Bell’s Palsy: What Is it, Conventional Approaches & How Acupuncture, Vitamin B12 Can Help
What is Bell’s Palsy?
Bell’s palsy (also called idiopathic facial paralysis) is a condition that leads to sudden weakness or paralysis of the muscles on one side of the face. It often comes on quickly, over 24–48 hours. The exact cause isn’t fully known, but likely involves inflammation of the facial nerve (cranial nerve VII), possible viral triggers (e.g. herpes simplex), immune system activity, and swelling that compresses the nerve. Most people recover fully or near‑fully over weeks to months, but some are left with residual weakness or other facial nerve issues.
Symptoms may include:
Drooping of the mouth or eyelid
Difficulty closing the eye on the affected side
Loss of facial expression / asymmetry
Possible pain or discomfort around the ear
Taste changes or sensitivity to sound (hyperacusis) on the affected side
Biomedical (Conventional) Approach
1. Corticosteroids (e.g., Prednisone)
These are considered the conventional first line of defence for Bell’s palsy in the first 72 hours after onset. They reduce inflammation and swelling around the facial nerve.
✅ Benefit: Most evidence shows improved recovery rates and reduced time to resolution.
⚠️ Potential Issues:
Can cause mood swings, insomnia, anxiety, or elevated blood sugar, especially in sensitive individuals or those with diabetes.
Contraindicated in some populations, including those with infections, gastric ulcers, or certain psychiatric conditions.
Some people experience weight gain, fluid retention, or high blood pressure after even short-term use.
2. Antiviral Medications (e.g., Acyclovir, Valacyclovir)
Sometimes prescribed if herpes simplex or another viral cause is suspected.
✅ Benefit: Some studies suggest they might help if given early, especially in combination with steroids.
⚠️ Potential Issues:
Evidence is inconclusive; many trials show no significant benefit when antivirals are used alone.
Side effects may include nausea, headache, rash, or kidney strain (especially in those with preexisting kidney issues).
3. Eye Protection & Artificial Tears
If facial paralysis prevents eyelid closure, protecting the eye from drying out or corneal abrasions is crucial.
✅ Benefit: Prevents vision-threatening damage like exposure keratitis or corneal ulceration.
⚠️ Potential Issues:
May cause blurred vision or discomfort, and some ointments can cause temporary eye irritation.
4. Physical Therapy / Facial Exercises
Used to help strengthen muscles, restore movement, and reduce the chance of long-term asymmetry or involuntary muscle movements.
✅ Benefit: Can help retrain facial muscle function and prevent disuse atrophy.
⚠️ Potential Issues:
If started too early, may cause synkinesis (involuntary movement during voluntary facial expressions).
How Acupuncture Can Help Bell’s Palsy
There is a growing body of research that acupuncture (and related modalities) can support recovery in Bell’s palsy, via several mechanisms. Some of the ways acupuncture may help:
Reducing inflammation and modulating immune response around the facial nerve. Research shows acupuncture may reduce pro-inflammatory cytokines and help balance immune signaling.
Improving blood flow and reducing edema: By needling certain acupoints, acupuncture may help relieve swelling that compresses the nerve and improve microcirculation in the facial region.
Facilitating nerve regeneration: Stimulating acupoints may support regeneration of nerve fibers, improve axon growth, and help restore nerve function more quickly.
Modulating neural plasticity: Some studies (animal or imaging‑based) suggest acupuncture can influence brain and nerve connectivity, potentially reducing maladaptive changes that occur when facial muscles are not used.
Check out the research here: Biological effect of acupuncture on peripheral facial paralysis
The Role of Vitamin B12
Vitamin B12 (often in the form methylcobalamin) plays important roles in nerve health. Vitamin B12 deficiency can cause nerve degeneration, and B12 injections have shown benefits for Bell’s palsy in some studies very early in the treatment course
It supports myelin sheath formation, which insulates nerves and is needed for proper nerve conduction.
Helps with nerve regeneration and repair.
