The prognosis for Erb’s palsy is typically positive. Most children born with this condition will recover fully and experience no lasting effects, or only very mild effects. Erb’s palsy is a weakness or paralysis—to varying degrees—of the shoulder, upper arm, lower arm, wrist, or hand, of either arm. It occurs most often during childbirth, but adults can develop this condition as well.
The cause of Erb’s palsy is damage to nerves called the brachial plexus. This is the bundle of nerves that controls the arms from the shoulders to the fingertips. 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 mild stress or extreme damage in the form of tears.
Most Infants Fully Recover from Erb’s Palsy
The good news for parents of a child born with this kind of damage is that it is most likely not permanent. The prognosis is mostly positive for this condition, with the majority of infants recovering fully in just three to nine months. This is because in most cases the damage caused to the brachial plexus nerves is mild.
A child being born may have these nerves stretched, which is most common in difficult births, long labors, and breech births, or when a child is unusually large at birth. The stretching can cause some damage, but it is usually minor.
The minor damage can heal naturally with time and with mild physical therapy. It is only when a child has more severe damage, such as tearing, to the brachial plexus, that the prognosis is not as favorable.
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 damage, physical therapy, as mentioned earlier, can speed the natural healing process and give a child better sensation and movement in an arm sooner. Physical therapy usually involves simple and gentle exercises, movement of the arm, range of motion exercises, stretching, stimulation, and massage.
For an infant with more serious damage to the nerves, treatment may involve surgery. The decision to use surgical treatment usually comes after physical therapy and time fail to lead to adequate healing.
Surgery may involve relieving pressure on damaged nerves or using donor nerves to graft or completely replace damaged nerves. The prognosis after surgery varies, but time to heal as well as physical therapy can improve the outcome. For many children with damage severe enough to require surgery, the prognosis is not completely positive. These children may face lifelong impairment.
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 of these infants end up with full use of the affected arm, no paralysis, and no permanent loss of sensation.
Some children, on the other hand, will experience some lasting effects of Erb’s palsy. This could be as mild as having the affected arm end up shorter than the other arm or mild impairments in the range of motion in the shoulder joint and mild arm weakness.
Those children with more severe cases of Erb’s palsy may end up with lasting deformities, paralysis, weakness, and limited range of motion in 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 tightening of the muscles and abnormal muscle contractions, bone deformities, shoulder dislocations, loss of sensation in the arm, and scoliosis of the spine.
Living with Erb’s Palsy
Even for children living with lasting effects of Erb’s palsy, life does not have to be a major struggle. Continued physical therapy, assistive devices, and even surgical options later in life, can all help promote better use of the arm and joints affected by Erb’s palsy.
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, and recreation, and getting involved. All of these will help your child develop self-esteem in spite of the disability.
Children living with Erb’s palsy need support as well. Having a good support system, in the form of family and friends, is great for coping with a disability. It provides a child with a safe community in which to share 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 simply coping with a disability.
Also very important for living with this condition is being around other children who are going through the same or similar experience. If you have a child with Erb’s palsy it’s a great idea to get her to connect with other children like her.
You can find networks online or through your pediatrician that provide social groups for children with Erb’s palsy and other disabilities. Being able to see other children like her is so crucial to your child’s self-esteem and ability to cope with being different from most other children.
A disability like Erb’s palsy does not have to limit a child’s life in any significant way. If you provide your child with the proper support, appropriate treatments, good social activity, and interactions with other disabled children, she can thrive and have as great a life as any other child. Even if the prognosis for your child does not include complete recovery, living with this condition can be as normal as any other child’s life.