From the Research
Management of Erb's palsy primarily involves a multidisciplinary approach focusing on physical therapy, which should begin as early as 3-4 weeks after birth, as supported by the most recent study 1 from 2019. This approach is crucial in preventing joint contractures and maintaining muscle elasticity. Key components of the management plan include:
- Gentle range of motion exercises performed several times daily
- Proper positioning techniques to avoid additional nerve stress, such as supporting the affected arm during handling
- Passive stretching exercises, sensory stimulation, and age-appropriate activities to encourage use of the affected limb Most cases (70-80%) resolve spontaneously within the first year with conservative management. For cases showing minimal improvement by 3-6 months, surgical intervention may be necessary, including nerve grafting, nerve transfers, or tendon transfers to restore function, as discussed in the study 1. Botulinum toxin injections may be used in some cases to address muscle imbalances, although the evidence for this is not as strong in the context of Erb's palsy specifically, but is supported by studies on similar conditions 2, 3, 4, 5. Regular follow-up with a pediatric neurologist and orthopedic specialist is essential to monitor progress and adjust treatment plans. Early intervention is crucial as nerve regeneration potential decreases with time, and the developing brain needs proper sensory input for optimal motor development and to prevent learned non-use of the affected arm. The importance of a multidisciplinary approach, including physical therapy, is highlighted by the study 1, which presents a case of Erb's palsy with a unique multidisciplinary approach to nonsurgical and surgical management, resulting in near normal functional recovery.