bell's palsy physiotherapy treatment pdf

Bell’s Palsy Physiotherapy Treatment PDF

Are you or someone you know experiencing Bell’s Palsy? This sudden facial paralysis can be a frightening and overwhelming experience. Fortunately, physiotherapy has been shown to be an effective treatment option for Bell’s Palsy. In this article, we will explore the various physiotherapy techniques used to treat Bell’s Palsy and provide a downloadable PDF guide for further information and resources.

Idiopathic facial nerve palsy, referred to as Bell’s palsy, accounts for a majority (60 to 75%) of the cases of facial paralysis. The development of the condition can occur in individuals irrespective of all age groups and is common among those aged 15-50 years. In addition to this, there is no gender bias associated with the condition. Notably, some effects are muscle weakness, atrophy, facial asymmetry, and severe negative implications on quality of life if not treated adequately.

Bell’s Palsy

Suddenly, one side of your face becomes weak or paralyzed; this is called Bell’s palsy. It happens when a nerve that controls your facial muscles starts having problems. Smiling can become difficult on that part; you might find it hard to eat on that side or close your eyes normally. Often, it develops suddenly and clears up within two weeks to three months without medical Treatment, but occasionally, doctors may give drugs or therapy to help speed the healing process, for it is not usually serious, even if it sounds scary when you experience this.

What Treatment works best for Bell’s palsy?

As far as treating Bell’s palsy goes, what works best often depends on the severity of an individual’s symptoms. Many treatments are available, but here are some suggestions:

Corticosteroids: These drugs reduce inflammation around the facial nerves, which may cause Bell’s palsy. For example, prednisone is one corticosteroid prescribed by doctors to accelerate recovery.

Antiviral Medications: Sometimes doctors prescribe antiviral medications also based on the suspicion that Bell’s palsy was caused by a viral infection like herpes simplex virus.

Eye Care: Because people with Bell’s palsy have difficulty completely closing their eyes, keeping them moist and shielded from injury is important. Artificial tears during the day and lubricating ointment or gel at night prevent dryness and protect against damage.

Facial Exercises: Movements that strengthen and stimulate the facial muscles can help in the recovery process, avoiding problems such as muscle weakness or contractures. Physical therapists often teach these exercises, or doctors prescribe them.

Moist Heat Therapy: Placing warm compresses on the affected side of the face to relieve pain and discomfort associated with Bell’s palsy is known as moist heat therapy. It can also ease tension in facial muscles and increase blood flow to that area, thereby promoting healing.

Electrical Stimulation: For some individuals, electrical stimulation therapy may be beneficial; it involves applying small electric pulses to facial muscles to help improve strength and control. Usually, this type of Treatment is carried out by a physical therapist.

Surgery (in rare cases): Surgical procedures may be done on some patients whose Bell’s palsy is very severe and does not respond to other treatments in order to decompress the facial nerve or change the position of some facial muscles.

Physiotherapy Treatment Protocol For Bell’s Palsy Patient

A Physiotherapy treatment protocol for Bell’s palsy provides comprehensive management strategies that minimize complications while enhancing recovery. Athawale et al.’s study has suggested the following four-week rehabilitation program.

Week 1: Phase 1 – Initial Rehabilitation

Facial Massage: Supine position massage techniques such as kneading, stroking, effleurage, and tapping should be performed for 15 minutes each at an interval of five minutes.

Facial Active Exercises: Teach the patient facial active exercises to be performed at home. Make the patient do active exercises on his or her face at home. These exercises are crucial for recovery. They should not miss them.

Duration: The Treatment should last for 2 hours daily, continuing for one week.

Week 2: Phase 2 – Intermediate Rehabilitation

Superficial Heat Therapy: Use superficial heat therapy on the facial muscles for 15 minutes per session.

Electrical Muscle Stimulation: Using an Electrical Muscle Stimulator with a pen electrode in the supine position, stimulate muscles such as the frontalis, corrugator, orbicularis oculi, orbicularis oris, buccinator, nasalis, and mentalis at 2-minute intervals followed by massage techniques lasting 45 minutes.

Continue: This phase extends through the first two weeks of rehabilitation.

Week 3: Phase 3 – Advanced Rehabilitation

Mirror Therapy: Begin mirror therapy (active exercises) by sitting down in front of a mirror. The patients must perform activities such as blowing air out of their mouths, widening their nostrils, smiling, raising and furrowing their eyebrows, opening and closing their eyes, and clenching their teeth once each for twenty minutes. Carry on with massage and electrical muscle stimulation afterward.

Continue: This phase is specifically for the third week of rehabilitation.

Week 4: Phase 4 – Final Rehabilitation

Resistance Training and Stretching: Incorporate resistance training into protocol with stretching exercises. Direct the patient to stretch his/her cheek downwards five times while stretching it further down continuously for half a minute during each repetition.

Electrical Muscle Stimulation: Continue faradic mode stimulation for muscle re-education.

Sunglasses: Tell them that they should put on sunglasses during daytime so as not to encounter future complications because of sunrays’ effect upon their eyes.

Download Bell’s Palsy Physiotherapy Treatment PDF

Final Words

This physiotherapy treatment protocol offers a structured approach to managing Bell’s palsy, underlining the significance of different techniques, including massage, electrical muscle stimulation, active exercises, and resistance training. The guidelines will ensure that patients’ facial function and quality of life are improved tremendously.


Athawale VK, Bawiskar DP, Phansopkar PA. Rehabilitation of a patient with Bell’s palsy. J Evolution Med Dent Sci 2021;10(20): 1551-1554.


"Hasan", I am a physiotherapy Doctor. I have completed my B.S.c course (4 years) under Rajshahi University, Faculty of Medicine, Rajshahi. Currently I am working as a clinical physiotherapist at a renowned physiotherapy center and I am continuing my MPT (Master's of physiotherapy) degree at CRP, Savar.

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