Bell’s Palsy: A Comprehensive Guide by a Singapore Chiropractor

Have you ever heard of Bell’s Palsy? Imagine waking up one day, and suddenly, one side of your face is not playing by the rules. We understand getting diagnosed with this condition is not easy, it can take a toll on your mental and physical health. However, knowing the disease and how it can affect your life can ease the discomfort a bit. Read on to learn what Bell’s palsy is, its causes, symptoms, treatment, and much more. A Singapore Chiropractor explains!

What is Bell's Palsy?

Bell’s Palsy is a neurological disorder that causes temporary facial paralysis. It is also known as acute peripheral facial palsy. The disease takes its name from the scientist, Charles Bell, who first described it in the 19th century. The stats show that almost 15 to 30 persons out of 10,000 develop Bell’s palsy.

It usually affects muscles on just one side of your face and rarely affects both sides. The weakness of facial muscles causes your face to droop or become stiff. You may find difficulty smiling and your smile might appear one-sided.

Furthermore, the eye on your affected side resists closing. The symptoms of Bell’s palsy appear suddenly and intensify within 48 hours. It can affect anyone, but most commonly it occurs between the age range of 15 to 60.  We know that the disease seems scary, but it’s not a serious condition and you can recover completely within 2 to 6 weeks.

elderly man with white hair holding his face in pain

Causes of Bell’s Palsy

The main cause of Bell’s palsy is the inflammation of the facial nerve (the seventh cranial nerve). As the name indicates, it is responsible for various functions related to facial movement and sensation.

We have two of these nerves, and each one carries nerve fibers to one side of your face. They control facial expression through muscles that help with smiling, frowning, and raising one eyebrow.

Additionally, it is responsible for the taste sensation of the front part of your tongue and for producing tears through controlling the lacrimal gland. It also innervates muscles in your ears and throat, thus helping with hearing and swelling.

Hence once your facial nerve is inflamed and swelled, it affects your ability to move muscles on your face. The exact cause is unknown, but experts in the industry believe that inflammation of the cranial nerve is caused by viral infection.

Some of the viral infections that result in Bell’s Palsy include:

  • HIV
  • Varicella- Zoster virus
  • COVID-19
  • Herpes Simplex 1
  • Epstein-Barr virus (mononucleosis).

Further triggers of Bell’s palsy include stress, weakened immune system, sleep deprivation, physical trauma, and autoimmune diseases. Lyme disease and damage to the myelin nerve fibers can also contribute to the swelling of facial nerves. Inflammation of the seventh cranial nerve results in reduced blood and oxygen supply to nerve cells, resulting in facial paralysis.

 

Risk Factors for Bell’s Palsy

Although Bell’s palsy can affect anyone with no gender or racial preference. However, literature shows that people with these conditions are at high risk of Bell’s palsy:

  • Pregnancy, especially in the last three months or a few days after birth
  • Diabetes
  • Preeclampsia, a condition characterized by high blood pressure in pregnancy
  • Obesity
  • Hypertension
  • Lung Infection
  • Mononucleosis
  • Shingles
woman with brown hair in striped top holding face in pain trigeminal neuralgia

Bell’s Palsy Symptoms

Symptoms of Bell’s palsy can vary in severity from mild weakness to facial paralysis. The more your facial nerve is exposed to inflammation and compression, the longer it will take you to recover from Bell’s palsy. Typically, the symptoms develop within 1 to 2 weeks of viral infection.

They come without any warning and reach peak severity within 48 to 72 hours. You may find it difficult to control full-face expression and your face may feel numb. Other symptoms include:

Never try to self-diagnose Bell’s palsy based on its symptoms as they are similar to the stroke. Instead, call your doctor right away to seek medical help.

Bell’s Palsy vs. Stroke

Both these disorders cause facial paralysis on one side of the face and have several similar symptoms, such as face drooping and difficulty closing the eyes. However, there are significant differences between the two conditions.

A stroke is an emergency condition that needs immediate medical attention. It is caused by the blockage of blood flow to the brain. Unlike Bell’s palsy which involves facial nerves, stroke can affect multiple cranial nerves.

