Treating Erb’s Palsy

Over 80 percent of children diagnosed with Erb’s palsy will make a full recovery and regain complete control of the muscles in their affected arm. In the majority of cases, all that is necessary is physical therapy. However, a small minority of cases will require surgery. Studies have shown that beginning therapy as quickly as possible following an Erb’s palsy diagnosis will significantly increase the chance of a full recovery.

Treatment Timeline for Erb’s Palsy

Although Erb’s palsy treatments can be daunting, it is important to remember that over 80% of children with the condition will make a complete recovery.

Each case of Erb’s Palsy is unique and varies in severity. The condition may also differ in how it affects your child’s nerves and muscles in their arm, shoulder, wrist, hand and fingers. Your doctor will recommend a treatment plan that is best for your child’s particular case of Erb’s palsy. Their recommended treatment timeline will depend on your child’s condition and symptoms.

Generally, a treatment timeline begins with a diagnosis. After the diagnosis is made, most children will be advised to undergo physical therapy. If physical therapy is not successful, further evaluation is conducted before moving to surgical options.

Below are specific Erb’s palsy treatment recommendations based on published research.

Initial Erb’s Palsy Treatment

If your child has been diagnosed with Erb’s palsy, your medical provider will likely provide you with a list of treatment recommendations and guidelines for handling your child so that you do not harm their affected arm.

These guidelines include the following:

  • Protect the affected arm by carefully handling the baby.
  • Allow time for any inflammation from the birth injury to settle down.
  • Do not lift child under the arms.
  • When dressing the child, place the affected arm into the sleeve first, then the head and the unaffected arm.

It is important to realize that even though it is vital to follow these guidelines, your child will likely still require physical therapy from a medical professional. This physical therapy may begin about two weeks after birth.

Erb’s Palsy Treatment After 2 Weeks of Age

The initial treatment and handling guidelines for parents is a bit different than the type of physical therapy that begins after the infant turns two weeks old. Once a child with Erb’s palsy is two weeks old, they can begin more intensive physical therapy for their affected arm or shoulder.

In these cases, the treatment is typically conducted with a licensed physical therapist on a weekly or biweekly basis. The physical therapist may provide parents with additional physical therapy instruction to complete at home as well.

The treatment usually involves the following:

  • Weekly or biweekly formal physical therapy
  • Physical therapy instruction for parents
  • Gentle passive motion of joints
  • Daily home-based stretching and exercise
  • Monthly follow-up at clinic
  • Adaptive equipment like splints to prevent contractures

Erb’s Palsy Surgery

There is no standardized approach regarding surgery for Erb’s palsy. Fortunately, surgery is only necessary in about 5% of Erb’s palsy cases.

Surgery can help improve range of motion in some but not all children. Typically, surgery for children under the age of 5 involves methods such as muscle lengthening, muscle transfers, nerve reconstruction or reconnection and bone remodeling. Surgery for children over the age of 7 usually involves the bone remodeling.

Microsurgical neurolysis is considered a controversial and ineffective surgical treatment when it comes to the recovery of hand function. However, it is a treatment option that surgeons may choose in extreme cases of Erb’s palsy.

Erb’s Palsy Treatments After Surgery

Although surgery is successful for most patients with severe cases of Erb’s palsy, it can take several months for a child to regain full control of the muscles in their arm and lower hand. During this time, doctors will recommend that the child continue physical therapy and medical evaluation.

Here is what most medical providers recommend to parents post-surgery:

  • Physical therapy must be continued.
  • Doctors continue monitoring child’s progress.
  • Parents and child resume exercise program.

The American Academy of Orthopedic Surgeons (AAOS) recommends frequent medical checkups for a baby with Erb’s palsy to determine if the nerves are healing. It may take up to two years for symptoms to lessen. The AAOS also states that daily physical therapy is the basis of Erb’s palsy treatment.

Erb’s Palsy Diagnostic Tests

If your doctor suspects Erb’s palsy, they will run a series of tests to confirm a diagnosis. These tests can help determine the extent of the baby’s injury and their chances for recovery.

Common diagnostic tests include:

  • Neck X-rays
  • MRIs
  • Nerve conduction tests (NCV/EMG)

X-rays and MRIs are imaging tests used to determine whether there is any damage to the bones and joints of the neck and shoulder. NCVs and EMGs can determine if there are any nerve signals present in the neck and shoulder area.

Regardless of what the Erb’s palsy diagnostic tests reveal, therapeutic treatment is crucial in speeding up recovery.

Treatment Outlook for Children with Erb’s Palsy

Treatment for Erb’s palsy varies based on the severity of the condition. Fortunately, children diagnosed with the condition have a great chance of complete recovery.

The majority of children with Erb’s palsy will regain complete control of their arm through physical therapy. Only a small percentage of these children will require surgery, and an even smaller percentage will have lifelong symptoms.

After Erb’s palsy has been diagnosed, it is imperative to begin treatment as quickly as possible to increase your child’s chances of a full recovery.

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

Author:Birth Injury Justice Center
Birth Injury Justice Center

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.

Last modified: January 7, 2019

View 1 References
  1. https://www.sciencedirect.com/topics/medicine-and-dentistry/neurolysis