Bell’s Palsy

Bell’s Palsy Treatments with Acupuncture in Atlanta

Bell’s Palsy is a neurological disorder affecting about 40,000 people in the United States every year that manifests as a paralysis of the face. This disorder often affects only one side of the face. Bell’s Palsy is thought to be a result of damage to the facial nerve that controls the muscles on one side of the face, which then causes those muscles to droop. The facial nerve damage that affects the facial muscles can also impact a person’s taste, saliva, or ability to cry. Bell’s Palsy is most common in young adults, the elderly, diabetics, and pregnant women, but it can affect anyone.

This condition is often a shock, as it comes on overnight. The majority of patients wake with the facial muscles in paralysis. Most patients either have no symptoms beforehand, or they miss the warning signs, which are subtle and can include neck pain, pain behind the ear, or pain in the back of the head. People with Bell’s Palsy can experience difficulty with multiple facial functions including closing their eyes, eating, smiling, and their speech can also become slurred. Often, people jump to the conclusion that a stroke has occurred, but thankfully, Bell’s Palsy is not the result of a stroke, and is also a temporary affliction. While the condition comes on suddenly, it usually passes or gets better on its own within three weeks.

Because the facial nerve has so many functions, damage to the nerve or a disruption in its function can lead to many symptoms, which vary from person to person and range in severity from mild weakness to total paralysis. They may include twitching, weakness, or paralysis on one or both sides of the face, drooping of the eyelid and corner of the mouth, drooling, dryness of the eye or mouth, impairment of taste, and excessive tearing in one eye. Other symptoms may include pain or discomfort around the jaw and behind the ear, ringing in one or both ears, headache, loss of taste, hypersensitivity to sound on the affected side, impaired speech, dizziness, and difficulty eating or drinking.

What Causes Bell’s Palsy?

Most scientists believe that a viral infection such as viral meningitis or the common cold sore virus – herpes simplex – causes the disorder. They believe that the facial nerve swells and becomes inflamed in reaction to the infection, causing pressure within the Fallopian canal and leading to an infarction (the death of nerve cells due to insufficient blood and oxygen supply). In some mild cases, there is damage only to the myelin sheath of the nerve, or the fatty covering-which acts as an insulator-on nerve fibers in the brain.

The disorder has also been associated with influenza or a flu-like illness, headaches, chronic middle ear infection, high blood pressure, diabetes, sarcoidosis, tumors, Lyme disease, and trauma such as skull fracture or facial injury.

Western Medicine’s Approach to Bell’s Palsy

There is no cure or standard course of treatment for Bell’s palsy. The most important factor in treatment is to eliminate the source of the nerve damage. The condition affects each individual differently. Some cases are mild and symptoms usually subside on their own within 2 weeks. For others, treatment may include pharmaceutical medications and other therapeutic options.

Steroids are often used as a treatment for Bell’s palsy. An antiviral drug such as acyclovir combined with an anti-inflammatory drug such as the steroid prednisone may be prescribed in order to reduce damage to the nerve. Analgesics such as aspirin, acetaminophen, or ibuprofen may be given relieve pain.

Chinese Medicine’s View on Bell’s Palsy

Bell’s Palsy is known as “Zhong Feng” in Chinese Medicine, which translates to “Wind Attack”. It is categorized as an External Wind Stroke attack with the main pattern differentiation being Wind invasion due to emptiness or vacuity of the Channels (Maclean and Lyttleton 1998). Wind is thought to enter the body and attack the sinews and vessels in the area of the face. This results in Qi (energy) and Blood stagnation, causing the inability of flesh to relax or contract (Wolfe 2003) and making it more difficult for the channels to nourish the affected areas on the face. The principle of treatment for Bell’s Palsy is to eliminate this Wind and promote the movement of Qi and Blood by expelling Stasis (or, stagnation) in the vessels and channels.

