Erb’s Palsy Treatment Explained
Erb’s palsy is a condition that results from a birth injury to the brachial plexus. The brachial plexus is a network of nerves that controls the arms and hands.
Research published by the British Medical Journal (BMJ) suggests to begin Erb’s palsy treatment as soon as possible following the injury. Erb’s palsy treatment options include surgery as well as non-surgical therapies.
The BMJ states that the “treatment of Erb’s palsy has been evolving. Different centers recommend different treatments for different reasons, but the overall goal is to maximize the use and function of the arm.”
Treatment Timeline for Erb’s Palsy
Your doctor will recommend a treatment plan that is best for your child’s particular case. Below are some specific Erb’s palsy treatment recommendations from this published research.
Initial Erb’s Palsy Treatment
- 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 affected arm into the sleeve first, then head and then unaffected arm
Erb’s Palsy Treatment Beginning at 2 Weeks of Age
- Physical therapy instruction for parents
- Gentle passive motion of joints
- Daily home-based stretching and exercise
- Weekly or bi-weekly formal physical therapy
- Monthly follow-up at clinic
- Adaptive equipment like splints to prevent contractures
Erb’s Palsy Surgery
Choices about appropriate Erb’s Palsy surgery must be individualized. Some severe conditions clearly call for surgery, and some experts recommend very early surgery. Surgery can help improve range of motion in some but not all children.
Surgery for children under 5 includes muscle lengthening, muscle transfers, nerve reconstruction or reconnection and bone remodeling. Surgery for children over the age of 7 usually involves the bone. However, nerve reconstruction or reconnection surgery is very controversial.
No standardized treatment is recommended at this time.
Erb’s Palsy Treatment for After 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 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, he or she will run a series of Erb’s palsy tests to confirm a diagnosis. Erb’s palsy tests can help determine the extent of the baby’s injury and his or her chances for recovery.
Common Erb’s Palsy Tests
Erb’s palsy tests can include:
- X-ray of the neck
- Nerve conduction tests (NCV/EMG)
X-rays and MRIs are used to learn 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.
Fortunately, most cases of Erb’s palsy are mild and will not result in lifelong disability. Regardless of what the Erb’s palsy tests reveal, therapeutic treatment is crucial in speeding up recovery.