Physical Therapy for Bell Palsy

What's physical therapy for bell palsy?

Bell's palsy is a condition whereby the seventh cranial nerve becomes irritated. This nerve controls facial muscle movement, and any irritation can result in paralysis or weakness of the facial muscles. In the majority of cases the condition only affects one side of the face, and incidences of paralysis or weakness on the right and left sides of the face are approximately equal. So, what's physical therapy for bell palsy?

Bell's palsy affects between 30,000 and 40,000 Americans each year. Those between the ages of 20 and 40 are most likely to experience it, with pregnant women and diabetes sufferers at an increased risk.

What are the symptoms of Bell's palsy?

The symptoms of Bell's palsy are particularly fast-onset and can worsen drastically during the early stages of the illness. Most symptoms typically manifest during the first 203 days, although certain symptoms can take up to a fortnight to appear.

The most common symptoms include:

  • Drooping face (particularly on one side)
  • Muscle weakness and paralysis
  • Difficulty drinking or eating
  • Difficulty speaking
  • A running nose
  • Constantly stuffy nose
  • Difficult breathing out of the nostril on the affected side
  • Complete nostril collapse on affected side
  • Wrinkles on forehead disappear
  • Extra-sensitive to sounds
  • Excessive salivation
  • Reduced salivation
  • Swelling of the face
  • Diminished taste
  • Pains behind the ear on affected side

Some symptoms also affect vision, including:

  • Difficulty closing the eye on the affected side
  • Photosensitivity
  • Lower eyelid drooping
  • Tears don't coat the cornea
  • Drooping brow
  • Excessive tears, or lack or tears

What are the causes of Bell's palsy?

Healthcare professionals still do not completely understand how Bell's palsy affects people, although studies suggest that the reactivation of the HSV herpes virus is the blame. The herpes virus is also responsible for causing cold sores, and it is hypothesized that the same virus also causes the seventh cranial nerve to shut down.

Other potential causes include:

How physical therapy for Bell palsy helps

Anecdotal evidence suggests that facial exercises can be significantly beneficial in improving facial function for Bell's palsy sufferers.

The majority of long-term Bell's sufferers experience hypertonic muscles, spasms, cross-wiring and synkinesis, and each of these can contribute to the muscles developing inappropriate movements which may require corrective co-ordination via retraining them. In short, some muscles may be holding others captive, and these must be re-educated to allow the primary muscles to regain proper movement.

Physical therapy for Bell's palsy focuses on recreating the routine and relationship between the brain, nerve and muscle. To begin with, the goal is to try to regain the capability of voluntarily correcting muscle movement while focusing mentally on the actions involved.

Other a period of time, this physical therapy helps movements to become automatic and natural. It can be a lengthy process, but it's one that is ultimately beneficial for regaining muscular control.

Understanding the face, and how Bell's palsy affects it

Physical therapy for Bell palsy: Before embarking on any muscular exercises or physical therapy, it is important to familiarize yourself with the face, its nerves, muscles and the properties of each of these. A brief study of the anatomy of the face goes a long way it terms of helping Bell's palsy sufferers to isolate muscle movements and co-ordinate the movement of multiple muscles.

The key is to regain balanced, symmetrical muscular movements.

Bell's palsy physical therapy routine: what to expect

Because each case is different, a physical therapist should be able to highlight the particular issues affecting an individual with the condition and then tailor an exercise routine suited to their needs.

Many therapists make use of moist heat and massage combined with exercises designed to regain muscle control and strengthen muscles. Facial neuromuscular training can be a complex and highly-specialized field, and patience is important when working towards a recovery. Although it can be frustrating, time is key to correcting nerve and muscle issues.

Facial muscles need to be worked gently – the premise of physical therapy for Bell's palsy is not simply to regain movement, but to balance motions on the affected side of the face with the good side. Forcing movements so that the sides pull against each other can be harmful. It is therefore advised that a mirror is used when exercising facial muscles in order for the patient to have a visual example of their facial movements.

Last Reviewed:
July 11, 2017
Last Updated:
October 18, 2017