Erb’s Palsy, What Is It?

Erb’s Palsy is usually caused by a birth injury. Known also as Brachial Plexus Paralysis, the injury affects the primary nerves which control movement and feeling in a baby’s arm. It can cause partial or complete paralysis of the arms, depending on the extent of the injury.

What is the Brachial Plexus?

The brachial plexus is the group of five primary nerves which give movement and feeling to the arm. Shortly after coming out of the neck, these nerves come together to form the brachial plexus and run under the collarbone to about the level of the armpit, before dividing among the muscles and tissues of the arm. Ask your doctor to refer your child to an Erb’s Palsy specialist

Some babies with Erb’s Palsy recover on their own however others need early specialist intervention. Early testing is crucial to find out which nerves are damaged and the extent of the damage. Treatment in the first year of life can significantly improve recovery, so if you are worried your child to be seen by an Erb’s Palsy specialist.

What is the Treatment?

• Physiotherapy

• Occupational Therapy

• Hydrotherapy

• Nerve grafts

• Tendon or muscle release

Which nerves are affected?

Of the five brachial plexus nerves the C5 and C6 are most often involved. A classic sign of this is an elbow which does not bend and hand being held in a ‘waiters tip’ position, turning backwards. If all nerves are damaged, weakness or paralysis will affect the entire arm and hand. A limp hand is a sign of this. The baby may also suffer Torticollis, where they face away from their affected arm and are unable to face forward for any length of time. They may also suffer from sensory loss in the arm and hand.

What is the nerve damage?

If the nerve has only been mildly stretched, your child should recover quite quickly. The more that nerves are stretched or pulled apart, the weaker the muscle will be and the longer it will take to start working properly again. A nerve that has been severely damaged, but is still connected may heal, however scar tissue may form at the injury site and stop nerve messages getting to the muscles. A severed nerve cannot repair itself, so the muscles it controls are paralysed. Sometimes it is possible to mend the nerve surgically and restore some muscle function, though the child is always likely to be left with some residual weakness in their arm. In rare cases the nerve may be severed from the spinal column, a so-called avulsion and in these cases it is crucial that you consult a Brachial Plexus Injury specialist as soon as possible to discuss treatment.