BELL’S PALSY – How Our Physiotherapists Can Help

What is Bell ’s palsy?

Bell’s palsy is a temporary form of facial paralysis, affecting the nerves and muscle on one side of the face. This results in weakness of the muscles, causing obvious drooping of that side of the face. It typically occurs suddenly and with no obvious or known cause. It can cause varying degrees of paralysis and will typically begin to recover naturally and accelerated with the help of a physiotherapist. Recovery time-scale can vary anywhere from 3 weeks to 6 months, depending on severity.

What causes it?

The cause of Bell’s palsy remains unknown. However, it has been linked to the Herpes virus which causes cold sores, as well as the chickenpox and shingles virus, although this is not always the case.

The symptoms arise through inflammation or irritation of the 7^th cranial nerve. There are 43 facial muscles on each side of your face. The 7^th cranial nerve is also responsible for sensation to the front of the tongue, the sweat glands of the face and the tear ducts.

Signs and Symptoms

Usually a quick onset over the space of a few hours.

 It is important to note that these symptoms are also associated with the initial signs of a stroke. Therefore is vital that a person experiencing these symptoms seeks medical attention immediately to rule this out. 

Symptoms of Bell’s palsy include:

• One-sided facial droop – sagging eyebrow/ drooping mouth
• Inability to close the affected eye
• Altered sensation on one side of the face
• Over or under production of tears.
• Drooling
• Reduced taste
• Difficulty speaking
• Pain behind the ear
• Headache

Treatment

It is important to seek medical attention immediately to rule out more sinister causes of facial paralysis, such as stroke. It is also important to seek treatment quickly for Bell’s palsy to maximise your recovery.

Medical management can vary, however it is common to be prescribes steroids to reduce inflammation as well as anti-viral medication if there is a suspected viral link. The eye may also be taped closed for protection.

Physiotherapy treatment is an important part of recovery for Bell’s palsy, in order to regain the full power of the facial muscles as the nerve begins to regenerate.  

Your physiotherapist will begin with an assessment where they will review your medical history and current symptoms as well as a physical examination of your facial muscles. This will involve asking you to perform certain facial expressions.

Your physiotherapist will then work with you to regain the strength of the facial muscles, as well as the normal movement pattern required for facial expressions and functional movement such as blinking and eating. Achieving normal movement patterns is a crucial part of recovery as even if the muscles regain their full strength, they may not be able to function well if they do not work together effectively to achieve certain expressions or functions.

Physiotherapy Plan

A physiotherapy treatment plan for Bell’s palsy will involve:

• Advice around protecting the eye area.
• A progressive home exercise programme, instructed by your physiotherapist, and then performed independently at home a couple times per day. These exercises will then be gradually progressed by your physiotherapist as appropriate.
• Massage if necessary to release any tension build up in the muscles around the face, as well as teaching self-massage and release techniques to do at home.

If you have recently been diagnosed with Bell’s palsy, get in touch with your nearest Optimum Health Solutions clinic to book in with one of our physiotherapists!