What is Erb's Palsy?

Erb’s Palsy, causes, symptoms, diagnosis, treatment and prognosis

Erb’s Palsy, also known as Erb-Duchenne Palsy, is a form of brachial plexus injury that primarily affects newborns during childbirth, but it can also occur in adults due to trauma. It involves damage to the upper nerves (specifically C5 and C6) of the brachial plexus, a network of nerves that sends signals from the spinal cord to the shoulder, arm, and hand.

🧠 What is Erb's Palsy?

Erb’s Palsy is a neurological condition characterized by partial or complete paralysis of the arm due to injury to the upper brachial plexus nerves. The affected arm may appear limp or weak, and the child may have difficulty moving the shoulder or elbow.

📍 Causes of Erb's Palsy

Erb's Palsy usually occurs during difficult labor or delivery, especially when there is:

  • Shoulder dystocia (baby's shoulder gets stuck during birth)

  • Large baby size (macrosomia)

  • Prolonged labor

  • Use of forceps or vacuum extraction

  • Pulling or stretching of the baby’s neck

In adults, causes can include:

  • Trauma from accidents

  • Falls or sports injuries

  • Gunshot or stab wounds

⚠️ Symptoms of Erb’s Palsy

The symptoms depend on the severity of nerve injury:

  • Weakness or paralysis in one arm

  • Decreased grip strength

  • Loss of sensation in the arm

  • Arm hangs by the side and is rotated inward

  • Inability to move the shoulder or elbow

  • “Waiter's tip” position: arm hangs with palm facing backward

🧪 Diagnosis

Diagnosis is based on:

  • Physical examination

  • Medical history (especially birth history)

  • Imaging tests like MRI or ultrasound

  • Electromyography (EMG) to assess nerve and muscle activity

🛠️ Treatment Options

Treatment depends on severity and age of the patient:

🔹 Non-Surgical Options:

  • Physical therapy – to strengthen muscles and improve range of motion

  • Occupational therapy – for functional activities

  • Stretching exercises – to prevent stiffness

🔹 Surgical Options (for severe cases):

  • Nerve grafts or transfers

  • Muscle/tendon transfers

  • Surgery is considered if there’s no improvement by 6–12 months

🔄 Prognosis and Recovery

  • Mild cases often improve without surgery in 3 to 6 months

  • Severe cases may require long-term therapy or surgery

  • Early diagnosis and intervention significantly improve outcomes

✅ Key Points

  • Erb’s Palsy affects the upper arm due to brachial plexus injury

  • Most common in newborns after difficult delivery

  • Early treatment is essential for full recovery

  • Symptoms range from mild weakness to complete arm paralysis

❓ FAQs About Erb's Palsy

🔸 Can Erb’s palsy be cured?

Yes, especially in mild cases with early therapy. Some severe cases may require surgery.

🔸 Is Erb’s palsy permanent?

It can be, but with treatment, many children and adults recover full or partial function.

🔸 How can it be prevented?

Careful monitoring during childbirth and avoiding excessive pulling on the baby's neck during delivery may help reduce risk.


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