An acute case of Bell's palsy could very well be one of the scariest events a person will ever live through.
It is a nerve disorder that affects the muscles of the face and eye — first with an onset of pain and progressing toward complete or near-complete loss of function to half of the face.
The muscles responsible for blinking, smiling, frowning and other facial expressions like raising your eyebrows cannot be voluntarily controlled. The abilities to see, to eat and use your face to communicate a smile to the rest of the world are in jeopardy.
Although there are several competing theories, the cause of Bell's palsy is poorly understood, with explanations ranging from a central nervous system disorder to a viral attack specifically on the facial nerve root.
While no definitive cause has been identified, two commonly reported precipitating events are child birth and sleeping next to an open window. Nearly 30 percent of people with Bell's palsy relate their disorder to one of these variables, but medicine has yet to establish a firm link to these claims.
Bell's palsy is benign in nature and rarely — if ever — results in severe, long-term dysfunction or disfigurement of the face. Unfortunately, there are no medicinal or surgical interventions available for patients with Bell's palsy that work to alleviate symptoms with any consistency. There are, however, plenty of conservative treatment options that can be explored in physical therapy.
Physical therapy treatment is aimed to restore muscle function and muscle tone in the face, thus resolving the impairments associated with the disorder. Here are just a few of the many treatment options:
Electrical stimulation to the facial muscles. E-stim preserves facial muscle tone and prevents degeneration. It even assists with muscle and nerve healing, giving you a better chance to return to baseline.
Facial exercises. There is a series of exercises to help patients with Bell's palsy regain muscle function. General movements of the face and eyes are not enough to make measurable improvements, therefore a specific regimen is indicated to properly rehabilitate the muscles and prevent harmful wasting of the sensitive muscle tissue.
Eyelid weights. One of the most devastating side effects of Bell's palsy is the inability to fully close the eyelid. An inability to blink could dry out the eyeball and cause scarring of the cornea — often resulting in permanent eye damage and subsequent vision loss. A physical therapist can custom fit a set of eyelid weights to your eyes to help prevent this from occurring.
TENS stands for trans-cutaneous electrical nerve stimulation. This type of treatment may help patients that have persistent nerve pain. This pain occurs in 10 percent to 15 percent of the cases and can sometimes be remedied with a special TENS unit that patients can use at home.
Bell's palsy is an incredibly personal and traumatizing disorder. It's fair to say that most patients need and deserve help to get through it. There's a strong possibility you'll fully recover without any intervention, but why leave your face to chance?
Joe DiVincenzo is a physical therapist and clinical specialist in manual therapy. He writes "On the Mend" weekly. Questions may be submitted to Joe by e-mail joedivincenzo@comcast.net.
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