Chiropractic Care of a Patient with Erb's Palsy with a Review of the Literature

Chiropractic Care of a
Patient with Erb's Palsy
With a Review of the Literature

This section is compiled by Frank M. Painter, D.C.
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FROM:   Clinical Chiropractic 2008 (Jun);   11 (2):   70–76

Joey D. Alcantara, Joel Alcantara, and Junjoe Alcantara

Research Director, International Chiropractic Pediatric Association,
Media, PA and Private Practice of Chiropractic,
San Jose, CA, USA

Background:   Descriptions of the inability of children to move their arms following birth have been recorded since the days of Hippocrates. In industrialized countries, the incidence ranges from 0.38 to 3.0 per thousand live births, making it a very common injury in neonates and a clinically common presentation. Sentinel observations by Erb (due to injury to the upper brachial plexus) and Klumpkey (due to injuries to the lower brachial plexus) now bear their names. Birth weight greater than 4000 g, the use of forceps and a very difficult delivery are just some of the risk factors involved. An alternative explanation for obstetric palsy may involve an irregular contour of the posterior pelvis of the mother causing impaction of the posterior shoulder of the fetus as it passes over the sacral promontory.

Although testimonials are replete in chiropractic on the successful care of patients with various pediatric conditions, documentation in the scientific literature is wanting. To address this issue, we provide the following case report as a first step towards establishing an evidence base for chiropractic management of the condition.

Case Presentation:   The patient was an 8-year-old female with medically diagnosed Erb's Palsy. She presented with the typical ‘waiter's tip’ deformity in the right arm. Since birth, the patient had restricted range of motion in the right upper extremity at all involved joints along with muscle rigidity despite long-term medical care. Her condition affected several aspects of her life including interpersonal processes with her peers at school and in her social environment.

Methodology:   Single case report.

Intervention:   The patient was cared for with site-specific, low amplitude, high velocity chiropractic adjustments (Gonstead Technique) to sites of vertebral and extravertebral subluxations as well as myofascial release of the right upper extremity.

Outcome:   Following 3 months of care, the patient's range of motion was bilaterally symmetrical and muscle tonicity had normalized. The patient was able to fully participate in social and sporting activities, including rock climbing.

Conclusion:   This case report demonstrates a single case in which a pediatric patient suffering from obstetric palsy (i.e., Erb's Palsy) benefited from chiropractic care.

Keywords:   Erb's Palsy; Birth trauma; Chiropractic

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