Erb’s Palsy Treatment

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.

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.

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 $905 Million for these families over the last 40+ 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.