Top Bell's Palsy Fact Answered: Which Medical Professional To See, When Can I Start To Exercise? Work?, Does Acupuncture Help?, What Makes Bell's Palsy Recovery Worse?
What healthcare professionals can help me when I am dealing with Bell’s Palsy?
First and foremost, you should be evaluated by a physician. Most people will see their primary care physician/family doctor, or an Emergency or urgent care department physician. The goal here should be for a correct Bell’s Palsy diagnosis and prescription of steroids and antivirals.
Consulting with a facial specialist within the first 3 weeks after onset, especially if there are no signs of improvement, should be the next step. You can consult with:
An Otolaryngologist, or ENT( for ear, nose and throat doctor).
An Opthalmologist, especially if your eye is involved, you cannot blink, your eyes is irritated, itchy, red and painful. If your condition goes on for too long, an oculopastic surgeon ophtalmologist should be helpul
Neurologist: there exist many different type of neurologist and subspecialty and of course, I would recommend one with extra facial paralysis and conditions training
Physical / Physio Therapist ( that’s me , ).
I would be particularly picky in finding a PT with experience and training in treating Bell’s Palsy. A normal university PT curriculum does not teach facial muscles rehab to their student. Just ask when you contact them.
If you failed to progress after several months and still suffer with severe paralysis, consulting with a facial plastic surgeon would be helpful as they can help with recovery of facial movements and expressions
When Is It Safe To Return To Activity / Workout?
Common question people ask, wanting to make sure they won’t make things worse by exercising.
There exists many reasons to stay active and return to your exercise routine even if you suffer from facial paralysis.
But before we talk about exercising, let’s talk about rest:
-rest can be important as facial paralysis can be very taxing emotionally and physically.
Remember BP diagnosis and cause is linked to an exposure to a virus, during a time when your immune system was down.
So that would make sense that during this time you feel fatigue and tired.
BP affects people very differently, to different degrees, and rest might be necessary initially, just like when you have flu symptoms. That rest will help your body use energy to heal.
The key here is to listen to your body and do what you can. If you feel you are only mildly affected, i would suggest to continue your normal routine as much as possible. If you are exhausted, maybe taking some time off work might be necessary
Exercising and staying active remains to this day the single most important factors in keeping multiple body systems healthy: musculoskeletal, cardiovascular, respiratory, immune system amongst other...
Exercising helps release endorphins , which is your body’s own painkiller, and promote increased circulation. These could be needed with managing your Bell’s Palsy symptoms.
Exercising could also be a distraction from your current symptoms, and have been shown to help improve mental health.
The key here is to let your body guide you. Resume exercising and activity as early as you feel ready for it.
You might have to return progressively to it and that is ok.If you are normally sedentary and don’t exercise, going on walks should be beneficial and I would highly suggest it.
Common question: Should I get acupuncture treatment with a diagnosis of Bell’s Palsy? Can it help?
Studies have shown that acupuncture can help decrease inflammation and pain. Bell’s palsy can produce facial and neck pain and is an inflammation of the 7th cranial nerve. Hence, acupuncture could be a helpful modalities in treatment of BP.
Acupuncture assists with relaxation. Avoiding stress and striving to relax should be part of treating Bell’s palsy as symptoms are made worse by stress.
Studies have shown that the insertion of a needle can help start an immune reaction, which could boost healing of facial muscles and nerve.
Acupuncture is a fairly safe modality and can be used early on after onset of Bell’s Palsy.
Not to be negated, acupuncture could have a placebo effect, just from the fact of being treated. And if it is, so be it. Nothing wrong with that.
If you choose to try acupuncture, make sure you work with an acupuncturist that has training and experience with neurological condition
Predictors of recovery with Bell’s Palsy
Here are some data that might help predict your recovery from Bell’s palsy and can be a sign of more difficult recovery.
No significant difference between male and female, meaning your gender in itself does not seem to affect your chance of recovery
Bell’s Palsy can really take place at any age with a majority of cases between age 15 and 45. That said many experience Bell’s Palsy after 45. It is rare after age 60 but was found that full recovery tends to be more complicated and least likely.
Being diabetic, you have more chance of developing Bell’s Palsy, and that also puts you at more risk for a more difficult recovery. Possibly because healing tends to be slower in general in this population.
Obesity and hypertension have also been found to put you at more risk of developing Bell’s Palsy.
The incidence of developing Bell’s palsy during pregnancy for the expecting mother is also a known risk factors and also put her at more chance of a possible longer and more difficult recovery. Having preeclampsia during a pregnancy is also another risk factor
Upper respiratory problems, such as an infection, was also found to put you at more risk of developing Bell’s palsy. Anecdotally, I struggled with difficulty breathing and heavy coughing for a whole month about 3-4 months before I was diagnosed with my BP. I will of course never know for sure if that was the reason, but studies have shown a link between the two.
A relationship between experiencing significant pain upon onset of Bell’s palsy and a more difficult recovery has been shown.
Of course, just because you have any of the above does not mean you will experience or struggle with your recovery from it. What I would keep in mind is how important it is to be proactive and act early in your Bell’s Palsy treatment. Just like a stroke, BP is a neurological condition. Nerve heals very slowly, if ever. Time and waiting are not on your side when you suffer from Bell’s Palsy.
Find help to be guided, taught and cued with how to properly perform facial exercises, which one you should focus on, make this treatment tailored to your needs ( remember Bell’s palsy presents differently from one person to another). If you have been going over three weeks with no changes, you owe it to yourself to absolutely seek help if you expect to recover. Also remember that no improvement for 1.5 months is also a sure sign for a difficult recovery.
Facial exercises are an essential and necessary part of treating Bell’s Palsy correctly
Facial paralysis from Bell’s Palsy leads to weak and possibly unresponsive muscles due to inflammation of the facial nerve.
Facial exercises are essential in regaining facial motion, control and expression.
The problem resides once again from a lack of consistent and common consensus and treatment plan once the patient has been diagnosed with BP and prescribed steroids (and hopefully antivirals, as it has been shown that people prescribed with both recover quicker).
Mainly, some patients are recommended to start facial exercises, without any real guidance, and a vast majority are told to wait for steroids to do their magic.
Well, in regards to muscles function and physiology as well as recovery from a nerve injury and paralysis, it makes sense to start facial exercises early to increase your chance of full recovery
Most BP patients learn about these exercises after some online search, finding description and pictures on various site and on YouTube.
It is a start in the right direction.
The problem is that a vast majority are generic at best and do not address individual needs. Bell’s palsy manifest itself very differently in symptoms from one person to another.
The appropriate way to perform them often requires some modifications and cueing, proper direction and technique from a trained professional.
Many end up performing an oversimplified version of these which can lead to complication, incomplete healing and synkinesis.
Get Help With Your Facial Exercise!!
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Pierre-Yves Butheau, MPT, CMP has been a physiotherapist for 19 years and has a passion for helping people move better, return from and prevent injuries, as well as improve their function and quality of life. He has a strong interest in addressing the root cause of and treating neuro-musculoskeletal conditions while educating his patients with the knowledge to manage their conditions and prevent recurrence. Pierre also has a niche in treating Bell's palsy and temporomandibular joint dysfunctions.