Erb’s Palsy Treatment

Erb’s palsy is a type of injury that occurs when a newborn suffers damage to the brachial plexus nerves that control movement in the shoulder, arm, and hand. These kinds of neonatal brachial plexus injuries often happen during difficult deliveries and may be the result of a medical mistake or error by a health care professional. However, it’s possible that Erb’s palsy treatment can help your child recover from this condition and its symptoms.

If a medical mistake led to your child’s injury, Sokolove Law may be able to help you recover compensation to pay for your child’s treatment.

Get a Free Erb’s Palsy Case Review

How to Treat Erb’s Palsy

The type of Erb’s palsy treatment a child needs will depend on several factors, including their age and the severity of the birth injury. Your pediatrician can give you a detailed picture of what needs to be done to help your baby lead a normal, healthy life.

With early treatment, there’s a very good chance your child may recover from Erb’s palsy. In fact, 70-80% of infants with Erb’s palsy see a full recovery within the first year of their life, with the number nearing 100% if treatment is started within the first four weeks of birth, according to Baptist Health.

Learn More About Your Options

Treating your child's Erb's palsy can be expensive. Thankfully, Sokolove Law may be able to help you pursue compensation that can help provide your child a better quality of life.

Contact Us

Therapies and Treatment for Erb’s Palsy

There are a variety of different treatment options for Erb’s palsy. There’s a very good chance your child will be able to make a complete recovery without the need for surgery. There are, however, some cases when surgery may be recommended or required.

Erb’s palsy treatment options often include:

  • Physiotherapy
  • Occupational therapy
  • Hydrotherapy
  • Botox injections
  • Neuromuscular electrical stimulation
  • Surgery

Erb’s Palsy Physiotherapy Treatment

Daily physical therapy is the most effective treatment for Erb’s palsy, according to Baptist Health. A physical therapist may conduct a physical examination of your child’s injuries and limitations to determine what may work best for their treatment and recovery.

After that, they often will establish a specific Erb’s palsy physical therapy protocol and outline the specific range-of-motion exercises that may help your child, because the parent or caregiver will need to take an active role in performing this protocol at home as well.

Typically, the goal of Erb’s palsy physical therapy treatment is to help:

  • Promote the recovery of your child’s muscle strength and range of motion
  • Prevent permanent muscle weakness and joint stiffening in the affected areas
  • Make sure the unaffected muscles continue to function normally
  • Increase the child’s awareness of the arm through sensory stimulation activities
  • Utilize splints or orthotics to prevent further complications from occurring
  • Inform parents on how to handle and care for their child to maximize their potential recovery

Physical therapy for a child is very different from physiotherapy treatment for Erb’s palsy in adults. Parents must be as gentle as possible in order to prevent further muscle damage or nerve injury.

Erb's Palsy Occupational Therapy Treatment

While physical therapy for Erb’s palsy is designed to improve a child’s ability to perform specific movements, occupational therapy focuses on helping both the child regain their strength and the parents perform everyday activities, like feeding them or changing their clothes, without causing further injury to their child.

Overall, occupational therapy for Erb’s palsy focuses on helping to:

  • Improve your child’s motor skills and arm function
  • Regain functional sensation in their affected arm
  • Protect the child’s arm as the injury heals
  • Teach parents how to perform gentle exercises on their baby’s shoulder, elbow, and wrist
  • Address any remaining tightness or weakness after the injury heals

Stages of Occupational Therapy for Erb’s Palsy

Depending on the severity of the injury and your child’s age, Erb’s palsy occupational therapy typically consists of five stages, according to The Permanente Medical Group:

  • Stage 1: Stage 1 of Erb's palsy treatment in newborns lasts for the first 2 weeks of their life. During this stage, the occupational therapist will show you how to hold your child correctly when changing diapers or dressing and feeding them.
  • Stage 2: The second stage will usually cover 2 weeks to 4 months of age, focusing on activities such as helping the baby develop age-appropriate skills like controlling their head and improving their upper arm strength and range of motion.
  • Stage 3: Stage 3 lasts from 4-6 months of age and helps show the baby how to use both arms simultaneously as well as other skills that are appropriate for this age range.
  • Stage 4: The occupational therapist will work to help the baby achieve certain developmental milestones, like crawling, walking, and standing. This stage typically occurs when the baby is 6 months to 1 year old.
  • Stage 5: This final stage focuses on developing motor skills and showing the child how to use both arms at the same time. The length of this final stage of occupational therapy depends on the severity of the condition. In extreme cases, it can last until the child is 4 years old.

