Understanding Erb’s Palsy vs Klumpke’s Palsy

For Every Birth. For Every Baby. For Every Family.

Erb’s Palsy vs Klumpke Palsy – two common brachial plexus injuries that can occur during childbirth, and cause damage the nerves controlling the shoulder, arm, and hand. Damage to the nerves can lead to weakness, limited movement, or even paralysis.

Both Erb’s Palsy and Klumpke Palsy make everyday tasks challenging for adults and may slow the physical and emotional development of children. If you or your child is affected, contact Fletchers Solicitors. With over 30 years of experience supporting families in similar situations, we’re here to help when birth doesn’t go to plan.

In this article, you’ll learn about each condition, the differences between Erb’s Palsy vs Klumpke Palsy, the risk factors and long-term impacts, and how you can pursue compensation.

What is Erb’s Palsy?

Erb’s palsy is a nerve condition that can cause weakness or loss of muscle function in the shoulders and arms.

Also known as Erb-Duchenne paralysis, it affects the upper C5 and C6 nerves of your brachial plexus. This is a network of nerves running from your spine through your armpit, controlling movement and sensation in your shoulder, arm, and hand.

If you’d like to learn more about Erb’s Palsy, go to our Erb’s Palsy page.

What causes Erb’s Palsy?

Erb’s Palsy often happens during childbirth. Here are some of the more common causes:

• Difficult delivery: A challenging vaginal birth or C-section can put extra strain on your baby.
• Nerve stretching or tearing: When healthcare staff move the baby’s head to the side during delivery to help the shoulders pass through the birth canal, this might stretch or tear the brachial plexus nerves.
• Too much force: Sometimes, excess force is applied to the baby’s head and neck during delivery.
• Shoulder dystocia: When the baby’s shoulder gets stuck behind the mother’s pelvic bone, more force may be used to deliver the baby.

Erb’s Palsy can also occur in adults, usually as a result of a road traffic accident (commonly motorcycle accidents), playing contact sports, industrial accidents at work, knife or gunshot wounds, tumours, or complications during surgery to that spinal area (occasionally determined to be medical negligence).

Erb’s Palsy Symptoms

If you think you or your child has Erb’s Palsy, you might notice the following Erb’s Palsy symptoms:

• Weakness or paralysis: Difficulty moving shoulders, arms, or elbows. Bending the elbow and moving the arm away from the body can be nearly impossible.
• Numbness or tingling: There can be a loss of feeling in arms or hands.
• The “waiter’s tip” position: This is when the arm hangs by the side with the palm facing backwards and the fingers curled.

Erb’s Palsy Treatment

The good news is that there are Erb’s Palsy treatments available to help improve your or your baby’s movement and strength.

Physiotherapy and exercise are a big help with Erb’s Palsy. They can prevent stiffness and improve muscle function in the arm, hand, and wrist, and treatment normally starts at around three weeks of age. Other options include using splints, hydrotherapy, and Botox® injections.

Sometimes, surgery might be suitable, especially in more severe cases. An operation can repair your or your baby’s nerves (through grafts and transfers) and muscles.

Starting treatment early can improve mobility and reduce long-term effects. If you suspect you or your baby has Erb’s Palsy, speak with a healthcare provider as soon as possible.

What is Klumpke Palsy?

Klumpke Palsy is a condition that affects the nerves in your lower brachial plexus.

Also known as Klumpke’s Palsy, Klumpke’s paralysis or Dejerine-Klumpke’s Palsy, the C8 and T1 nerve roots that run from your spinal cord through your armpit and into your arm and hand are damaged.

As a result, you may experience weakness or paralysis in your forearm, wrist, and hand.

What causes Klumpke Palsy?

Klumpke Palsy can occur for several reasons, including:

• Breech deliveries: Babies positioned feet-first in the birth canal are at greater risk.
• Shoulder dystocia: As with Erb’s Palsy, your baby’s shoulder gets stuck behind the mother’s pelvic bone during delivery.
• Difficult vaginal births: This is more prevalent when forceps or vacuum extractors are used incorrectly.
• Maternal conditions: Diabetes, excessive weight gain during pregnancy, a previous child affected by the condition, or older birthing age increase the risks.
• High birth weight or prolonged second stage of labour: These factors increase the chance of injury.
• Adult trauma: Accidents, falls, sports injuries, and even tumours near the brachial plexus nerves can also cause Klumpke’s palsy.

