Acupuncture Case Study: Bell's Palsy

Initial assessment. Bell's Palsy affecting right side. Tongue deviation and eyelid won't close with clear deviation toward left due to strength and function on left side.

Bell's Palsy is a condition generally effecting one side of the face causing temporary facial paralysis, hypertrophy of muscles and/or loss of motor control of facial muscles. In Chinese Medicine, we diagnose it as "Wind Cold invading the collaterals of the face". The extent of the effect and recovery time vary from person to person. Typically, with a Wind Cold invasion, the sooner a practitioner can work with the patient, the better and faster the recovery. Bell's Palsy is often sudden and without warning, leaving patients wondering if they have had a stroke or what exactly is happening. Earlier this year, I had the opportunity to work with two patients within a week of each other both afflicted with Bell's Palsy. Here I discuss one of those patients, the treatment and the outcomes. Images and videos are all used with patient's permission.

Video of patient after first treatment with partial restored movement.

Patient Intake: Patient is a 42yo woman with a high stress and very busy life. Over Mother's Day weekend (Sunday) 2025, she started the day feeling a little "off". She was spending time with friends and family and began to notice the right side of her face not feeling right. As the day progressed, she was unable to close her eye, smile on one side of her face, puff her cheeks or pucker her lips. Additionally, instead of drooping on the effected side, her muscles became spastic and taut not allowing for movement. This produced the effect of making the unaffected side look like it was drooping. I bring this up to add awareness to those assessing patients that the "droop" you see, may not be the affected side and may in fact be the natural facial control of the patient. Don't assume the side that "looks affected" is the actual side where the problem is. She sought immediate medical attention and was given a standard prescription medication for this type of event given the medical community sees it as an infection on the nerves affecting the face. She began to take the medication and reached out to me to see if acupuncture could help restore function and recover her from the condition.

Assessment: Timing matters with treatment. Though I had a full schedule, I worked her in between patients to get her assessment and first treatment done as close to the origination of the problem. I was able to see her 4 days after her condition began. She had taken the medications with little effect up to that point. I walked her through testing her blink, eyebrow raises, smile, lip pucker, and cheek puff abilities noting the muscle activity or lack thereof. I did palpation to test sensation on the skin surface of the effected side. I also did tongue (deviated left - confirming wind) and pulse assessments (thin, wiry - confirming stress and qi deficiency).

Treatment Plan: Early and often is the course of action for recovering patient's full facial function. Of course, we must also work within the financial budget and time availability of the patient. With this patient, we decided on once a week together for 6-8 weeks. Ideally, I would have liked to do 2 visits per week for 3-4 weeks but the patients schedule did not allow for that. We used local acupuncture needles with electrostimulation, as well as body needles for systemic work to deal with the causative factors (wind, qi deficiency and stress). The needle prescription included:

Electrostimulation hooked to acupuncture needles on face for Bell's Palsy treatment

Local points on the right side: GB 2 (Tinghui), GB14 (Yangbai), TW23 (Sizhukong) , ST2 (Sibai), ST3 (Juliao) , ST 4 (Dicang), ST 6 (Jiache), ST 7 (Xiaguan), SI18 (Quanliao), M-HN-18 (Jiachengjiang). These points shifted and some were used as ashi based on the progress or lack thereof with each visit to effect muscle contraction and relaxation. These points were also paired for electrical stimulation to effect muscle contraction and relaxation to teach the muscles how to work and relax properly once more. I used a Pantheon set at low frequency of 2hz continuous with the amplitude to patient's tolerance and visual muscle contraction. Caution is recommended with needle depth and excessive amplitude as the face is very sensitive and there isn't that much depth before breaking through into the mouth. It's always best to go slow and check in with patient regularly for comfort, explaining that more doesn't equal better.

Distal points bilaterally for systemic treatment: GB 20 (Fengchi), LI4 (Hegu), ST36 (Zusanli), GB34 (Yanglingquan), SP6 (SanyinJiao), LR3 (Taichong). These points were chosen to expel wind, tonify and move the qi, command the face, nourish yin, and work with muscles and tendons.

In addition to these in office treatments, patient was sent home with a moxa stick to do treatment on her cheek and ST36 (Zusanli) in the first week. She was also given a tutorial on daily facial guasha and areas of concentration to help circulate and move the qi and blood flow more regularly through the facial meridians, muscles and collaterals. Patient was very compliant with home treatments and highly motivated for recovery.

Day after first treatment. Patient tongue returning toward midline.

Outcomes: First three treatments were spaced one week apart. Patient showed marked improvement after first visit. Tongue deviation very nearly disappeared indicating the wind effecting the body was being expelled. Upper eyelid was easier to close and hold closed indicating a return to improved muscular function. She had more ability to lift and lower eyebrows, though still work needed on right side. She was able to have better command over cheek puff, lip pucker and smile, though both had much more recovery to go and were still subject to deviating left due to lack of right sided strength.

After second visit, tongue deviation completely gone and upper eyelid closing and opening with blinking and sleeping per normal. Improved muscular function with command over eyelid raises, cheek puff, smile and lip pucker, but still weak and short lived in all respects. More work needed here.

After third visit, final treatment to eyelid in this visit and patient has full command and control over eyelid as per normal. Eye dryness gone now that able to blink and lubricate regularly. Muscular function of cheek and lips improving with very minor lag in tensile strength to hold closed or hold smile. Patient feels full recovery on the horizon.

Video of patient after third treatment with near full access to facial movements.

It was recommended that patient continue with a few more visits just to ensure the results held and all systems maintained. Patient was scheduled for three additional follow up visits but cancelled due to her full recovery.

As of September 2025, checked in with patient and full recovery remains with full function and sustainability.

If you or someone you know has been recently diagnosed with Bell's Palsy, please reach out. You can see that acupuncture is an effective treatment for restoring recovery and getting facial expression and muscle control back to normal. As I've mentioned above, early and often is the approach. So, please don't wait until it's been a month or more and nothing else has worked. Acupuncture works! It works better if we are able to see you as close to diagnosis and symptoms as possible.

Click here to reach out for a free 15 minute phone consultation to see if acupuncture can help you get function back and make a full recovery.