Get the Help Your Child Deserves

You may be eligible for compensation. We may be able to help.

Get a Free Case Review

Hydrotherapy for Erb’s Palsy

Hydrotherapy is a form of therapy that uses water and aquatic exercise to help relieve pain and improve range of motion. Water provides resistance, which can help build strength.

A combination of hydrotherapy and other forms of physiotherapy can help boost motor skills in children with Erb’s palsy. For example, studies have found hydrotherapy can help increase a child’s range of motion by enhancing their ability to extend their muscles.

Botox Injections for Erb’s Palsy

Botulinum Toxin A or Botox is a type of drug that temporarily paralyzes the muscles it’s injected into. In cases of Erb’s palsy, Botox may be recommended with physical therapy if your child’s shoulder joint is tight or sitting in an improper position by the age of 4-6 months, according to the BC Children’s Hospital Research Institute.

Erb’s palsy often results in muscle tightness, inflexibility, and weakness in the affected arm, while the other arm develops normally. Over time, this imbalance in muscle strength and flexibility can affect the shoulder joint’s growth and movement. Botox injections for Erb’s palsy are used to help restore that balance.

Injecting your child’s tight muscles with Botox can help your physical therapy to:

  • Work on the positioning of the shoulder joint
  • Lengthen the tight muscles
  • Strengthen the weaker muscles

The effects of Botox are usually felt within 1-2 weeks and last about 3 months. As the affected arm gets stronger, it improves the chances both arms will eventually be equally strong.

Neuromuscular Electrical Stimulation

As a type of Erb’s palsy treatment, neuromuscular electrical stimulation (NES) uses mild electrical pulses to increase blood flow to the area and encourage muscle growth, which can help:

  • Stimulate feeling in the affected area
  • Strengthen the affected muscles and nerves
  • Increase the child’s range of motion

According to the results of one study, a group of children with Erb’s palsy who received NES in combination with physical therapy had a far greater range of motion than the group who underwent conventional physical therapy alone.

Surgical Treatment of Erb’s Palsy

If physical and occupational therapy isn’t enough to help with your child’s condition, a surgical procedure on the affected nerves may be needed instead. This is usually the case if a child doesn’t show any improvement after 3-6 months, according to the American Academy of Orthopaedic Surgeons (AAOS).

Some of the more common Erb’s palsy surgeries include:

  • Microsurgery: This involves the use of powerful microscopes and extremely small surgical instruments to try to repair the nerves affected by Erb’s palsy. Microsurgery can be undertaken as early as 3-6 months of age but isn’t as effective as the child ages, usually until around 18 months of age, when reinnervation may no longer be possible, according to Cincinnati Children’s Hospital Medical Center.
  • Nerve grafts: A nerve graft is performed by taking a nerve from a different part of the body and grafting or splicing it onto the damaged nerves in an attempt to repair them, according to the AAOS.
  • Nerve transfer: Similar to a nerve graft, nerve transfers involve using a nerve from a different muscle to restore partial function of the arm.

Pursue Compensation to Pay for Your Child’s Treatment

Over time, the costs of physical therapy, occupational therapy, Botox, surgery, and more can add up, easily becoming far too expensive for many families to afford.

What many families may not realize, however, is that an error made by your doctor or medical professional at the time of your child’s birth may have been responsible for causing their condition. For example, the doctor delivering the child may have used too much force when removing the baby from the mother’s birth canal, stretching the nerves in the baby’s neck and shoulder in the process and resulting in Erb’s palsy.

If this happened to your child, you may be eligible to pursue compensation that can cover the costs of your child’s treatment. Sokolove Law has helped families of infants injured at birth due to medical malpractice or negligence, recovering over $917 Million for these families over the last 45+ years.

Get a free case review or call (800) 995-1212 today to learn more about your options and see if we may be able to help with your case.

Erb’s Palsy Treatment FAQs

How can an Erb’s palsy lawsuit help me afford treatment?