Klumpke Palsy Symptoms

You or someone you know with Klumpke’s paralysis might experience:

• Weakness or paralysis: You feel this primarily in the forearm, wrist, and hand.
• “Claw hand”: This is when the hand curls in on itself, with the wrist and fingers flexed.
• Numbness: There is a lack of sensation in your lower arm and hand.
• Poor reflexes and stiff joints: These further restrict movement.

In some cases, you may also experience symptoms of Horner’s syndrome. This may include a drooping eyelid, a constricted pupil, and sweating on one side of the face only.

Klumpke Palsy Treatment

Treatment options for Klumpke Palsy are similar to those for Erb’s Palsy and include:

• Physiotherapy: This treatment can restore movement and strength to your arm, hand, and wrist.
• Neuromuscular electrical stimulation (NES): NES improves your blood flow and helps build your muscle back up.
• Splinting: This is highly effective at preventing joint stiffness while you regain your strength and range of motions.
• Surgery: In severe cases, you might need to undergo a procedure like a nerve graft, nerve transfer, or even muscle transfers.

Early treatment improves your chances of regaining as much function as possible and reducing the long-term effects of your injury. If you suspect Klumpke Palsy, consult your healthcare provider for the best options.

Erb’s Palsy vs Klumpke Palsy: Key Differences

Erb’s Palsy and Klumpke Palsy share a lot in common. Here’s a quick breakdown to help you understand the differences:

Erb’s Palsy vs Klumpke Palsy: Causes

Brachial plexus injuries, including Erb’s Palsy and Klumpke Palsy, often happen during childbirth when there’s physical stress or trauma to your baby’s neck and shoulder.

What causes the injury is the stretching and tearing of your child’s brachial plexus nerves. They’re responsible for the movement and sensation you feel in your arm.

There are always risks in childbirth but careful management of your labour can help reduce those risks.

How do these injuries happen during childbirth?

During delivery, your healthcare team might need to move your baby’s head to the side to help the shoulder pass through the birth canal. When the baby is in a difficult position or too much force is applied, the brachial plexus nerves can be stretched or torn.

Shoulder dystocia, where a baby’s shoulder gets stuck behind the mother’s pelvis bone, often requires extra force to free the baby, which adds to the risk.

Pulling too hard on the baby’s head, neck, or arm during delivery can lead to an injury when a baby is in a difficult position or in breech.

What are the common risk factors?

There is a selection of risk factors that can increase the chances of a brachial plexus injury such as Erb’s Palsy or Klumpke’s Palsy, including:

• Macrosomia: Bigger babies are harder to deliver, which raises the risk of injury.
• Prolonged or difficult labour: A long or complicated labour can increase the chances of nerve damage.
• Breech delivery: Babies in a breech position are more likely to experience brachial plexus injuries.
• Instrument use: Tools like forceps or vacuum extractors, while sometimes necessary, can raise the risk if healthcare professionals don’t use them carefully.
• Maternal factors: These include small maternal size, pelvic abnormalities, older maternal age, excessive weight gain, gestational diabetes, or a previous birth involving nerve injuries.

Other factors can include induced labour, carrying past the due date, and complications during vaginal births.

Erb’s Palsy vs Klumpke Palsy: Long-term Impact and Challenges

Brachial plexus injuries can lead to serious long-term issues if not treated promptly. The overall impact on you or your baby depends on the extent of the nerve damage and how quickly treatment begins. Make sure you attend every appointment during treatment.

Physical disabilities and limited mobility

If the damage is serious or left untreated, this can lead to partial or complete paralysis of the arm or hand. This will limit your range of motion in your shoulder, elbow, wrist, or fingers.

