Klumpke’s Palsy
Help restore your hand strength, movement, and independence with personalised neurological rehabilitation designed around your individual recovery needs.
Contents
Take the First Step Towards Better Movement
Our experienced physiotherapists are here to help you improve mobility, regain strength, and move with greater comfort and confidence.
What is Klumpke’s Palsy?
Klumpke’s Palsy is a neurological condition caused by injury to the lower part of the brachial plexus.
The brachial plexus is a network of nerves that begins in the neck and travels through the shoulder into the arm and hand.
These nerves carry signals that control:
Shoulder Movement
Arm Movement
Forearm Movement
Wrist Movement
Hand Movement
Finger Movement
They also provide sensation to parts of the upper limb.
In Klumpke’s palsy, the lower part of this nerve network—most commonly involving the C8 and T1 nerve roots—is injured.
Because these nerves contribute significantly to the function of the muscles of the hand, the condition can lead to:
Weakness of the Hand
Difficulty Moving the Fingers
Reduced Grip Strength
Difficulty with Fine Motor Activities
In more severe cases, the hand may develop a characteristic position known as a claw hand deformity due to an imbalance between different muscle groups.
The severity of Klumpke’s palsy depends on whether the nerve has been:
Stretched
Compressed
Partially Torn
Completely Torn
Avulsed from Its Attachment Near the Spinal Cord
Some nerve injuries improve over time, while severe injuries may require specialised medical or surgical treatment.
What Are The Symptoms Of Klumpke’s Palsy?
Hand Weakness: The hand may have reduced strength and control.
Weak Grip: Holding or carrying objects may become difficult.
Difficulty Moving the Fingers: Bending, straightening, spreading, or bringing the fingers together may be affected.
Reduced Fine Motor Skills: Tasks such as writing, buttoning clothes, using utensils, typing, or picking up small objects may be difficult.
Claw Hand Appearance: In some cases, the fingers may develop an abnormal resting position due to weakness of certain hand muscles.
Reduced Finger Coordination: Movements of the fingers may be less controlled or precise.
Difficulty Pinching: Holding small objects between the thumb and fingers may be difficult.
Reduced Hand Muscle Bulk: Long-standing nerve injury may lead to wasting of the small muscles of the hand.
Numbness or Tingling: Altered sensation may occur in areas supplied by the affected nerves.
Forearm Weakness: Some movements involving the forearm may also be affected.
Wrist Weakness: Depending on the extent of the nerve injury, certain wrist movements may be weak.
Difficulty with Daily Activities: Dressing, grooming, eating, writing, working, and other everyday tasks may be affected.
Horner’s Syndrome: In severe injuries involving the T1 nerve root, signs such as a drooping eyelid and a smaller pupil may occur on the affected side and require medical assessment.
What Are The Causes Of Klumpke’s Palsy?
Klumpke’s palsy occurs due to injury affecting the lower brachial plexus.
Birth-Related Injury: In newborns, excessive stretching of the lower brachial plexus during a difficult delivery can cause injury.
Excessive Upward Pulling of the Arm: Sudden forceful stretching of the arm away from the body may injure the lower nerve roots.
Falls: Falling while holding onto an object or experiencing sudden traction on the arm may stretch the brachial plexus.
Road Traffic Accidents: High-energy trauma can cause significant nerve stretching or tearing.
Sports Injuries: Contact sports or accidents involving sudden force on the shoulder and arm may damage the brachial plexus.
Direct Trauma: Deep injuries or severe impact around the neck, shoulder, or upper arm may damage the nerves.
Shoulder Trauma: Certain severe shoulder injuries may involve traction on the brachial plexus.
Tumours or Masses: Rarely, a growth affecting the lower brachial plexus may cause similar symptoms.
Surgical Injury: In rare cases, injury or traction to the nerves may occur during certain surgical procedures.
The type and severity of the nerve injury strongly influence the expected recovery.
Diagnosis Of Klumpke’s Palsy
Medical History: A healthcare professional will ask about the injury, birth history where relevant, onset of weakness, sensory changes, and functional difficulties.
Physical Examination: The arm, wrist, hand, and fingers are assessed for posture, muscle strength, movement, muscle wasting, and sensation.
Neurological Examination: Reflexes, muscle function, sensory changes, and signs of nerve involvement are assessed.
Brachial Plexus Assessment: Specific muscle groups and movement patterns may be tested to identify the level of nerve injury.
Hand Function Assessment: Grip, pinch, finger coordination, and fine motor ability may be evaluated.
Electromyography (EMG): EMG can assess electrical activity in muscles and provide information about nerve-related muscle dysfunction.
Nerve Conduction Studies: These tests can help assess how electrical signals travel through peripheral nerves.
MRI: MRI of the brachial plexus, neck, or surrounding region may help identify nerve injury or structural causes.