Erb’s palsy can often be the result of a preventable injury to the brachial plexus nerves at the time of your child’s birth. During difficult deliveries, like in cases of breeches (when the child presents bottom-first) or shoulder dystocia (when the baby’s shoulder get stuck in the birth canal), the doctor may use excessive force or medical instruments like forceps to free the baby from the womb, which can stretch the baby’s neck and cause Erb’s palsy.

You may be entitled to compensation that can cover your child’s Erb’s palsy treatment if a medical mistake is to blame. Get a free case review today to learn more.

What is Erb’s palsy?

Also known as brachial plexus birth palsy, Erb’s palsy occurs when a network of nerves called the brachial plexus is stretched or damaged. These nerves are rooted in the spinal cord and are responsible for shoulder and arm strength and movement.

Many instances of Erb’s palsy occur in infants who have gone through a difficult delivery, particularly when the baby’s shoulders become stuck in the birth canal and the doctor uses excessive force when pulling the child out, stretching or tearing the nerves of the brachial plexus in the process.

Is Erb’s palsy permanent?

According to Baptist Health, 70-80% of newborns with Erb’s palsy fully recover within the first year of their life, and if treatment is started within the first 4 weeks of birth, the recovery rate climbs to nearly 100%. There are, however, some unfortunate instances when the symptoms of Erb’s palsy — namely, muscle weakness and nerve damage — are not caught in time and become permanent.

Is Erb’s palsy curable?

There are many types of treatment for Erb’s palsy that have a high rate of success. Physical therapy and occupational therapy are usually the first and most effective courses of action. If those don’t work, your child’s doctor may recommend surgery as well.

How long does it take for Erb’s palsy to heal?

In more mild cases of Erb’s palsy, 70-80% of newborns make a full recovery by 12 months old, particularly if treatment is started earlier. For others, the path to recovery can take much longer. If surgery is needed, recovery could take 18 months or more. In more severe cases, recovery may not be possible or may only be partial.

Is Erb’s palsy painful?

Most children experience numbness or weakness in the affected area or have difficulty moving the affected arm or shoulder, but in more severe cases of Erb’s palsy, discomfort or pain may be experienced.

Sokolove Law Team

Contributing Authors

The Sokolove Law Content Team is made up of writers, editors, and journalists. We work with case managers and attorneys to keep site information up to date and accurate. Our site has a wealth of resources available for victims of wrongdoing and their families.

Last modified: August 30, 2021

  1. Baptist Health. “Erb's Palsy (Erb Duchenne Palsy).” Retrieved from: Accessed on July 1, 2021.
  2. American Academy of Orthopaedic Surgeons (AAOS). “Erb's Palsy (Brachial Plexus Birth Palsy).” Retrieved from: Accessed on July 1, 2021.
  3. Physiopedia. “Erb's Palsy.” Retrieved from Accessed on July 1, 2021.
  4. The Permanente Medical Group. “Occupational Therapy for Erb’s Palsy.” Retrieved from: Accessed on July 1, 2021.
  5. Science Direct. “Hydrotherapy.” Retrieved from: Accessed on July 1, 2021.
  6. Skoutelis, V. “Hydrotherapy as an Adjunct to Physiotherapy Management in an Infant with Obstetric Brachial Plexus Palsy: a Case Report.” Retrieved from: Accessed on July 1, 2021.
  7. British Columbia Children’s Hospital Research Institute. “Botox injections.” Retrieved from Accessed on July 2, 2021.
  8. Cincinnati Children’s. “OTPT | Neuromuscular Electrical Stimulation (NMES).” Retrieved from: Accessed on July 2, 2021.
  9. Nigerian Quarterly Journal of Hospital Medicine. “Comparison of electrical stimulation and conventional physiotherapy in functional rehabilitation in Erb's palsy.” Retrieved from: Accessed on July 2, 2021.
  10. Nemours Kids Health. “Newborn Brachial Plexus Injuries.” Retrieved from: Accessed on July 2, 2021.
  11. Cincinnati Children’s. “Treatment for Brachial Plexus.” Retrieved from: Accessed on July 2, 2021.
  12. Los Angeles Nerve Institute. “Brachial Plexus Palsy: Erbs Palsy Treatment.” Retrieved from: Accessed on July 2, 2021.
  13. Boston Children’s Hospital. “Brachial Plexus Birth Injury.” Retrieved from: Accessed on July 2, 2021.