A Focus on Bells Palsy

Many patients visit their osteopath when they are in need of reassurance, it’s not uncommon for an osteopathic patient presenting with left sided chest and arm pain to confess that they thought they were having a heart attack and indeed it’s the osteopath’s job to discern whether the pain they are experiencing is in fact musculoskeletal in origin.

Because of the osteopath’s primary position within the community, patients present with all manner of problems. Today we will focus on Bell’s Palsy: what it is and how it can be treated.

Bell’s Palsy is defined by the National Institute of Neurological Disorders and Stroke (NINDS) as ‘a form of temporary facial paralysis resulting from damage or trauma to one of the two facial nerves’.

Symptoms result from inflammation of the facial nerve (cranial nerve VII) within the facial canal and can often be due to a reactivation of the Herpes Simplex Virus (common cold sore) within the geniculate ganglion.

The condition usually affects one of the paired facial nerves – thus affecting one whole side of the face. The unilateral facial weakness (drooping) often causes significant distortion and is often alarming to patients as they can think that they’ve suffered a stroke. The thing that differentiates Bell’s Palsy from a stroke is that it affects all the facial muscles, including the forehead.

Symptoms often appear suddenly and reach a peak within 48 hours. The severity of the symptoms range in severity from a mild facial weakness to a total paralysis that might include:

• Aching around the ear (often first sign)

• Twitching, weakness, paralysis,

• Drooling eyelid, or excessive tearing,

• Drooling from the corner of the mouth,

• Dry eye or mouth,

• Impaired taste,

• The sufferer will have trouble drinking, eating and speaking due to the muscle weakness around the mouth.

The cause of Bell’s Palsy isn’t fully understood however, scientists believe it to be caused by a viral infection such as Herpes Simplex. Rarer causes of the condition can be due to: a middle ear infection, pregnancy and trauma, such as fractures of the petrous temporal bone (bone making up the skull).

The standard course of the condition is variable, some cases are mild and resolve without treatment in around 2 weeks, however, some cases are severe and require medication. The prognosis with any case of Bell’s Palsy is usually good. The extent of the nerve damage will determine the length of the recovery and most cases (with or without treatment) will recover completely within 3 to 6 months.

There are as yet, no cures for Bell’s Palsy, however, the most important factor in its treatment is elimination of the cause (if known). This is often combined with strong anti-inflammatories such as steroids which act to reduce the inflammation and swelling. To be effective, the course of steroids needs to be administered within 72 hours of the onset.

As well as medications advice on; caring for the eye on the affected side e.g. wearing an eye patch as well as facial exercises to be performed in front of a mirror can all be offered in the form of treatment in the acute stages.

An osteopathic approach to the management of Bell’s Palsy would be similar to that of orthodox therapy initially, i.e. discussing the events preceding the onset to try to incriminate a cause, alleviating the patients fears and talking through their concerns. They would then give similar advice on caring for the affected eye e.g. wearing an eye patch, as well as advising ways to help diminish any pain (pain killers) and to exercise the facial muscles.

In addition to this, some osteopaths might consider a natural approach to aid drainage of tears and decrease the inflammation.

Osteopathy will not cure a Bell’s Palsy, however, it may help to speed the recovery.

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Tags : muscle, pregnancy

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