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Erb’s Palsy

Erb’s Palsy, also know as Brachial Plexus Birth Palsy, is a condition that is caused by a complication of pregnancy and delivery. The Brachial plexus is a group of nerves that supply the upper extremities. Erb’s Palsy is the paralysis or weakness of the muscles of the shoulder, arm, and/or hand and is caused by damage to the brachial plexus. The severity of this condition depends on the location of the injury.

Erb’s palsy is known as waiter’s tip posture because of some of the common symptoms which include: Partial or complete arm paralysis, infant is unable to move the upper or lower arm and/or hand from the shoulder, the arm is limp, and held against the body, infant is unable to bend the elbow, decreased grip, Infant is unable to rotate the arm outward from the shoulder, arm numbness due to brachial plexus nerve damage. Treatment of Erb’s palsy should include a multidisciplinary team including

neurologists, orthopedic surgeons, neurosurgeons, physical and occupational therapists (OT), and social workers. An occupational therapist will conduct an evaluation to see the severity of the condition and how functional the affected arm is. OT’s work on the affected arm by performing gentle message, and strengthening and range of motion exercises. When necessary, an OT can make a splint to position the affected arm properly. In order for the child to benefit from therapy and be able to gain functional use of the affected arm the OT will instruct the parents of the child on a home exercise program. It is important for the parents to be involved and continue working on the child at home. The OT will also educate the parents on how to carry the child to prevent any further injuries of shoulder or elbow dislocations. An OT can recommend special equipment for the child to increase independence and improve quality of life.