Erb’s Palsy Therapy

Quick Answer

Erb’s palsy is often treated with noninvasive and gentle therapy. With the help of therapy, most children with Erb’s palsy completely recover within the first year of life. Ongoing therapy through childhood and beyond can help your child adapt to any remaining movement limitations and live happily.

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Therapy for Erb’s Palsy Explained

Therapy for Erb’s palsy is a nonsurgical treatment to restore function and sensation to the affected arm. This treatment is highly recommended for Erb’s palsy because of its high success rate.

Erb’s palsy is caused by damage to a specific cluster of nerves responsible for controlling the arms and hands. Therapy is the most common form of treatment for this condition. Therapy helps children maintain arm strength and shoulder flexibility while encouraging the regrowth and repair of damaged nerves.

A variety of Erb’s palsy therapies are performed by occupational therapists, physical therapists, massage therapists and surgeons. Parents also play a crucial role in keeping their baby’s arm strong as the damaged nerves heal.

Babies should begin therapy as soon as possible for the highest chance of successful recovery. Since the condition is often diagnosed at birth, treatment typically begins when children are 3 weeks old.

Although it can be scary to learn that your child has Erb’s palsy, the majority of cases heal in 6 to 12 months with the help of therapy.

Therapy for Erb’s palsy includes a variety of therapeutic strategies, including:

  • Range of motion exercises
  • Strengthening exercises
  • Training kids to use adaptive equipment
  • Massage therapy
  • Electrical stimulation of the muscles
  • Botox therapy

Many of these therapies (such as exercises) are performed daily with help from therapists. Therapists also teach parents how to support their child and perform exercises at home.

Without therapy, the muscles in the arm can become extremely weak from disuse. This may cause permanent loss of muscle strength and tendon flexibility in the arm. Delaying therapy for Erb’s palsy can make it harder for children to take care of themselves or participate in activities as they grow.

What are the Goals of Therapy for Erb’s Palsy?

The overall goal of therapy is to repair the nerve damage and help the child use their arm properly. Therapy for Erb’s palsy helps the damaged nerves heal without, or in addition to, surgical intervention. For the first 6 months of treatment, the aim of therapy is preventing functionality problems from becoming permanent disabilities.

Erb’s palsy therapists often seek to:

  • Keep the arm muscles strong
  • Ensure arm tendons remain flexible
  • Prevent arm joints from becoming stiff
  • Help babies avoid further injury
  • Teach children skills to cope with movement limitations in the long-term

Ideally, therapy will help your child regain function of their arm before they turn 1—this is the case for 80% to 90% of children. How well your baby recovers in the first few weeks following birth often determines if they will make a full recovery. Still, anywhere from 3% to 25% of children with Erb’s palsy have some level of permanent impairment.

Long-term therapy will teach your child the skills they need to gain independence and engage in healthy, fun activities despite their limitations.

If your doctor is not satisfied with your child’s rate of improvement in therapy, they may recommend surgery to repair the damaged nerve. Although this sounds serious, surgery tends to be very successful at restoring arm function. In addition, therapy after surgery is essential for maintaining the arm’s muscles, tendons, tissues and joints until the damaged nerve heals.

Types of Therapy for Erb’s Palsy

Since children with Erb’s palsy can have a variety of symptoms, ranging from mild arm weakness to complete paralysis, there are several options for therapy.

Physical Therapy

Physical therapy focuses on stimulating and strengthening the child’s arm through different exercises. Therapists will also recommend activities that parents can continue at home. As your child grows up, your physical therapist may guide them through developmental activities like crawling or playing.

Adaptive equipment may also be used to help children engage in daily activities and play. For example, splints and braces hold the arm in place to prevent it from injury. Additionally, adaptive scissors, sports equipment and writing aids can help children enjoy a wide variety of activities.


When the nerves are more severely damaged, or the baby has other physical injuries, experts may recommend hydrotherapy. Hydrotherapy is done in water and is very low-impact on the child’s body. Research shows that hydrotherapy can help children maintain their range of motion in shoulder joints and recover control over their affected arm.

Occupational Therapy

Occupational therapy is recommended for children with mild to moderate Erb’s palsy. This therapy helps children engage in everyday self-care and leisure activities. Occupational therapists are trained to recognize the limitations your child may face in their daily lives and help them develop age-appropriate skills.

Massage Therapy

Massage therapy is used to relax the muscles and increase blood circulation in the affected arm to keep it functioning properly. However, it’s also used on older children and adults to treat pain that results from neck, shoulder or arm tightness.

Neuromuscular Electrical Stimulation

Neuromuscular electrical stimulation (NMES) uses electrodes (electrical conductors) to send a small electrical current to the muscles affected by Erb’s palsy. Electrical currents increase blood flow to the muscles, encourage muscle growth and prevent muscles from becoming permanently weakened. Research suggests that NMES is especially helpful when combined with physical therapy.

Botox Therapy

Doctors recommend botox therapy when a child’s shoulder joint is tight or sitting in an improper position. Botox is injected into tight muscles by a plastic surgeon or orthopedic surgeon, temporarily paralyzing them so the arm can be positioned correctly. The treatment is not painful and may even relieve your child from discomfort.

What to Expect With Therapy for Erb’s Palsy

Therapy for Erb’s palsy is noninvasive and very gentle on your baby. Therapists are highly trained and know how to carefully strengthen your baby’s arm without causing further injury. Parents play an important role in their child’s therapy and are expected to perform exercises at home to encourage healing.

Your child’s therapy may involve a combination of different therapeutic approaches, including:

  • Gentle stretching of the arm
  • Games and low-impact activities to encourage your child to use their arm
  • Helping your child to sit up and crawl
  • Teaching parents how to hold and position the baby to prevent injury to their arm
  • Development of fitness and diet to continue progress

One of the most important things for parents to remember is that therapy is a long-term solution. Your therapist will continue to work with your child as they grow to help them participate fully in childhood activities and day-to-day life. This will help your child feel included in society and family life at home.

If therapy isn’t effective in helping your child regain function of their arm, your doctor or therapist may recommend surgery. In this case, your child should return to therapy soon after.

Fortunately, young children are very adaptable to mobility limitations and find many ways to work around these problems.

Financial Compensation for Erb’s Palsy Therapy

Erb’s palsy is a birth injury caused by excessive stretching or tearing of nerves in the neck during delivery. It can often be avoided with proper medical care. If a preventable mistake during birth caused your child’s disability, you may be able to file for legal compensation. This can help you pay for therapy and ongoing support for your child’s condition.

An attorney experienced in Erb’s palsy cases can help you better understand your situation from a legal perspective. Contact the Birth Injury Justice Center today at 800-914-1562 and receive a free medical case review.

Birth Injury Support Team

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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