If you feel numbness or weakness in your arms or legs in addition to facial paralysis, it might be a stroke. But whatever the symptoms, consult your healthcare professional right away if you feel sudden weakness on one side of your body.

young woman with dark hair holding her head in pain

Treatment for Bell’s Palsy

Bell’s palsy usually recovers on its own even if you don’t get treatment. However, your facial muscles might take several months to regain their strength. Here are some of the treatments that your healthcare provider can suggest to speed up the recovery:

1. Medications

Corticosteroids

Your doctor might prescribe you oral corticosteroids (prednisolone) to reduce the swelling and inflammation of the facial nerve. They provide the best results if started within several days of the onset of symptoms.

Analgesics

You might want to take analgesics, such as acetaminophen or ibuprofen for the pain associated with facial palsy. However, we recommend you consult your pharmacist before taking over-the-counter drugs to avoid any interaction if you are already taking prescription medicines.

Antivirals

Your doctor might prescribe you some antivirals (acyclovir)  if the viral infection is responsible for Bell’s Palsy. Studies suggest that a combination of corticosteroids along with antivirals is more effective in treating Bell’s Palsy.

2. Eye Care

If your eyes are affected, lubricating eye drops or eye patches can help you keep your eyes moist. Wearing an eyepatch is especially important to keep the dust and dirt out if you find difficulty closing your eyes.

3. Physical Therapy

Your healthcare provider might recommend physical therapy as it can strengthen your facial muscles and improve their function. Additionally, it can also stimulate facial nerves.

4. Surgery

Decompression surgery is used to relieve pressure from the facial nerve. However, it is usually not recommended as it increases the risk of permanent hearing loss and nerve damage. Further, reconstructive surgery might be needed to reduce deformity and correct damage.

Bell’s Palsy Prognosis

Bell’s palsy recovery time can vary based on the extent of nerve damage. However, its prognosis is usually good as more than two-thirds of its patients have a full spontaneous recovery.

Most people start to recover within 1 to 2 weeks after the appearance of symptoms and return to normal function within 3 to six months. However, symptoms persist longer in some cases and the disorder may reoccur on the opposite side of the face.

Bell’s Palsy Complications

The following complications may occur in the more severe cases of Bell’s Palsy.

  • Irreversible damage to the facial nerve
  • Irregular growth of nerve fibers
  • Corneal dryness leading to visual loss
  • Partial or complete blindness of the affected eye

Living with Bell’s Palsy

Besides taking medication, here are some of the tips that you can take to ease the discomfort associated with Bell’s palsy:

  • Use a straw to drink as it reduces the chance of dribbling water down your chin.
  • Use eye drops during the day to prevent dryness.
  • Always use lubricating ointment for eyes at night as it can make your vision blurry.
  • You can use surgical tape to close your eyelid when about to sleep.
  • Take rest and get plenty of sleep.
  • Don’t hesitate to talk to someone if you are feeling down about your appearance.
  • Maintain your oral hygiene, and be cautious to avoid biting your inner gum as it increases the risk of infection.

Treatment for Bell’s Palsy

Bell’s palsy usually recovers on its own even if you don’t get treatment. However, your facial muscles might take several months to regain their strength. Here are some of the treatments that your healthcare provider can suggest to speed up the recovery:

1. Medications

Corticosteroids

Your doctor might prescribe you oral corticosteroids (prednisolone) to reduce the swelling and inflammation of the facial nerve. They provide the best results if started within several days of the onset of symptoms.

Analgesics

You might want to take analgesics, such as acetaminophen or ibuprofen for the pain associated with facial palsy. However, we recommend you consult your pharmacist before taking over-the-counter drugs to avoid any interaction if you are already taking prescription medicines.

Antivirals

Your doctor might prescribe you some antivirals (acyclovir)  if the viral infection is responsible for Bell’s Palsy. Studies suggest that a combination of corticosteroids along with antivirals is more effective in treating Bell’s Palsy.

2. Eye Care

If your eyes are affected, lubricating eye drops or eye patches can help you keep your eyes moist. Wearing an eyepatch is especially important to keep the dust and dirt out if you find difficulty closing your eyes.

3. Physical Therapy

Your healthcare provider might recommend physical therapy as it can strengthen your facial muscles and improve their function. Additionally, it can also stimulate facial nerves.

4. Surgery

Decompression surgery is used to relieve pressure from the facial nerve. However, it is usually not recommended as it increases the risk of permanent hearing loss and nerve damage. Further, reconstructive surgery might be needed to reduce deformity and correct damage.

