--- title: How Effective Is Physiotherapy Treatment for Bell’s Palsy? description: Find out more about how electrotherapy and physiotherapy treatment can be used to help you overcome Bell’s palsy or any other ailment. image: https://ckphysio.co.uk/hubfs/Physiotherapy%20Clinic%20with%20Facial%20Massage%20Demonstration.jpg --- [![Spinal Problems, Sports Injuries, Joint Pains & Others! | London | CK Physiotherapy](https://ckphysio.co.uk/hubfs/CK%20physio%20-%202023/Images/CK%20LOGO%20main%20with%20wordmark%2032pt%20SVG%201.svg)](https://ckphysio.co.uk) - [About](https://ckphysio.co.uk/about-us) - [Testimonials](https://ckphysio.co.uk/testimonials) - [Links](https://ckphysio.co.uk/links) - [Infection prevention](https://ckphysio.co.uk/infection-prevention) - [Treatments](https://ckphysio.co.uk/treatments) - [Physiotherapy](https://ckphysio.co.uk/treatments/physiotherapy) - [Shockwave therapy](https://ckphysio.co.uk/treatments/shockwave-therapy) - [Shockwave Video](https://ckphysio.co.uk/treatments/shockwave-therapy/shockwave-video-hanwell) - [Electrotherapy](https://ckphysio.co.uk/treatments/electrotherapy) - [Conditions](https://ckphysio.co.uk/conditions) - [Bookings](https://ckphysio.co.uk/bookings) - [Resources](https://ckphysio.co.uk/resource) - [Blog List](https://ckphysio.co.uk/blog) - [Educational Videos](https://ckphysio.co.uk/in-depth-guide-video) [Contact us](https://ckphysio.co.uk/contact) ![Physiotherapy Clinic with Facial Massage Demonstration](https://ckphysio.co.uk/hs-fs/hubfs/Physiotherapy%20Clinic%20with%20Facial%20Massage%20Demonstration.jpg?width=1200&height=628&name=Physiotherapy%20Clinic%20with%20Facial%20Massage%20Demonstration.jpg) ![calender](https://ckphysio.co.uk/hubfs/CK%20physio%20-%202023/Images/Group%20427324665.svg) 29. September 2020 # How Effective Is Physiotherapy Treatment for Bell’s Palsy? Conditions  ·  Facial Palsy BK Written and clinically reviewed by **Bryan Kelly, Chartered Physiotherapist (MCSP)**, CK Physiotherapy, Hanwell & Ealing. Published 29 September 2020  ·  Last reviewed 14 July 2026 **Bell’s palsy is the sudden onset of weakness or paralysis on one side of the face. It happens when the facial nerve — which controls the muscles of expression — becomes swollen and compressed, most often for reasons that are never fully identified (which is why doctors also call it *idiopathic facial paralysis*). It usually develops over a matter of hours, reaching its worst within two to three days.** ## Bell’s Palsy Self-Care: An Evidence-Based Guide from Chartered Physiotherapists **In short:** Bell’s palsy is a sudden, one-sided facial weakness caused by irritation of the facial nerve. It is frightening but usually temporary — around **7 in 10 people recover fully on their own**, and more with early treatment. The most important things you can do are to **see a GP or call NHS 111 urgently** (so steroids can be started within 72 hours), **protect your eye**, and **rest**. Gentle facial rehabilitation with a Chartered Physiotherapist can support your recovery once movement begins to return. Act quickly — and rule out a stroke first A sudden facial droop can be a sign of a **stroke**, which is a medical emergency. Remember **FAST**: **F**ace drooping, **A**rm weakness, **S**peech difficulty, **T**ime to call **999**. If a stroke has been ruled out, still contact your **GP or NHS 111 urgently**. Steroid treatment for Bell’s palsy works best when it is started **within 72 hours** of symptoms beginning. ## What is Bell’s palsy? Waking up with a drooping face is understandably alarming. Your smile may pull to one side, your eye on the affected side may not close properly, and eating, drinking or speaking clearly can suddenly feel difficult. The reassuring news is that Bell’s palsy is, for the vast majority of people, temporary — and there is a clear, sensible path to recovery. ![woman with facial droop](https://ckphysio.co.uk/hs-fs/hubfs/woman%20with%20facial%20droop.jpg?width=800&height=447&name=woman%20with%20facial%20droop.jpg)In the UK, Bell’s palsy affects roughly **20 to 37 people in every 100,000 each year**, and about **1 in 60 people** will experience it at some point in their lifetime. It occurs equally in men and women, is most common between the ages of 15 and 45, and is more likely during pregnancy and in people with diabetes.   ### Common symptoms - Rapid weakness or complete paralysis on one side of the face, developing over hours or days - A drooping mouth, a one-sided smile, and difficulty making facial expressions - Difficulty closing one eye, or an eye that feels dry and gritty - Drooling, difficulty eating and drinking, or slightly slurred speech - Pain around or behind the ear on the affected side, sometimes before the weakness appears - A changed sense of taste, or heightened sensitivity to sound in one ear ## Is Bell’s palsy curable? There is no single “cure” for Bell’s palsy, but the outlook is genuinely positive. The body heals the nerve over time, and the right early care gives you the best possible chance of a complete recovery. Around **7 in 10 people recover fully without any treatment at all**. Starting a short course of steroid tablets (usually prednisolone) within 72 hours improves those odds further — in the landmark UK trial, full recovery rose from about 64% to 83% at three months, and to over 94% at nine months. Your GP will decide whether steroids are suitable for you. ## What is the fastest way to recover from Bell’s palsy? There is no overnight fix — nerves heal slowly, and patience is part of the process. But you can genuinely give recovery its best chance by acting quickly and looking after the basics: 1. **See a GP or call NHS 111 straight away** so steroids can be started within 72 hours. 2. **Protect the affected eye** day and night (see below) — this is the most important piece of self-care. 3. **Rest and be gentle with your face.** Resist the urge to “work” it hard; forcing movement too early can cause problems later. 