Erb's palsy symptoms - Cerebral Palsy Guide

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Mild Symptoms
Severe Symptoms
Long-Term Effects
Symptom Management

Common signs and symptoms of Erb’s palsy

Erb’s palsy (also known as Erb-Duchenne palsy) is a birth injury caused by damage to the brachial plexus network of nerves during childbirth. This group of nerves connects the neck (clavicle) and torso (upper trunk) areas of the spinal cord to the arm.

Stretching or pulling on the brachial plexus network can cause significant damage and long-term or permanent symptoms affecting the use of the shoulder, arm, hand, and/or fingers.

An illustration of a baby with nerve damage on their left side. — Example of Erb's palsy

Symptoms of Erb’s palsy usually only affect one side of a newborn’s body.

Common Erb’s palsy symptoms include:

Limp arm
Muscle weakness
Numbness
Reduced grip ability
Partial or complete paralysis of the arm
Waiter’s tip (dangling arm with fingers curved upward)

The severity of Erb’s palsy symptoms can depend on the type and extent of the brachial plexus nerve injury. For example, a child might suffer from paralysis when the nerve is torn completely from the spinal cord, but might only experience numbness if the nerve is merely stretched.

If your child is showing symptoms of brachial plexus birth palsy, talk with one of our registered nurses to learn if their injury was preventable.

Mild Erb’s palsy symptoms

A child can develop mild Erb’s palsy symptoms when the brachial plexus nerves are stretched during birth. Mild types of Erb’s palsy stretch injuries include neuromas and neuropraxias.

Also known as “stingers” due to the burning symptoms they cause, neuropraxias occur when the nerves are stretched but not torn. Neuromas occur when nerve fibers are stretched enough to become damaged and cause scar tissue to form.

Mild Erb’s palsy symptoms include a burning sensation, muscle weakness, and/or numbness in the affected arm.

Thankfully, most mild cases of Erb's palsy usually resolve on their own around three months of age and do not have a long-lasting impact on a baby’s overall development. According to the American Academy of Orthopaedic Surgeons (AAOS), most babies diagnosed with Erb’s palsy will recover movement and feeling in the affected arm with daily physical therapy treatment.

Severe Erb’s palsy symptoms

Some rare cases of Erb’s palsy during childbirth can be more severe and can result in a wider variety of symptoms.

Ruptures and avulsions are the most severe types of brachial plexus injuries and cause more intense Erb’s palsy symptoms.

Ruptures occur when the brachial plexus nerves are torn and are no longer able to heal on their own. Avulsions are the most serious types of brachial plexus injuries and occur when the nerve root is completely torn from the spinal cord.

Severe signs of Erb’s palsy include:

Complete or partial paralysis in the affected arm
Muscle weakness
Significant loss of motion in the shoulder, arm, hand, and/or fingers

Physical therapy is the main treatment option to eliminate severe symptoms of Erb’s palsy. This treatment focuses on range-of-motion exercises to help babies regain strength and movement in the affected arm.

Cases of ruptures and avulsions can be treated with nerve graft or nerve transfer surgeries. These surgical treatments replace severely damaged brachial plexus nerves with healthy nerves.

Long-term effects of Erb’s palsy

Many cases of brachial plexus palsy do not have long-lasting consequences. According to a study by Dalhousie University and the IWK Health Centre in Canada, 80-90% of all children diagnosed with Erb’s palsy make a full recovery.

In rare cases, Erb’s palsy symptoms can cause several long-term effects and coexisting conditions due to the brachial plexus nerve damage.

Other long-term effects of Erb’s palsy include:

Contractures (tightened muscles, joints, or tendons)
Infant torticollis (stiffness of the head or neck)
Muscle atrophy
Stiff joints
Numbness

Many of these coexisting conditions can be managed with daily Erb’s palsy physical therapy.

Learn more about Erb’s palsy symptom management

It can be scary if your child is showing symptoms of Erb’s palsy. Thankfully, the majority of Erb’s palsy symptoms will resolve on their own, leading to a complete recovery for children.

If any of these apply, be sure to keep an eye out for Erb’s palsy symptoms:

You had a prolonged or difficult delivery.
Your child had a high birth weight of more than 8 pounds, 13 ounces (macrosomia).
Your child was born feet first (breech delivery).
Your child was stuck in the birth canal.
Your doctor used forceps or vacuum extractors.

The instances listed above are risk factors for developing Erb’s palsy symptoms. Early intervention and medical treatment can help your child make a full recovery from their condition.

To learn more about Erb’s palsy symptoms and treatments, download our free Erb’s Palsy Guide today.

Erb's palsy symptoms FAQ

What are common Erb’s palsy symptoms?

The most common symptoms of Erb’s palsy include muscle weakness, numbness, loss of range of motion, and partial or complete paralysis of the affected arm.

One side of the body is usually affected in most cases of brachial plexus palsy. Symptoms can vary in type and severity depending on the extent of nerve damage sustained during childbirth.

What does Erb's palsy look like?

Although every case is different, some children with Erb’s palsy may have a droopy, hanging arm or a waiter's tip. A waiter’s tip occurs when the child’s arm hangs low and their fingers point outward.

These Erb’s palsy symptoms can be corrected with daily physical therapy sessions to help children strengthen the affected arm.

Which nerves are affected in Erb's palsy?

The brachial plexus is affected in cases of Erb’s palsy. These nerves start at the neck and torso and connect to the arm.

Is Erb’s palsy curable?

Yes. In fact, about 80-90% of all children with Erb’s palsy make a total recovery. In rarer and more severe cases, children can manage their symptoms of Erb’s palsy with physical therapy and surgery.