Standing Up For You

What should you know about Erb’s palsy?

Erb’s palsy is a serious neurological condition that could paralyze one of your baby’s shoulders and arms, preventing both movement and feeling in the affected limb. 

The good news is that the American Academy of Orthopaedic Surgeons reports that Erb’s palsy occurs in fewer than 1% of U.S. births. In addition, many babies who sustain this birth injury respond well to daily physical therapy and range of motion exercises, ultimately regaining much, if not all, feeling and motion in the affected shoulder, arm, hand and fingers. Unfortunately, however, others face a lifetime of problems. 

Cause

Erb’s palsy, named for William Erb, one of the physicians who first described the condition, occurs when the nerves in and near your baby’s neck become stretched to the side during delivery. 

Risk factors

Your baby’s risk of Erb’s palsy increases under the following conditions: 

  • Your baby is unusually large at birth. 
  • Your baby delivers in a breech position, i.e., bottom-first or feet-first instead of head-first. 
  • You have a long or difficult labor. 
  • The doctor must use forceps or another forceful method to deliver your baby. 

Treatment

Daily physical therapy beginning when your baby is about three weeks old represents the main Erb’s palsy treatment. Your pediatrician or a physical therapist will show you how to manipulate your baby’s shoulder, elbow, wrist and hand to prevent these joints from becoming permanently stiff. 

Given that damaged nerves heal very slowly, however, it may take your baby as long as two or three years to regain full function in the affected limb. Unfortunately, some babies never do. Your pediatrician will closely monitor your baby’s progress and, if necessary, possibly recommend a surgical procedure such as a nerve graft or nerve transfer.