q Erb’s Palsy – What It Is, How It Happens, and How It’s Treated - Harcourt Health

Erb’s Palsy – What It Is, How It Happens, and How It’s Treated

If you are pregnant and have been swapping stories with other moms and moms-to-be, you may have heard of brachial plexus injuries. One of the most common of these birth injuries is called Erb’s palsy. It sounds scary, but how serious is it, and is there anything you can do to prevent it from occurring? Read on for answers to some frequently asked questions about Erb’s palsy.

What Is Erb’s Palsy? 

Erb’s palsy is a type of brachial plexus palsy. “Palsy” means weakness, and the brachial plexus is a network of nerves leading from the neck to the arm. So this medical term simply describes a problem with the arm that can range from weakness, soreness, or limited range of motion to complete paralysis. 

Erb’s palsy results from a nerve injury that occurs during vaginal birth. This injury occurs when the infant’s neck, head, or shoulders are pulled or stretched as they emerge from the birth canal. The nerves in the brachial plexus can be torn or stretched.

What Are the Risk Factors? How Common Is This Condition?

High birth weight, presentation of the baby in a breech presentation, or prolonged labor are a few of the risk factors for Erb’s palsy. Forceps and vacuum extractions that are not performed properly may also result in this condition. A brachial plexus injury can occur to any baby, however, if his or her shoulders become wedged within the birth canal or if the head is stretched to the side during birth (or even in the prenatal period).

“Erb’s palsy occurs in about one or two out of every 1,000 births,” explains John A. Lancione, a birth injury attorney with The Lancione Law Firm. “It’s more common than you might think, despite the fact that it’s not an injury that many people have heard of.”

Is Erb’s Palsy Serious? Is It Permanent?

Erb’s palsy can be permanent, but most often it is temporary. In the mildest cases, the tearing or stretching resolves on its own over the first few months of the infant’s life.  The child recovers both feeling and normal movement in the arm, and no further treatment is required.

If there are still signs of the condition at the child’s six-month check-up or anytime thereafter, continued treatment may be necessary. 

How Are More Serious Cases Treated?

Physical therapy and occupational therapy are often effective in moderate cases of Erb’s palsy. Physical therapy combines exercises and gentle massage to help strengthen the child’s muscles, as well as to improve immobility or stiffness. Together, these treatments help improve the infant’s ability to move and operate his arm and hand, and therefore to continue developing normally.

Occupational therapy, similarly, helps the child develop joint function and muscle tone in the affected arm. It may also focus on practical applications of movement, like picking up a toy or using the arm to crawl.

Lastly, surgery may be necessary in the most severe cases of Erb’s palsy. This usually entails a nerve graft to the damaged nerve. Experts recommend performing the surgery as early as is feasible, for the best possible outcome. Surgery will be followed up with physical and occupational therapy to help the child develop mobility and strength.

What Are the Outcomes?

Nerves regenerate very slowly, so if the baby has undergone nerve-graft or nerve-transfer surgery, it may take a while — months, or even a year or longer — for those muscles in the brachial plexus area to reach the muscles of the forearm and hand. It’s important to continue the recommended therapies and to be patient with the child’s progress.

In addition, there may be some lingering weakness in the shoulder, arm, and hand. Future surgeries may be required. However, remember that many Erb’s palsy patients do make a full recovery in time.