Bell's Palsy presents in clients from a wide array of conditions. It can be brought about by a myriad of causes and contributors and is often a secondary condition for those having to undergo surgery or work to the upper cervical or cranium area. Often the symptoms can sneak up on sufferers and can vary from fluttering of muscles, to full paralysis of the face.
This is a condition of impairment to the cranial nerve VII (the nerve that supplies the facial nerve). This nerve is responsible for the expression of the face that comes as a daily communicative tool that we all take for granted. You can reiterate the context of your point when you are using your eyes, nose, mouth, brow to reinforce the meaning behind what you are saying. It’s one of the fundamental tools of communication that we are often not even aware of – being read like a book.
The Cranial nerve itself is exists the spinal column via a small foramen (opening) just behind the earlobe, often associated with TMJ syndrome (Temporo-mandibular Joint or jaw). The paralysis of this nerve can result in a ‘dropping’ of one side of the face (similar to a stroke victim), difficulty eating and at times, difficulty closing the eye of the affected side. Headaches, pain and even taste can also be affected by damage to this nerve.
The nerve gets damaged from either inflammation or from a ‘mechanical’ interference, ie an autoimmune disorder or damage to the nerve. Tumors, bone spurs, ,middle ear infections, sublaxation of the cervical vertebrae are al conditions that can increase pressure and decrease space around the formen that can lead to pressure on the nerve and thus inflammation. The good thing about Bell’s Palsy is that the facial nerve is a ‘peripheral nerve’ and any damage to the neurilemma or outer protective covering can be regenerated at a slow rate, so often you can ‘recover’ full function from damage to this nerve.
Another indication that comes with this condition is the Herpes Simplex Virus. This virus stimulates antibodies that create an inflammatory response that can affect the Facial nerve. This virus is actually a leading indicator in the onset of Bell’s Palsy episodes. Likewise Diabetes and Lymes disease can also effect peripheral neuritis (inflammation of peripheral nerves) and thus bring on Bells Palsy.
Most cases of Bell's Palsy resolve without interference, that is they are temporary conditions unlike Cerebral Palsy which effects the Central Nervous System and are much more aggressive and permanent in nature. Bell’s Palsy however, does respond very well to bodywork and massage treatment. If the underlying inflammation of the peripheral nerve is not a tumor or autoimmune disease, massage works to keep the facial muscles in tact and ‘toned’ to combat the flaccidity of the facial muscles that are left destitute from the stimulating nerve. It also keeps the blood circulation flowing which is most important for recovery after the acute episode. Massage is often used to afford complete recover following acute phases of Bell’s Palsy.
Relieving pressure from the mechanical nature of any nerve impingement or inflammation is also advised. Massage can help with this condition, especially if TMJ is a contributing factor. Releasing pressure around the tissue of the stylomastoid foramen (hole where the facial nerve leaves the cranium) is of paramount importance. Working through the facial muscles such as the mastoid, masseter and temporalis muscles on the superficial level (larger muscles acting on jaw) and the intrinsic muscles of the Stylohyoideus and the Posterior Digastric (active during swallowing) can be of primary benefit.
Other areas to be aware of are those of the anterior neck which can act on the TMJ and limit flexion/extension of the upper cervical spine. These articulations can act on the TMJ and alignment of the entire region thus limiting or impeding function of the myriad of tiny muscles that act in swallowing and tongue movement. These are the hyoid group (thyohyoid/sternohyoid/omohyoid/sternothyroid) and are made up for the main muscles that lie deep on the anterior neck, right at the internal level of the cervical vertebrae. This is possible to palpate and is not always appropriate for some persons but can help with the underlying aligment of the cervical vertebrae that can have direct impact on any reduced space for normal articulation movement.
Symptoms and issues of Bell's Palsy can be attended to by a talented therapist who can see a client through a phase of acute inflammation and paralysis. Monitoring and ensuring a constant maintaining of alignment and reducing restriction can have great benefits to sufferers who seek reduction of the condition. Thus assisting with minimising the impact this has on the long term damage to muscle tissue and tone of the affected muscles.
Peter Furness