Over time, without proper stimulation, your muscles can weaken and shrink. This can mean, in severe cases, your joints become permanently stiff. If you develop the “claw hand” condition, this can significantly impair the functioning of your hands.

Emotional and psychological effects

Children with brachial plexus injuries are more likely to have low self-confidence and have to cope with anxiety and depression. Socialising, schooling, and taking part in leisure activities can be difficult and they might not be that interested in looking after themselves.

In adults, a traumatic brachial plexus injury may lead to depression and PTSD, among other effects. (SOCAL Brain & Spine Surgery)

Social and educational barriers

Limited mobility makes school and work harder. Children may not play sports or spend time with classmates during playtime. They may find learning and the process of getting work as an adult hard to handle.

Adults can withdraw from social interactions and develop anxiety, identity and body image issues. For children and adults, early and ongoing treatment can help improve outcomes.

Legal Avenues for Pursuing Klumpke or Erb’s Palsy Compensation

If you or your child developed Erb’s Palsy or Klumpke’s Palsy because healthcare providers didn’t deliver the standard of care, you may claim compensation.

You or your baby’s injury may have been caused by improper use of force during delivery or not dealing properly with risk factors like high birth weight, breech presentation, maternal diabetes or prolonged labour.

For adults who now have either condition, your injury may have been caused by medical negligence during a surgical procedure.

Pursuing a compensation claim

If you believe medical negligence led to your or your child’s Erb’s Palsy or Klumpke Palsy, get in touch with a brachial plexus injury solicitor.

They are specialist birth injury claims lawyers with the experience and knowledge of the law to bring the strongest possible case.

They will gather:

• Medical records: These show details about the pregnancy, labour, delivery, and any treatment given to you and your child
• Expert opinions: Independent medical experts will show that a breach of duty caused your injury
• Impact statements: Personal accounts of how the injury has affected your child’s life physically, mentally, and emotionally

Your solicitor negotiates a fair settlement on your behalf first, taking the other side to court if negotiations fail.

Why compensation makes a difference

Klumpke or Erb’s Palsy compensation isn’t just about money. It’s about helping you manage the challenges of a brachial plexus injury.

Here’s how it helps:

• A feeling of justice: You know that those responsible for the injury have been held accountable.
• Financial fairness: You’re not out of pocket through lost income or additional expenses associated with the condition if you or your partner have had to take time off work to manage the condition or seek medical services and therapy not covered by the NHS.
• Long-term stability: Funding for ongoing care needs, educational support, and your future life

Get in touch to start an Erb’s Palsy or Klumpke Palsy claim. 

Why choose Fletchers Solicitors?

Fletchers Solicitors has a dedicated Birth Injury Unit that specialises in serious birth injury claims, including Erb’s Palsy and Klumpke Palsy. If you’re an adult who is now living with Erb’s Palsy or Klumpke’s paralysis, our medical negligence team is waiting to help you.

We have a track record of success. We secured £320,000 for a baby with Erb’s Palsy caused by a birth injury and £1.4 million for a man with a brachial plexus injury from a motorbike accident.

Fletchers Solicitors works on a no win, no fee basis. You only pay if we secure compensation for you. We can also connect you with rehabilitation and medical specialists for physiotherapy, occupational therapy, speech and language support, and psychological care.

Start your claim here or call 0330 013 0252.

Erb’s Palsy and Klumpke’s Palsy lawyers

Recognised by The Legal 500, and Chambers & Partners, we have many legal professionals and their teams ready to represent you with your Erb’s Palsy and Klumpke Palsy compensation claims.

Trevor Ward – Partner & Birth Injury Team Leader

Trevor is an incredibly respected and knowledgeable solicitor with almost 40 years’ experience, dealing with complex, catastrophic birth injury cases. Throughout his illustrious career, he has recovered multi-million pounds in damages.

Sahida Patel – Partner & Head of Birth Injury

Sahida is a Partner and heads the Birth Injury Team in Leeds. She has over 27 years’ experience in representing claimants in complex and high value medical negligence claims, often involving birth injuries,  cerebral palsy or other brain injuries.

Additional commentary and legal insight provided by Associate Solicitor, Leanne Devine.