May reduce oxidative stress and inflammation in peripheral nerves.
In Bell’s palsy specifically, some clinical trials have looked at combining acupuncture with Vitamin B12 injections. One meta‑analysis (Wang et al., 2015) found that acupuncture + B12 had a lower rate of incomplete recovery (about 44.5%) than acupuncture alone (about 62.6%) over at least 4 weeks of treatment. See the research here: Acupuncture & Vitamin B12
Ensuring adequate B12 (ideally verified by labs) — whether through diet, supplementation, or injections (when needed) — is often a helpful adjunct in supporting nerve recovery and combined with acupuncture can enhance recovery improving the odds of more complete recovery.
Important Things to Consider for Optimal Healing from Bell’s Palsy:
Get Treated Sooner Rather Than Later
Time is an essential factor in Bell’s palsy recovery. While many people recover fully, starting treatment within the first 72 hours to 7 days offers the best chance at full nerve regeneration and avoiding long-term issues.
Corticosteroids are most effective when started within the first 3 days of symptom onset.
Acupuncture, B12, and physical therapy also show better outcomes when initiated early, ideally within the first week.
Delaying treatment can increase the risk of incomplete recovery, muscle atrophy, and synkinesis (unwanted facial movements during voluntary actions).
Commit to a Full Treatment Plan
Healing from Bell’s palsy is often gradual. Even if symptoms seem mild, consistent treatment supports deeper nerve repair and facial symmetry restoration.
Expect at least 4–6 weeks of treatment for most cases.
Severe or delayed cases may require 3 months or longer of consistent care.
What a Treatment for Bell’s Palsy Might Look Like at Healing Feeling Acupuncture & Wellness:
First visit is the iInitial evaluation, which should happen ideally within the first 7 days of onset, as early treatment leads to better recovery. During this intake we will discuss when symptoms began, severity, medical history, and checking facial movement baseline. After intake and light palpation of the body, we will get started with the treatment. Each treatment, we will likely first administer a methylcobalamine (Vitamin B12) injection to help with nerve regeneration. Acupuncture points will include local needling in the face with super thin needles, usually points in the cheek, or alongside the face. Mild electric stimulation will potentially be applied depending on the case. Points further down on the arms and legs will also be needled to help support the underlying pattern present. Acupuncture points on the top of the head and ear can also help support the treatment and calm the nervous system.
In terms of frequency, often the first 2-3 weeks after onset of symptoms, acupuncture treatments should occur 1-2 times a week. Then by week 3, treatment will drop down to once a week for a few weeks. Vitamin B12 injections will be administered once a week. Depending on the severity of the case and when treatment started, the treatment course can be anywhere from 6 weeks to 3 months.
Aftercare & Recovery at Home
Supporting your healing process outside the clinic is just as important as the sessions themselves. Here are a few holistic self-care tips:
Protect your eyes if eyelid closure is incomplete. Use moisturizing drops and consider a sleep patch or eye shield.
Stay warm and rest often — exposure to wind or cold may aggravate symptoms. Wearing scarves, and using a heating pad on your neck/shoulders to allow for continued blood flow to your head is ideal.
Eat nutrient-dense, nerve-supportive foods rich in B12, folate, and omega-3s (e.g., salmon, dark greens, eggs, walnuts).
Facial exercises can be helpful but should only be started at the right time — not too early/not during the acute inflammatory phase (until 7-10 days) but exercises can start once voluntary facial movements have started to return.
Stress reduction is key: consider meditation, gentle yoga, and avoiding overexertion. Emotional overwhelm can impact recovery just like physical strain
Conclusion
Bell’s palsy can be a distressing condition, but many people recover well with appropriate care. Acupuncture offers a promising complementary therapy that may speed healing, improve outcomes, reduce the risk of incomplete recovery, especially when paired with Vitamin B12. If you are experiencing Bell’s palsy, it may be worth exploring an acupuncture plan along with your medical provider’s recommendations. Always consult your physician before starting any new therapy or supplement.
