Erb’s Paralysis: Complete Guide to Treatment and Physiotherapy
Erb’s Paralysis, also known as Erb’s Palsy, is a type of brachial plexus injury that primarily affects newborns but can also occur in adults due to trauma. At Johar Medicare in Johar Town, Lahore, we specialize in non-surgical management and physiotherapy of Erb's Palsy to improve outcomes in both children and adults.
What is Erb's Paralysis?
Erb's Palsy refers to weakness or paralysis of the upper arm caused by injury to the upper trunk of the brachial plexus (nerves C5 and C6). It results in limited movement of the shoulder and elbow.
Anatomy and Function
The brachial plexus is a network of nerves that originates from the spinal cord and controls the shoulder, arm, and hand. The upper part, particularly nerves C5-C6, control shoulder abduction, external rotation, and elbow flexion. Damage to these nerves leads to muscle weakness or paralysis.
Causes and Risk Factors
- Birth trauma due to difficult delivery or shoulder dystocia
- Large birth weight or prolonged labor
- Forceful pulling during childbirth
- Motorcycle or sports injuries in adults
- Fall on shoulder causing nerve traction
Signs and Symptoms
- Arm held against the body with internal rotation (“waiter's tip” position)
- Inability to move the shoulder or bend the elbow
- Weakness in hand grip (in some cases)
- Muscle wasting if untreated over time
Diagnosis
Clinical examination is the first step in diagnosing Erb's Palsy. Doctors may also recommend:
- Electromyography (EMG)
- Nerve conduction studies
- Ultrasound or MRI of the brachial plexus
Differential Diagnosis
- Klumpke’s Palsy (lower brachial plexus injury)
- Fracture of clavicle or humerus
- Cerebral palsy
- Shoulder dislocation
Treatment Options
Initial management depends on the severity of nerve injury. In most cases, conservative treatment is recommended for the first few months.
- Observation for spontaneous recovery
- Splinting and positioning
- Botox therapy (in selective cases)
- Surgical repair if no improvement in 6 months
Physiotherapy at Johar Medicare Johar Town Lahore
Our expert physiotherapists in Johar Town follow a customized Erb's Palsy rehabilitation plan including:
- Passive range of motion exercises to prevent joint stiffness
- Strengthening exercises for shoulder and biceps
- Functional electrical stimulation (FES)
- Tactile and sensory stimulation
- Mirror therapy for motor recovery
Home Exercise Program
We also educate parents on home-based exercises that support faster recovery. These include:
- Shoulder external rotation and abduction
- Elbow flexion and extension exercises
- Supination-pronation training
Recovery Timeline
Most infants with mild Erb’s Palsy show signs of recovery within 3–6 months. Complete recovery may take up to 1–2 years. The prognosis depends on early intervention and severity of nerve damage.
Prognostic Factors
- Age at which physiotherapy starts
- Severity and type of nerve injury (neuropraxia, axonotmesis)
- Response to initial therapy
- Family cooperation in home exercise
Prevention Tips
- Antenatal care to assess large babies or narrow birth canals
- Skilled birth attendance to manage shoulder dystocia
- Use of cesarean section when indicated
Why Choose Johar Medicare in Johar Town Lahore?
- Experienced physiotherapists in pediatric nerve injuries
- Personalized care plans
- State-of-the-art modalities and electrical therapy
- Affordable packages for long-term rehabilitation
FAQs – Erb's Paralysis
It is a type of brachial plexus injury involving C5–C6 nerves that causes weakness or paralysis in the upper arm.
Most commonly caused by birth trauma, shoulder dystocia, or injury from falls or accidents in adults.
Yes. Most mild to moderate cases recover with physiotherapy and regular monitoring.
Arm hangs by the side, rotated inward, and no active movement of the shoulder or elbow.
Yes, early and consistent physiotherapy improves movement and muscle strength significantly.
Mild cases recover in 3–6 months; severe cases may take 1–2 years or more with physiotherapy.
Shoulder ROM, elbow flexion, forearm supination, and tactile stimulation exercises.
It can be if left untreated. Early intervention improves the chances of full recovery.
Yes, due to motor vehicle accidents, falls, or sports injuries causing brachial plexus trauma.
Erb’s affects the upper brachial plexus (C5–C6); Klumpke’s involves lower nerves (C8–T1).
Johar Medicare in Johar Town, Lahore, offers specialized physiotherapy care for Erb’s Palsy patients.
Yes, FES helps improve muscle tone and nerve reactivation.
Yes. Muscle wasting, joint contractures, and permanent paralysis may occur.
Yes, gentle massage improves circulation and prevents stiffness but must be done by trained therapists.
Rarely. It typically affects one arm due to unilateral nerve injury.