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Erb's Palsy

What Is Erb's Palsy?

The brachial plexus is a group of nerves near the shoulder that control movement to the rest of the arm and hand. When these nerves are damaged, weakness, numbness or full paralysis can ensue. Erb's palsy (also called brachial plexus palsy) is a birth injury that is caused by damage to these nerves. It typically affects the upper portion of the arm, and results from too much pressure and pulling on a baby's head during delivery.

It is widely estimated that one to two out of every 1,000 babies suffer from this condition. Many babies recover in a couple of months on their own, or with the help of surgery. Others suffer permanent damage and live with weakened muscle movement throughout their lives. Sadly, these babies would have been perfectly normal and healthy had the injury not occurred.

Signs and Symptoms of Erb's Palsy

Erb's palsy is easily recognizable by the lack of movement or weakness in one of the arms. A normal newborn will have sporadic movements in the limbs as it learns to control the muscles. A baby with Erb's palsy, however, will not move the injured arm, or will not lift it as high as the other one. A doctor may do a test to determine whether there is any feeling, as paralysis is another sign of the condition. Typically, Erb's palsy symptoms will be present right away. However, it may take a couple of days to notice because prognosis is based on observations of a baby's movements.

Causes of Erb's Palsy

Erb's palsy most often occurs in difficult labor and deliveries, such as when a baby is too large to move smoothly through the birth canal, the baby is breech or the labor is delayed for whatever reason. In these situations, doctors may need to pull or apply some pressure to deliver the baby. The injury can result if the neck is stretched or the doctor does not take measures to free the shoulders and ensure a safe delivery. Although conditions for Erb's palsy to occur may be outside of anyone's control — such as if the baby is large — the injury is always caused by a medical error.

Treatment and Care

Many newborns suffering from Erb's palsy will recover naturally on their own with the help of daily physical therapy to work on muscle movement and control. It is important that parents also work with the baby's arm at home to keep the muscles limber and prevent the joints from stiffening. It can take up to two years for complete recovery.

Surgery is necessary in more serious cases to repair the damaged nerves. In most cases, surgery is not performed until the child is three to six months old, or later. Even with surgery, the nerves can take a long time to heal, if ever. Children with moderate Erb's palsy will most likely suffer limited arm movement throughout their lives. Further surgical treatment may be possible as the child ages; however, permanent repair is not likely possible. You will need to discuss with your doctor the prognosis for your child's specific injury.

If your child suffers from Erb's palsy, you will likely notice a significant difference in the use of one arm over the other. The lack of use may result in the injured arm being smaller than the other one. Consider long-term physical therapy to help your child gain the most use out of the arm as possible. Be supportive and encourage your child to participate in the same activities as other children. Be informative and explain to your child what the injury is and how it affects the arm. Most importantly, do what you feel is necessary to give your child as normal a life as possible.

The Birth Injury Team is a subsidiary of Silvers, Langsam & Weitzman, P.C., made up of experienced attorneys and medical professionals. Our lawyers have more than 100 years of combined experience handling birth injury cases. We are dedicated to helping parents understand their child's condition and guiding them through the process of securing the care and support they need. Located in Philadelphia, we serve clients across the United States.


Located in Philadelphia, Silvers, Langsam & Weitzman, P.C., home of MyPhillyLawyer, serves clients in Philadelphia County, Pennsylvania, and throughout the United States.

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