Alternative Therapies
Many people who live with facial palsy, which has not recovered within the first three weeks following the onset of their symptoms, will want to find out what treatment options are available. Most people will have received the standard medical treatment for Bell’s palsy (oral steroids which must be taken within the first 72 hours following the onset of symptoms), and the standard medical treatment for Ramsay Hunt syndrome (oral steroids with oral antiviral medication commenced within the first 72 hours). Whilst the majority of people will recover within the first 3 weeks some people will experience a delayed recovery even when treatment with the recommended medicine has been followed.
When facial palsy persists beyond 3 weeks many people look to other forms of treatment or alternative therapies. (If you do not experience any improvement within the first three weeks following the onset of your symptoms, you should ask your GP for a referral to a facial nerve specialist or specialist facial palsy service). The standard treatment is physiotherapy or facial therapy which is available through the National Health Service (NHS). However, access to specialist physiotherapy is variable across the UK. Some people may struggle to access help from a therapist experienced in the management of facial palsy which prompts them to look for alternative therapies. Looking for alternative interventions may help people feel in control because they are actively doing something to help themselves.
What will help if you can’t access face to face therapy
- Facial massage
- Muscle releases
- Relaxation
Acupuncture without electrical stimulation
Acupuncture is often accessed privately or may be available from the NHS, but the acupuncturist must be experienced in its use for facial palsy. Its efficacy in the treatment of facial palsy is debatable although there is evidence that it helps reduce facial pain and may aid relaxation of facial muscles. There is no evidence that it speeds up nerve recovery or results in a better outcome. There is no evidence that it causes harm either and therefore if it relieves your pain and makes you feel more relaxed it can be a safe addition to standard treatment. It might complement other treatments, like facial rehabilitation therapy, but it is not a stand-alone treatment in the management of facial palsy where recovery is delayed beyond three weeks.
Acupuncture with electrical stimulation
Electrical stimulation can be given via acupuncture needles placed in the facial muscles and should only be carried out by acupuncturists experienced in the management of facial palsy. However, there are some schools of thought that all forms of external electrical stimulation to the facial muscles should be avoided. This is because people who experience a delayed recovery are at increased risk of developing increased muscle tone, and synkinesis.
When people experience a slow or delayed recovery, they will naturally be at high risk of developing too much tone in their facial muscles. This is because the recovering facial nerve is chaotic, it is unable to moderate its activity, and sends out too many electrical signals which increase the muscle tone. Muscle tone should not be confused with muscle strength. Too much tone will lead muscles to become short, thick and tight. They will have lost their elasticity and be unable to move. This is not because the nerve is unrecovered but because the nerve is overactive and supplying the facial muscles with too much electrical energy. Therefore, if you add an external source of electrical energy, such as stimulation through acupuncture needles, then you are increasing your risk of developing high muscle tone and synkinesis. It can be very difficult to reverse these symptoms or even just improve them and requires a great deal of dedication on behalf of the person with facial palsy.
Vitamin Supplements
There has been some research into the efficacy of treatment using vitamins in the management of facial palsy. Most studies are of poor quality because they do not control for the majority of people who will recover spontaneously. Remember the majority of people will recover completely without the aid of vitamin supplements.
There has been some debate about the use of Vitamin B12 in the management of Bell’s palsy. Normally it plays a role in nerve function and most importantly, in the production of red blood cells. It is found in poultry, meat, fish and dairy products. You can safely take recommended amounts of supplements because B12 is water-soluble, the body will only take as much as it needs, so excess amounts will pass out through your urine. There is no evidence that taking vitamin B 12 supplements will speed up your recovery or help you make a full recovery.
Vitamin B12 deficiency is rare because the body can store several years’ worth. People who might be deficient in vitamin B12 are vegans and vegetarians. Unless you have an underlying condition affecting your absorption of vitamin B 12, for example, pernicious anaemia, or are a vegan/vegetarian then it is unlikely that you will benefit from vitamin B12 supplements. If you do have a condition affecting the absorption of vitamin B 12 then you will be prescribed B12 in injection form.
There is no harm in taking recommended amounts of vitamin B12 supplements, but you might be wasting your money because excess amounts are excreted in your urine. The same is true of vitamin C so whilst supplements are harmless they may be an unnecessary expense. If you are in any doubt, then discuss vitamin supplements with your GP.
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