Bell’s Palsy Prognosis

Bell’s palsy recovery time can vary based on the extent of nerve damage. However, its prognosis is usually good as more than two-thirds of its patients have a full spontaneous recovery.

Most people start to recover within 1 to 2 weeks after the appearance of symptoms and return to normal function within 3 to six months. However, symptoms persist longer in some cases and the disorder may reoccur on the opposite side of the face.

Bell’s Palsy Complications

The following complications may occur in the more severe cases of Bell’s Palsy.

  • Irreversible damage to the facial nerve
  • Irregular growth of nerve fibers
  • Corneal dryness leading to visual loss
  • Partial or complete blindness of the affected eye

Living with Bell’s Palsy

Besides taking medication, here are some of the tips that you can take to ease the discomfort associated with Bell’s palsy:

  • Use a straw to drink as it reduces the chance of dribbling water down your chin.
  • Use eye drops during the day to prevent dryness.
  • Always use lubricating ointment for eyes at night as it can make your vision blurry.
  • You can use surgical tape to close your eyelid when about to sleep.
  • Take rest and get plenty of sleep.
  • Don’t hesitate to talk to someone if you are feeling down about your appearance.
  • Maintain your oral hygiene, and be cautious to avoid biting your inner gum as it increases the risk of infection.
female chiropractor talking to a male patient in singapore

How SingaporeChiropractic Care Can Help Bell’s Palsy?

Singapore Chiropractic care can help speed up recovery from Bell’s palsy. It addresses the underlying issue related to facial nerve and spinal adjustment.

Singapore Chiropractors identify nerves in the face linked to paralysis and manipulate areas of the face to restore facial movement and ease symptoms. Furthermore, adjustments in the neck and upper spine can improve nerve function, increase blood flow to the face and reduce inflammation. It also increases muscle and joint mobility, which further aids in recovery.

Our experts at Vitality Chiropractic in Singapore specialize in upper cervical Chiropractic care. Our experienced team provides personalized care tailored to your individual needs. If you or your loved one are suffering from Bell’s palsy, contact us right now to get your lovely smile back.

 

REFERENCES

Baugh, R. F., Basura, G. J., Ishii, L. E., Schwartz, S., Drumheller, C., Burkholder, R., Deckard, N. A., Dawson, C., Driscoll, C. L. W., Gillespie, M. B., Gurgel, R. K., Halperin, J. J., Khalid, A. N., Kumar, K. A., Micco, A. G., Munsell, D., Rosenbaum, S., & Vaughan, W. (2013). Clinical Practice guideline: Bell’s palsy. Otolaryngology-Head and Neck Surgery, 149(S3). https://doi.org/10.1177/0194599813505967

Bell’s Palsy. (n.d.). National Institute of Neurological Disorders and Stroke. https://www.ninds.nih.gov/health-information/disorders/bells-palsy

Dalrymple, S. N., Row, J. H., & Gazewood, J. (2023, April 15). Bell Palsy: Rapid evidence review. AAFP. https://www.aafp.org/pubs/afp/issues/2023/0400/bell-palsy.html#afp20230400p415-c1

Facial Palsy UK. (2023, November 17). Facial Nerve Recovery – Facial Palsy UK. https://www.facialpalsy.org.uk/support/patient-guides/facial-nerve-recovery/

Warner, M. J. (2023, August 17). Bell Palsy. StatPearls – NCBI Bookshelf. https://www.ncbi.nlm.nih.gov/books/NBK482290/

Zhao, H., Zhang, X., Tang, Y., Jin, Z., Wang, X., & Li, S. (2017). Bell’s Palsy: Clinical analysis of 372 cases and review of related literature. European Neurology, 77(3–4), 168–172. https://doi.org/10.1159/000455073

Written by

Shaan Rai (Chiropractic, Singapore)

Shaan (UK) is based in Singapore. He is a GCC registered Singapore Chiropractor, completing a 5 year course at AECC, attaining his Masters in Chiropractic. His career has been specialised in neurological cases, such as migraines and vertigo. He is the Vuce President and Chairman for Outreach & Charity for Alliance of Chiropractic (AoC) and is a founder of Vitality Chiropractic Singapore. He developed the NeuroPro method, combining Upper Cervical techniques with Functional Neurology Rehab.

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