Vacuity mostly refers to an insufficiency of Essential Qi. According to the Nei Jing: Plunder of the Essential Qi results in vacuity. Modern sources state that any disease in which there is an insufficiency of the necessary normal physiologic movement, or in which the functions of the body’s normal regulatory and compensatory actions are reduced, can be described as a vacuity pattern (Teng, Ergil et al. 1999). In CM terms, Qi is the normal regulative and compensative function of the human body (Teng, Ergil et al. 1999). Vacuity patterns emerge slowly over time and can be reflective of a lifestyle of consuming incorrect foods, overwork, stress and indulgence which consumes Qi without replenishment (Teng, Ergil et al. 1999).

While it is a sudden pattern which correlates to modern theories of pathogenic viral attack, according to CM principles, one of the main implications of the condition is an underlying Qi (a person’s inherent energy) deficiency. In Chinese Medicine terminology, the Wind-Cold attack that frequently causes Bell’s Palsy blocks the meridians so that facial muscles cannot operate properly. With Bells’ Palsy, the invading Wind-Cold primarily stays in the facial Yang-Ming channels. The Yang Ming is significant because these are the channels that are most abundant in Qi and Blood. In Bell’s palsy it appears that a vacuity pattern debilitates Qi and Blood thus exposing the channels to injury. The first vulnerable portion of the channel is then impaired.

Treating Bell’s Palsy with Chinese Medicine

In China, acupuncture has been used for thousands of years to assist in Bell’s Palsy recovery. Many studies have been done in China which show that acupuncture is extremely effective in treating Bell’s Palsy when it is used promptly (see more studies at end of this article). Complete recovery can take place in one or two weeks.The initial treatment goal according to CM would be to expel Wind and resolve Damp, as well as to invigorate Qi and promote blood circulation to the face. Consistent acupuncture treatments (usually recommended once or twice per week), can help soothe a patient, expedite the paralysis from dissipating, and enhance nerve function. Some people recover spontaneously, although this can take from a few weeks to a year.

From a Chinese Medicine perspective, acupuncture is seen as the main treatment for Bell’s Palsy. Using acupuncture points on the affected side of the face, neck, and head as well as other parts of the body allows the Qi to be spread through the meridians to decrease the healing time and prevent any residual dysfunction of facial muscles. Herbal formulas specifically designed for this condition can also be prescribed to effect healing from the inside out.

These herbal remedies may be used not only to offer a therapeutic effect but to promote effective functioning of the nervous system and prevent stress (which is thought to exacerbate Bell’s Palsy). Chinese herbs which will expel the wind and cold from the body and stop headaches include wild angelica, sage and cinnamon twigs. There are many other Chinese herbs which can also be used to treat facets of Bell’s Palsy affecting the nervous system.

Massage can also help ease the symptoms of Bell’s Palsy. Gently massaging the affected areas of the face, or practicing daily facial exercises can help the condition. Additionally, a full body massage on areas that are unaffected by the condition can help. Stress can worsen the condition, and is often thought to be a precipitating factor that may bring on an episode, so receiving a relaxing, full body massage can help soothe a patient and lead to a quicker recovery.

Some patients with Bell’s Palsy may want to take several weeks of recovery time in which they may choose to stay at home and take some time off from their normally rigorous daily routines. Our Atlanta acupuncturists offer several options, from herbal remedies to massage and acupuncture, to supplements, that patients may wish to investigate during their recovery period. All of these treatment options are tailored to fit the patient’s individual constitution, needs, lifestyle, health history, current condition and more.

More studies on treating Bell’s Palsy with acupuncture:

http://www.thecochranelibrary.com/userfiles/ccoch/file/Acupuncture_ancient_traditions/CD002914.pdf http://www.huffingtonpost.com/2013/02/26/acupuncture-bells-palsy_n_2767694.html http://www.cmaj.ca/content/185/6/473.abstract http://clinicaltrials.gov/show/NCT00608660 http://www.medpagetoday.com/Neurology/GeneralNeurology/37520

Other sources:

http://www.gancao.net/acupuncture/bells-palsy-acupuncture-herbs-228