Erb’s Palsy Prognosis

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The prognosis for Erb’s palsy is typically favorable. Most children born with this condition will recover fully and experience little or no lasting effects. Erb’s palsy is a weakness or paralysis—to varying degrees—of the shoulder and arm. It occurs most often during childbirth, but older children and adults can develop this condition as well.

The cause of Erb’s palsy is damage to some of the nerves that make up a larger bundle called the brachial plexus. This is the collection of nerves that control the arms from the shoulders to the fingertips. [1]

When an infant is born, the nerves may get stretched—if the head or shoulder gets pulled too hard, for instance—and the extent of that stretching can cause anything from mild stress to extreme damage if it causes tears.

Most Infants Fully Recover from Erb’s Palsy

The good news for parents of a baby born with this kind of injury is that it is most likely not permanent. The prognosis is generally positive, with the majority of infants recovering fully in just three to nine months. This is because, in most cases, the injury to the brachial plexus nerves is mild.

During the birth process, these nerves may be stretched, which is more common in difficult deliveries, prolonged labors, and breech births, or when an infant is unusually large at birth. The stretching can cause some damage, but the effects are usually minimal.

When the injuries are minor, the affected areas can heal naturally with time and physical therapy.  It is only when a child has more severe damage, such as tearing of the nerves, that the prognosis is not as favorable. [2]

Treatment

Treatment for Erb’s palsy can help improve the prognosis for a child with the condition. Although most will recover fully from mild nerve damage, treatment with physical therapy gives every child with Erb’s palsy a chance at a better outcome.

For those with mild impairment, physical therapy can speed the natural healing process and give a child better sensation and movement in the arm even sooner. Physical therapy usually involves simple and gentle exercises, movement of the arm, range of motion, stretching, stimulation, and massage.

For an infant with more serious damage to the nerves, however, treatment may involve surgery. The decision for surgery usually comes after therapy and time fail to bring about adequate healing.

Surgery may involve relieving pressure on damaged nerves or using donor nerves to graft or completely replace the injured nerves. The prognosis after surgery varies, but physical therapy and time to heal can significantly improve the outcome.

For many children with damage severe enough to require surgery, the prognosis is not completely positive as these children may face some degree of lifelong impairment in function.

Lasting Effects of Erb’s Palsy

In the majority of cases of Erb’s palsy in infants, there is no lasting damage. You may not ever be able to tell that an adult had Erb’s palsy as a baby. Most infants end up with full use of the affected arm, no paralysis, and no permanent loss of sensation.

Some children with Erb’s palsy, on the other hand, will experience mild lasting effects. These could include having the affected arm end up slightly shorter than the other, or minor impairments in range of motion at the shoulder joint along with mild arm weakness.

Children with more severe cases of Erb’s palsy may end up with lasting deformities, paralysis, weakness, and greater limitation in the range of motion of one arm. Surgery is designed to correct these issues, but for some, there will always be a lingering effect of the nerve damage sustained at birth.

These children may also live with complications from Erb’s palsy. These may include weakness and paralysis, chronic tightening of the muscles forming contractures, shoulder dislocation, loss of sensation in the arm, and scoliosis of the spine.

Living with Erb’s Palsy

Even for children living with the lasting effects of Erb’s palsy, life does not have to be a major struggle. Continued physical and occupational therapy, the use of assistive devices, and even surgical options later in life can all promote better use of the arm and joints affected by Erb’s palsy. [3]

If you have a child with Erb’s palsy, you can help them learn to live with this mild disability by encouraging positive social interactions, activity, recreation, and getting involved. Promoting these positive factors will help your child develop self-esteem in spite of the disability.

Children living with Erb’s palsy need emotional support as well. Having a good support system, in the form of family and friends, is excellent for coping with any disability. It provides the child with a safe community in which to share and process feelings and fears. It is a place to turn when a child experiences challenges, such as teasing or bullying by other children. Having strong support can mean the difference between thriving and merely trying to cope with a disability.

Also very important for living with this condition is being around other children going through a similar experience. If you have a child with Erb’s palsy, it’s a great idea to get them to connect with other children who are also facing physical challenges.

You can find networks online or through your pediatrician that provide social groups for children with Erb’s palsy and other challenges. Being able to see other children with visible disabilities is crucial to your child’s self-esteem and ability to cope with being different from other children.

A disability like Erb’s palsy does not have to limit a child’s life in any significant way. If you provide the proper support, appropriate treatments, enjoyable social activity, and interactions with other disabled children, your child can thrive and have as great a life as any other. Even if the prognosis for your child does not include complete recovery, living with this condition can be very normal and successful.