, hand or fingers.

Erb’s palsy is the most common type of brachial plexus injury. The brachial plexus is a bundle of nerves that starts at the spinal cord and goes behind the neck and collarbone, down to the arm, to the hand and fingers. It accounts for nearly half of all such injuries.

Other forms of brachial plexus injuries include total plexus involvement and Klumpke’s palsy. Total plexus involvement is the complete paralysis of the shoulder and arm. Klumpke’s palsy is a form of partial paralysis.

Erb’s palsy can be caused by:

  • Injury from forceps or vacuum delivery
  • Doctors pulling on the infant’s head or shoulders during delivery
  • Pressure on raised arms during delivery
  • Stretching of the shoulders during head-first delivery
Nurse’s Note:

During delivery, each newborn is immediately assessed for limb movement and tone. If there is a significant difference in mobility or tone between limbs, it’s documented and reassessed. Suspected cases of Erb’s palsy lead to further testing and comprehensive arm evaluation.

The earlier your child’s case of Erb’s palsy is diagnosed and treated, the higher the odds of a complete recovery. That is why it is important to recognize the symptoms of Erb’s palsy as quickly as possible.

The most common symptoms include:

  • Muscle weakness in one arm
  • Limp arm bent at the elbow
  • Limited ability to grip items
  • Numbness or lack of feeling in the shoulder, arm, wrist, hand or fingers
  • Partial or complete arm paralysis
  • Limited muscular or nerve development in the arm or hand

In children with Erb’s palsy, many of these symptoms will appear immediately. For example, a child born with a limp arm should be evaluated as quickly as possible to make a diagnosis and begin treatment. Symptoms can vary based on the severity of the Erb’s palsy injury.

Treatments for Erb’s Palsy Symptoms

Erb’s palsy is typically treated through physical therapy or surgery. In most cases, physical therapy will be enough for a complete recovery. Surgery is only necessary in about 5% of cases. In some mild forms of Erb’s palsy, the condition can even go away on its own within three to six months.

If, after six months, the condition is unchanged, surgery might be discussed to improve the chances of full recovery for the infant.

Physical therapy generally involves massaging the affected arm, shoulder, or hand and gentle exercise techniques to strengthen the surrounding muscles. Surgery usually involves nerve grafts or muscle transfers to improve the affected area’s nerve response.

Therapy for Erb’s Palsy

After Erb’s palsy has been diagnosed, your child will likely be referred to a physical therapist for the first course of action.

For infants, therapy is more focused on parents performing range of motion exercises to keep the shoulder, elbow, wrist, and hand mobile, which helps to prevent rigidity. These exercises are gentle and designed to maintain flexibility in the affected limb.

As children with Erb’s palsy grow, they can actively participate in more physical therapy movements on their own. This progression can include exercises that the child performs independently, tailored to their developing strength and mobility.

Eventually, therapy may involve exercise balls or light weights to build muscle strength in the affected arm.

It is important to remember that the overwhelming majority of Erb’s palsy cases will reach full recovery after several months through therapy. However, if physical therapy is not helping your child regain complete control of their arm or shoulder, surgery may be the next step.

Surgery for Erb’s Palsy

After physical therapy and continued medical evaluation, your medical provider may determine that surgery is your child’s best option for recovering full use of their arm and shoulder. Most Erb’s palsy cases that require surgery are treated with a nerve graft.

In a nerve graft procedure, healthy nerves from other areas of the body are removed and placed at the area of the disrupted or damaged nerve. After the surgery is complete, the child will begin occupational therapy to improve the strength in their affected arm and shoulder.

If surgery is necessary, it is better to do it as soon as possible. Research has found that waiting to perform surgery can lessen the odds of success.

There is always some risk in surgery. Even then, some Erb’s palsy cases are not resolved by surgery and require further medical evaluation. While this only occurs in rare cases, these children may not recover total movement in their affected arm.

Investigating Erb’s Palsy Symptoms

If you have noticed that your child is displaying Erb’s palsy symptoms, it is important to visit your local medical professional and get a diagnosis as soon as possible. When Erb’s palsy is quickly identified and treated, the rate of complete recovery rises dramatically.

However, when the condition is left untreated, the risk of lifelong symptoms setting in increases. Make sure that you investigate any Erb’s palsy symptoms with a medical professional. If your child had a difficult delivery, they may be at a higher risk of developing Erb’s palsy.

Erb’s Palsy and Medical Negligence

In over 80% of cases, children born with Erb’s palsy make a full recovery, but about 5% of all children born with the condition do not. In these cases, the symptoms persist for life.

Many cases of Erb’s palsy are caused by medical negligence. Pulling on the head or shoulders of the infant during delivery—by hand or through tools such as forceps—can cause the nerve damage.

If your child’s case of Erb’s palsy was caused by medical negligence, you may be eligible for a financial settlement. This settlement may cover some or all of your child’s treatments and medical expenses.

Birth Injury Support Team
Reviewed by:Katie Lavender, RN

Registered Nurse

  • Fact-Checked
  • Editor

Katie Lavender has over 8 years of experience as a Registered Nurse in postpartum mother/baby care. With hands-on experience in Labor and Delivery and a role as a Community Educator for newborn care, Katie is a staunch advocate for patient rights and education. As a Medical Reviewer, she is committed to ensuring accurate and trustworthy patient information.

The Birth Injury Justice Center was founded in 2003 by a team of legal professionals to educate and empower victims and families affected by birth injuries. Our team is devoted to providing you with the best resources and legal information for all types of birth injuries.

View Sources
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  2. Hanigan, W. C., et al. (1995). Symptomatic intracranial hemorrhage in full-term infants. Child’s nervous system : ChNS : official journal of the International Society for Pediatric Neurosurgery, 11(12), 698–707. Retrieved November 25, 2023, from
  3. Partridge, C., & Edwards, S. (2004). Obstetric brachial plexus palsy: increasing disability and exacerbation of symptoms with age. Physiotherapy research international : the journal for researchers and clinicians in physical therapy, 9(4), 157–163. Retrieved November 25, 2023, from