Erb's Palsy: Causes, Symptoms, and Treatment
Medically reviewed by Harsha Moole, MD, Internal Medicine. Last reviewed: October 23, 2026.
What kind of doctor treats Erb's Palsy?
A pediatrician (a children's doctor) usually spots Erb's palsy in a newborn and can refer the family to specialists. These may include a pediatric physical therapist, a neurologist (a nerve doctor), or a surgeon who repairs nerves. A direct primary care or concierge doctor can be a first stop for an evaluation and can refer you to a specialist when needed.
What is Erb's palsy?
Erb's palsy is an injury to the upper part of the brachial plexus. The brachial plexus is a network of nerves that carries signals from the spinal cord to the shoulder, arm, and hand. These nerves help you move and feel. When they are damaged, the arm can become numb or paralyzed.
Many of these injuries happen when a baby's shoulders become stuck during delivery and the nerves stretch or tear. The injury comes in four types. In neuropraxia, the nerve is stretched but not torn. This is the mildest type. In a neuroma, the nerve tore and healed, but scar tissue presses on it. In a rupture, the nerve is torn, but not at its attachment to the spinal cord. In an avulsion, the nerve is cut or torn from the spinal cord. This is the most severe type.
Symptoms
Symptoms of a brachial plexus injury may include:
- A limp or paralyzed arm
- Lack of muscle control in the arm, hand, or wrist
- Lack of feeling in the arm or hand
- Sudden pain in the shoulder or arm that may sting or burn
In newborns, symptoms can be seen right away or soon after birth. A baby may not move the upper or lower arm or hand. The arm may be held straight at the elbow and against the body.
Causes and who gets it
These injuries can come from trauma, tumors, inflammation, pressure, athletic injuries, or nerves being stretched too far.
In newborns, the nerves can be hurt by pressure inside the womb or during a hard delivery. This can happen when the head and neck are pulled to the side as the shoulders pass through the birth canal. Pulling on the arm or pressing on a baby's raised arms in a breech delivery can also do it.
These things raise the risk in newborns: a breech delivery, a mother with obesity, a larger-than-average baby, and shoulder dystocia. Shoulder dystocia means the baby's shoulder is hard to deliver after the head has come out. This injury is less common than in the past.
How doctors diagnose it
A doctor starts with a physical exam. The baby may not move the upper or lower arm or hand. The arm may flop when the baby is rolled from side to side. The doctor also checks the collarbone for a break, and the baby may need an x-ray.
A broken collarbone can look like a nerve injury. The baby does not move the arm because of pain, but the nerves are not damaged.
Treatment
Treatment depends on how bad the injury is. Some injuries heal without treatment. Some babies injured at birth improve or recover on their own by 3 to 4 months of age. Most children recover some function through physical and occupational therapy, which help with movement and daily tasks.
In mild cases, the provider may suggest gentle massage of the arm and range-of-motion exercises. A pediatric physical therapist can help with these. A baby may need specialists if the damage is severe or does not improve in the first few weeks.
Medicines can help with pain. Some people need assistive devices, such as splints or braces. Surgery may be needed in some cases, such as avulsion and rupture injuries. Doctors may consider surgery if strength does not improve by 3 to 9 months of age. It may involve nerve grafts or nerve transfers. It is not clear whether this surgery helps, and healing can take many years.
Without full recovery, there can be lasting problems. Muscles can tighten in a way that may be permanent. Some people have permanent partial or total loss of function in the affected nerves.
When to see a doctor
Contact your provider if your newborn is not moving an arm. Sudden pain in the shoulder or arm, or a limp or paralyzed arm, also needs a doctor's attention.
How a direct primary care or concierge doctor fits in
A direct primary care doctor charges a flat monthly fee instead of billing insurance, while a concierge doctor usually charges more and often works alongside insurance. Either kind of doctor can check your child's arm movement, explain the plan, and help set up visits with a pediatric physical therapist or other specialists.
Common questions
Does Erb's palsy go away on its own?
It can, especially in babies. Some children injured at birth improve or recover on their own by 3 to 4 months of age. Other injuries last longer, and some cause lasting problems.
What is the difference between Erb's palsy and Klumpke palsy?
Erb's palsy affects the upper part of the brachial plexus. Klumpke palsy affects the lower part, which causes loss of feeling in the wrist and hand.
Does a C-section prevent Erb's palsy?
No. A C-section lowers the risk of this injury, but it does not prevent it. A C-section also carries other risks. Doctors use it more often when they worry about a hard delivery.
Does a baby with Erb's palsy need surgery?
Not always. Mild cases are treated with gentle massage and range-of-motion exercises. Surgery may be considered if strength does not improve by 3 to 9 months of age.
Sources
- NINDS - Brachial Plexus Injury
- MedlinePlus - Brachial Plexus Injuries
- MedlinePlus - Brachial plexus injury in newborns
Medical Disclaimer
This content is for general educational and informational purposes only and is not medical advice. It is not a substitute for professional medical advice, diagnosis, or treatment, and reading it does not create a doctor-patient relationship. Always seek the advice of your physician or another qualified health provider with any questions about a medical condition, and never disregard or delay seeking professional advice because of something you read here. If you think you may have a medical emergency, call 911 (or your local emergency number) immediately.
