Facial Nerve Paralysis (Bell’s Palsy) and Acupuncture

Introduction: What Is Facial Nerve Paralysis?

Facial nerve paralysis—commonly known as Bell’s palsy—is a sudden-onset neurological condition characterized by partial or complete paralysis of the mimetic muscles on one side of the face. This condition can occur at any age but is most frequently seen in middle-aged and older adults. It typically develops unexpectedly, often without warning, and can significantly impair daily life by causing speech disturbances, eating difficulties, and psychological distress

This article provides an in-depth look at the causes, symptoms, and course of facial nerve paralysis, as well as treatment options from the perspective of Traditional Chinese Medicine (akupunktura), with particular emphasis on acupuncture. Special attention is paid to why early intervention is crucial, and what scientific evidence supports the effectiveness of acupuncture in treating this disorder.

Causes and Risk Factors of Facial Nerve Paralysis

The Role of Cold Exposure and Infections

The exact cause of Bell’s palsy is still not entirely clear; however, clinical experience and epidemiological studies have identified several predisposing factors. The most common triggers include sudden exposure of the face to cold air—such as drafts or cold winds—as well as acute upper respiratory tract infections (most commonly in the nasopharynx). These factors can induce inflammation, swelling, and temporary impairment of the facial nerve’s conductivity, which ultimately leads to paralysis of the affected mimetic muscles

Age and Other Contributing Factors

While facial nerve paralysis can develop at any age, it is more common among middle-aged and older adults. In some cases, underlying conditions such as diabetes, hypertension, immune deficiencies, or other metabolic disorders may further increase vulnerability of the nervous system.

Symptoms: How to Recognize Facial Nerve Paralysis

Most Characteristic Symptoms

Facial nerve paralysis typically develops suddenly, over the course of a few hours or a day. The patient notices unilateral paralysis of the mimetic muscles, often accompanied by the following symptoms:

Inability to furrow the forehead, raise or wrinkle the eyebrows (loss of forehead wrinkles)

Incomplete eyelid closure, difficulty closing the eye on the affected side

Mouth corner droops on the affected side and is pulled towards the healthy side

Dry mouth, eating difficulties: food or liquids may easily leak from the paralyzed side of the mouth

Speech difficulties due to impaired lip movement (e.g., difficulty producing sibilant sounds)

Excessive tearing or dryness of the eye on the affected side (due to incomplete eyelid closure)

Flattening or loss of the nasolabial fold on the affected sid

Associated Neurological Symptoms

In certain cases, facial nerve paralysis may be accompanied by additional neurological symptoms:

Loss or reduction of taste sensation on the anterior two-thirds of the tongue on the affected side

Increased sensitivity to sound (hyperacusis), as paralysis of the stapedius muscle impairs vibration dampening in the eardrum

Complications: What Happens If Treatment Is Delayed or Omitted?

While facial nerve paralysis is generally a benign, self-limiting disease with a high rate of complete recovery—especially with timely therapy—delayed or missing treatment can lead to the following complications:

Persistent contracture (shortening) of the affected mimetic muscles

Abnormal facial twitching, muscle spasms, numbness

"Synkinesis": abnormal involuntary movements, e.g., smiling causes the eye to close or vice versa

Chronic tearing or eye dryness

Permanent facial asymmetry, which can significantly reduce quality of life and psychological wellbeing

The Role of Acupuncture in the Treatment of Facial Nerve Paralysis

Scientific Evidence: The Earlier, the Better

In Traditional Chinese Medicine (TCM), acupuncture holds a prominent place in the treatment of facial nerve paralysis. Clinical studies and large-sample controlled trials consistently show that the effectiveness of treatment is closely linked to how soon after symptom onset acupuncture is started

A representative large-scale clinical trial yielded the following results:

Among patients who started acupuncture within two weeks of disease onset, the full recovery rate was 77.2%.

For those whose treatment began only 2–4 weeks after onset, the full recovery rate dropped to 51.8%.

In cases where the condition had lasted for more than a month before treatment, the six-month recovery rate was only 4.5%.

The differences are statistically highly significant. These data clearly demonstrate that prompt acupuncture treatment not only leads to faster and more complete recovery, but also reduces the risk of permanent complications and the need for other medical therapies (such as corticosteroids).

Myths About Acupuncture During the Acute Phase

Some older viewpoints suggested that acupuncture was not advisable during the acute phase of facial nerve paralysis, but clinical experience and modern studies have debunked this notion. In the initial, so-called "superficial" stage, when inflammation is limited to the peripheral nerves, appropriately administered acupuncture can be especially beneficial.

Acupuncture Treatment Protocols: Stages, Techniques, and Adjunct Therapies

Timing of Treatment and Therapy Stages

Acupuncture therapy for facial nerve paralysis can be divided into two main stages:

Acute Phase: In this stage, the patient typically seeks professional help due to the sudden appearance of symptoms. The main therapeutic goals are to dispel the "wind pathogen," improve local blood circulation, and rapidly reduce swelling or edema. During this phase, only a few acupuncture points on the face are used, and needling is gentle and cautious. Stimulation focuses primarily on points in the neck and limbs, often complemented by special light therapy (TDP lamp) to further enhance local microcirculation.

Recovery (Chronic) Phase: During the recovery stage, a greater emphasis is placed on facial acupuncture points, and more intensive techniques (including electroacupuncture or penetrating needling) may be used. Here, the aim is to restore muscle function, stimulate re-innervation, and prevent complications such as muscle spasms or facial asymmetry.

Other Adjunct Treatments

When necessary, acupuncture can be complemented with modern physiotherapy techniques, physical therapy, and traditional Chinese herbal medicine. In severe cases—when deeper tissues are affected—Western medicines (e.g., corticosteroids, antiviral agents) may be indicated, but acupuncture remains an effective adjunct, promoting more rapid regeneration.

In Everyday Life: Prevention and Self-Help

What Should We Watch For?

To avoid facial nerve paralysis, the following precautions are recommended—especially in colder seasons:

Avoid sudden cold or drafts on the face (wind, air conditioning, etc.)

Dress in layers, use scarves and hats in windy weather

Maintain proper oral hygiene and regularly clean the nasal passages

Consume plenty of fresh fruits and vegetables for immune support

Ensure adequate, restful sleep

Exercise regularly, as physical activity boosts circulation and immune function

Summary: Acupuncture Is Proven, Effective, and Safe for Treating Bell’s Palsy

Facial nerve paralysis is a sudden and often frightening disease, but the combination of modern medicine and traditional Chinese healing offers an exceptionally effective solution. Acupuncture has been scientifically shown to accelerate recovery, reduce the likelihood of complications, and promote complete restoration of function. The real key is quick recognition and prompt initiation of therapy—experience shows that this determines long-term outcomes.

If you notice sudden asymmetry in your face, disturbances in facial movement, speech or eating difficulties, do not delay! Consult a doctor or acupuncture professional as soon as possible, because early therapy is the key to your swift and complete recovery!