One page summary: Erb's palsy

In two sentences

Erb's palsy is weakness of the shoulder and upper arm caused by injury to the upper nerves of the brachial plexus, at the C5 and C6 levels. It is the most common brachial plexus birth injury. ¹

The typical picture is an arm hanging at the side, turned inward, elbow straight, palm facing backward. The hand usually works normally, which is a good sign, because it means the lower nerves are intact. ²

The numbers, with their sources

• Which nerves. The upper roots, C5 and C6, and sometimes C7. These supply the shoulder and the bending of the elbow ²
• How common brachial plexus injury is overall. Around 1.5 per 1,000 live births in the United States ¹
• Why the hand matters. A normally working hand means the C8 and T1 roots are intact, which is the more favorable pattern ²
• Recovery. Most babies recover full or near-full function, and most of that recovery happens in the first months ¹
• The checkpoint. Failure to bend the elbow against gravity by around 3 to 6 months is the usual trigger for surgical evaluation ¹
• What cannot be skipped. Daily gentle range-of-motion movement, because a shoulder that stiffens limits the final result even after the nerve recovers ¹

What to do this week

1. Ask for the delivery note, including any shoulder dystocia note with maneuvers and times.
2. Get a therapy referral today and have the exercises demonstrated to you.
3. Ask whether the hand and the diaphragm are working.
4. Ask when specialist referral happens. If it has not been mentioned by 3 months, ask.
5. Ask whether the collarbone was X-rayed.
6. Film the arm weekly in the same position.
7. Request the complete records with the records request builder.

Questions to take with you

Take these with you. Write the answers down in the moment, because you will not remember them later.

For the specialist team

• Which nerve levels are affected, and what injury type do you suspect at each?
• What movements are you tracking, and what should I see by 3 and 6 months?
• At what point would you operate, and what would the operation be?
• Is there any sign of Horner syndrome?

For the therapist

• Show me the exercises and watch me do them.
• How often, and what does too much look like?
• How do we get my baby to use that arm?
• What position for sleeping and in the car seat?

You can also build a printable list with the question generator.

Where to read more

The full page on this condition covers how it happens, causes split into what happens even with perfect care and what is associated with gaps in care, signs by age, diagnosis, treatment, outlook, daily life and lifetime cost.

Read the full page on Erb's palsy

Related pages are listed at the bottom of it, including the events that can lead to this condition and the guides that cover therapy, school and money.