CT Myelography: In selected severe injuries, specialised imaging may be used to assess possible nerve root avulsion.
Ultrasound: Ultrasound may be used in selected cases to examine parts of the brachial plexus and surrounding tissues.
Specialist Assessment: A neurologist, orthopaedic specialist, neurosurgeon, or peripheral nerve specialist may be involved depending on the injury.
Treatment Of Klumpke’s Palsy
Treatment depends on the cause, severity, location, and type of nerve injury.
Medical Monitoring: Some nerve injuries may be monitored over time to assess natural recovery.
Physiotherapy: Rehabilitation can help maintain joint movement, muscle flexibility, function, and physical independence.
Occupational Therapy: Occupational therapy may support hand function, self-care, adaptive techniques, and daily activities.
Splinting: Splints may be used to support the wrist or fingers and help maintain a functional hand position.
Range of Motion Exercises: Regular movement may help reduce stiffness and prevent secondary joint contractures.
Strengthening: Appropriate strengthening is introduced when muscle and nerve recovery allow.
Pain Management: A doctor may recommend medication or other treatment for pain.
Nerve Repair: Selected nerve injuries may require surgical repair.
Nerve Grafting: A damaged section of nerve may be reconstructed using a nerve graft in selected cases.
Nerve Transfer: A surgeon may redirect a functioning nerve to support recovery of a more important movement.
Tendon Transfer: In selected cases, tendons may be surgically transferred to improve hand function.
Post-Surgical Rehabilitation: Structured rehabilitation is important following nerve or reconstructive surgery.
Long-Term Functional Support: Adaptive equipment and rehabilitation strategies may help maximise independence where full nerve recovery is not possible.
What Is The Physiotherapy Treatment Of Klumpke’s Palsy
Detailed Neurological Assessment: At Pure Physio, rehabilitation begins by assessing muscle strength, active movement, joint mobility, sensation, hand posture, grip, pinch, coordination, and functional abilities.
Range of Motion Exercises: Gentle passive and active-assisted movements may help maintain mobility in the wrist, hand, and fingers.
Joint Contracture Prevention: Regular positioning and movement strategies may help reduce the risk of prolonged stiffness and abnormal joint positions.
Muscle Activation Training: Appropriate exercises may be used to encourage available muscle activation and movement control.
Progressive Strengthening: As nerve and muscle function recover, strengthening exercises may be gradually introduced.
Hand Function Training: Therapy may focus on gripping, pinching, releasing, reaching, and manipulating everyday objects.
Fine Motor Training: Activities may help improve finger coordination for tasks such as writing, buttoning, typing, and handling small objects.
Sensory Re-Education: Where appropriate, rehabilitation may help improve awareness and use of areas affected by altered sensation.
Neuromuscular Re-Education: Selected techniques may help improve muscle activation and coordination during functional movement.
Splint and Positioning Guidance: We provide guidance regarding the appropriate use of prescribed splints to support hand position and function.
Functional Activity Training: Rehabilitation focuses on meaningful daily tasks according to the person’s age, lifestyle, work, and goals.
Post-Surgical Rehabilitation: Following specialist treatment and medical clearance, physiotherapy can help restore movement and functional use of the arm and hand.
Home Exercise Programme: A personalised programme may be provided to support regular movement and rehabilitation between sessions.
Progress Monitoring: Strength, movement, sensation, and functional ability can be monitored and the programme adapted as recovery progresses.
Why Choose Pure Physio?
Individualised Neurological Assessment: We assess the specific pattern of nerve-related weakness, movement loss, sensation changes, and functional difficulties.
Personalised Rehabilitation Plans: Treatment is adapted according to the location and severity of nerve injury, stage of recovery, and individual goals.
Focus on Hand and Finger Function: Rehabilitation addresses the movements needed for grip, pinch, coordination, and everyday independence.
Safe Recovery Progression: Exercises are progressed according to available nerve recovery, muscle activation, and medical guidance.
Joint and Muscle Protection: We focus on maintaining mobility and helping reduce the risk of secondary stiffness or contractures.
Fine Motor Rehabilitation: Therapy supports practical skills required for writing, dressing, using devices, working, and handling everyday objects.
Functional Independence Focus: Treatment is centred around meaningful activities that matter in everyday life.
Support Before and After Specialist Treatment: Rehabilitation can support recovery during conservative management and following appropriate nerve or reconstructive surgery.
Integrated Care Approach: We work alongside recommendations from neurologists, orthopaedic specialists, neurosurgeons, peripheral nerve specialists, and occupational therapists when required.
Ongoing Progress Monitoring: Your rehabilitation plan can be regularly reviewed and adjusted as nerve recovery, movement, strength, and functional needs change.
Start Your Recovery Journey Today
Don’t let pain, stiffness, or reduced mobility affect your daily life. Get personalised physiotherapy care designed around your condition and recovery goals.