Massage therapy · Kitchener–WaterlooBell's Palsy

Bell's palsy causes sudden weakness in the muscles on one side of the face, which usually develops over a few days (NHS, 2023). Half of the face may appear to droop. Your smile becomes one-sided and the eye on that side of the face may be difficult to close. The condition can occur at any age (NINDS, 2026). Even though the exact cause isn't known, it's believed to be the result of inflammation and swelling of the nerve controlling the muscles on that side of the face. It may be a reaction that occurs after a viral infection, most often thought to be the herpes simplex virus (NINDS, 2026; Madhok et al., 2016). Bell's palsy is a type of facial palsy, and it is the most common cause of facial paralysis (NHS, 2023).

For most people, the condition is temporary. Symptoms often begin improving within a few weeks, and most people get better within six months, although it can take longer for some (NHS, 2023). A small number of people continue to have some facial weakness or other symptoms for the rest of their lives (NHS, 2023; Madhok et al., 2016). Rarely, the condition can come back, sometimes years later (NHS, 2023).

Even though the reason the condition occurs is unknown, it may be linked to a viral infection. With Bell's palsy, the nerve controlling the facial muscles, which passes through a narrow channel of bone on its way to the face, becomes swollen and inflamed. As well as the facial muscles, the nerve affects saliva, tears, taste and hearing on that side. So, as well as weakness on one side of the face, you may notice a drooping eyelid or corner of the mouth, drooling, a dry mouth, loss of taste, a dry or watering eye, or sounds seeming louder than usual (NHS, 2023; NINDS, 2026).

Bell's Palsy Anatomy

The facial nerve (also called the seventh cranial nerve) connects the brain to the muscles that control facial expression, such as frowning and smiling (NINDS, 2026). It also supplies the muscles used for closing the eyelids. It is mainly a nerve for movement, rather than for feeling (sensation) in the face. The facial nerve also carries taste sensations from the front part of the tongue to the brain, and helps to control tears and saliva.

How to Treat Bell's Palsy

Treatments you may want to discuss with your family doctor or nurse practitioner

Tips

• Protect the eye that you are unable to close, as described above.
• Pain relief: NINDS (2026) says pain medicines such as paracetamol (called acetaminophen in North America) or ibuprofen may relieve pain from Bell's palsy. If you already take prescription medicines, talk to your doctor or pharmacist before taking over-the-counter medicines. (This medicine information comes from NINDS, not from me. Always check with a pharmacist or your family doctor or nurse practitioner before taking any medicine.)
• Putting a washcloth that has been soaked in warm water on the face several times a day may help with pain.
• Keep up the facial exercises I show you.
• Living with Bell's palsy can make you feel low, stressed or anxious. Speak to your family doctor or nurse practitioner if it is affecting your mental health (NHS, 2023).

With Bell's palsy, the muscles on one side of your face have lost their nerve signal, so the tissue is easily overstretched. Your doctor leads the medical care. My aim is to protect those muscles and keep them moving until the nerve recovers, and to ease tension on the working side and through your neck and shoulders.

Please see a doctor before we start, ideally the same day symptoms begin. I then check how each side of your face moves, along with your neck and jaw.

Acute: New

Subacute: Healing

1. NHS (2023) Bell's palsy. Available at: https://www.nhs.uk/conditions/bells-palsy/ (Accessed: 7 October 2026).
2. National Institute of Neurological Disorders and Stroke (NINDS) (2026) Bell's palsy. Available at: https://www.ninds.nih.gov/health-information/disorders/bells-palsy (Accessed: 7 October 2026).
3. Madhok, V.B., Gagyor, I., Daly, F. et al. (2016) 'Corticosteroids for Bell's palsy (idiopathic facial paralysis)', Cochrane Database of Systematic Reviews, (7), CD001942. doi: 10.1002/14651858.CD001942.pub5
4. Gagyor, I., Madhok, V.B., Daly, F. and Sullivan, F. (2019) 'Antiviral treatment for Bell's palsy (idiopathic facial paralysis)', Cochrane Database of Systematic Reviews, (9), CD001869. doi: 10.1002/14651858.CD001869.pub9
5. Teixeira, L.J., Valbuza, J.S. and Prado, G.F. (2011) 'Physical therapy for Bell's palsy (idiopathic facial paralysis)', Cochrane Database of Systematic Reviews, (12), CD006283. doi: 10.1002/14651858.CD006283.pub3