Bell’s palsy is a neurologic condition of the facial nerve (cranial nerve VII) that causes weakness or paralysis of the muscles on one side of the face. This condition is seen equally in men and women, usually between the ages of 20 and 60. Bell palsy affects about 40,000 U.S. adults and children each year. What causes Bell’s palsy is usually unknown, but viral infections are often implicated. Massage when combined with other interventions may help improve face function and quality of life. 

Bell’s palsy is a sudden unilateral facial paralysis in areas supplied by cranial nerve VII (facial nerve). The symptoms may be transient, lasting only a few months, or permanent. Bell’s palsy can recur. Bell’s palsy is often first noticed in the morning after having developed overnight; symptoms reach their peak within 72 hours. Unilateral facial paralysis is also a hallmark sign of a stroke. However, a stroke affects more than just facial muscles so check other stroke markers such as unilateral arm weakness while making this determination.

Symptoms begin suddenly and range from mild to severe. The person may experience facial pain or a pulling sensation behind or in front of the ear. Headaches are common. Paralysis often causes distortion of facial express115778_1_Layers.psdions . Paralysis may be so severe the person may not be able to open or close an eye; one side of the mouth may droop. When this event occurs, the person is unable to smile, whistle, grimace, or control salivation on the affected side. The person with Bell’s palsy may have difficulty with eating and drinking. What causes damage to the facial nerve is often unknown, but viral infections are often implicated (usually herpes simplex).

The goals of treatment are to reduce inflammation (anti-inflammatories) and relieve pressure on the facial nerve. Corticosteroids are used to decrease inflammation. Analgesics are used to reduce pain. Antivirals may be used, depending on the cause of the disease. Artificial tears or an eye patch may be needed to protect the affected eye from outside elements. In rare cases, surgery is used to relieve nerve pressure by increasing the diameter of the bony structure through which the nerve passes. Spontaneous recovery is fairly common; therefore, medical treatment of Bell’s palsy continues to be controversial


Massage Therapy and Bell’s PalsyMassage techniques such as quickly applied effleurage directed upward may improve facial symmetry (Garanhani et al, 2007). These massage techniques may be included in a general massage session for a client with Bell’s palsy or in a session to specifically address the condition. Obtain permission before applying facial massage as the client may feel self-conscious and not want the face to be touched. Instruct the client to massage his or her own face 2 to 3 times a day.

research iconResearch. A 20-minute session of facial exercise and massage administered 3 times a week for 2 weeks improve facial muscle function and decreased depression in patients with facial palsy (Choi & Shin, 2016). Three session per week for 4 weeks of exercise therapy and biofeedback accompanied by massage improved face function and increased quality of life among patients with Bell palsy (Mirzakhani et al, 2017).

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Choi, H.J., Shin, S.H. (2016). Effects of a facial muscle exercise program including facial massage for patients with facial palsy. J Korean Acad Nurs, 46(4), 542-551.

Garanhani, M.R., Rosa Cardoso, J., Capelli Ade, M., Ribeiro, M.C. (2007). Physical therapy in peripheral facial paralysis: retrospective study. Braz J Otorhinolaryngol, 73(1), 106-9.

Mirzakhani, N., Angooti Oshnari, L., Akbarzadeh Baghban, A., Eliyspoor, D., Javantash, A., Kamalifar, M., Parsamanesh, T. (2017). The comparison between exercise therapy and biofeedback therapy in facial function and quality of life of Bell’s palsy. J Clin Physio Res, 2(3), 139-143.

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Dr. Susan Salvo is a massage therapist, author, educator, researcher, explorer, and perpetual student. To learn more, check out the “About Susan” tab. You can contact Susan at