4. **Once movement starts to return**, work with a Chartered Physiotherapist on gentle, guided facial rehabilitation. ## Bell’s palsy self-care at home Good self-care protects you from complications while your nerve recovers and helps you feel more in control. Here is what matters most, in order of priority. Priority 1  ·  Protect your eye If your eye won’t close fully, it can dry out and become damaged — so eye protection is the single most important thing you can do. Speak to a pharmacist or GP, who can recommend: - Lubricating eye drops during the day - A thicker eye ointment at night - Gently taping the eye closed at night if it will not shut (ask a health professional to show you how) Seek same-day advice if the eye becomes red, painful or your vision changes. Avoid using a standard eye patch, which can rub the surface of the eye. Priority 2  ·  Gentle facial massage In the early stage, when the face is still “floppy”, **gentle massage is preferable to facial exercises**. Using your hands to soften and support the muscles keeps the area comfortable and helps you stay connected to your face without forcing it to move. Facial Palsy UK recommends daily gentle massage as one of the best ways to reduce the risk of later complications. Priority 3  ·  Rest, eating and wellbeing Give yourself permission to rest — recovery takes energy. Take small bites and sips, chew on the stronger side, and choose softer foods if eating feels awkward. Bell’s palsy can also take an emotional toll; feeling low or anxious about your appearance is completely normal, and talking to someone you trust, or your GP, can help. ## What about facial exercises? **Important:** gentle is always better than forceful. Pushing your face to move harder or faster can encourage *synkinesis* — unwanted linked movements, such as the eye closing when you smile. Never start a facial exercise programme without professional guidance. Facial exercise means using your own facial muscles to make movements, which is different from massage. Specialists generally advise **waiting until at least three months after onset**, and only once the face is no longer floppy, before introducing movement retraining — and even then, it should be tailored to you and supervised. This is where a [Chartered Physiotherapist](https://ckphysio.co.uk/treatments/physiotherapy) can help. The current evidence for tailored facial retraining is encouraging — reviews suggest it can improve facial function, particularly in moderate or longer-lasting cases — though the quality of that evidence is still described as low to moderate. We’ll always be honest with you about what the research does and doesn’t show. ## How long does Bell’s palsy last? Recovery is different for everyone, but a typical pattern looks like this: Hours–3 days Symptoms appear and reach their peak. This is the window to start steroids. 2–3 weeks Most people begin to notice improvement. Around 70% improve within three weeks. 3–4 months The majority of people have recovered fully by this point. Up to 9 months A minority take longer. About 3 in 10 are left with some lasting effect, such as mild weakness or synkinesis, which specialist rehabilitation can help manage. If you have seen **no improvement at all after three weeks**, go back to your GP — a referral to a facial-nerve specialist may be appropriate. ## Does electrical stimulation (TENS or EMS) help? The evidence is mixed, and specialist UK bodies do not currently recommend electrical stimulation for Bell’s palsy. For this reason, **we do not offer electrical stimulation as a treatment for facial palsy.** You may read online that a TENS or EMS machine can speed recovery. In our view it’s important to be straight with you: Facial Palsy UK advises that electrical stimulation is not generally used by facial-palsy experts, because it may be less effective than other approaches and could increase the risk of synkinesis during recovery. While some studies report benefit, the picture is not consistent enough for us to recommend it for this condition. We would rather focus on the things the evidence supports — eye care, gentle massage, and carefully guided rehabilitation. You can read more about our approach to [electrotherapy for other conditions](https://ckphysio.co.uk/treatments/electrotherapy) here. ## How is Bell’s palsy different from a stroke? This is the most important distinction to understand. **Bell’s palsy affects the whole of one side of the face, including the forehead** — so you won’t be able to raise the eyebrow on the affected side. A **stroke usually spares the forehead** (you can still wrinkle it) and is often accompanied by arm weakness or slurred speech. If there is any doubt, treat it as a stroke and call **999**. It is also worth knowing about **Ramsay Hunt syndrome** — facial weakness together with a painful rash or blisters in or around the ear, which needs prompt antiviral treatment. If you notice a rash, tell your GP or 111 straight away. Our related guide on [physiotherapy for facial paralysis](https://ckphysio.co.uk/blog/role-physiotherapist-facial-paralysis-treatment) explains the wider picture. ## How CK Physiotherapy can help After the acute stage, our Chartered Physiotherapists can support your recovery with a calm, personalised approach: assessing your facial movement, teaching you safe gentle massage and eye-care techniques, and — at the right stage — guiding you through tailored facial rehabilitation designed for *your* face and *your* recovery. We’ll always explain what the evidence supports and work alongside your GP or specialist. If getting to us is difficult, we also offer [home visit physiotherapy](https://ckphysio.co.uk/blog/home-visit-physiotherapy-guide). Ready for a more active, pain-free life? Talk to a Chartered Physiotherapist about your recovery. [Book an appointment](https://ckphysio.co.uk/bookings) [Talk to us](https://ckphysio.co.uk/contact) ## Frequently asked questions ### Is Bell’s palsy curable? There is no specific cure, but the outlook is very good. Most people recover completely on their own, and steroids started within 72 hours improve the chances of a full recovery. Around 70% recover fully even without treatment, rising to over 90% with early steroids. ### What is the fastest way to recover from Bell’s palsy? See a GP or call NHS 111 urgently so steroids can begin within 72 hours. Protect the affected eye day and night, rest, and once your face starts to recover, work with a Chartered Physiotherapist on gentle, guided rehabilitation. There is no quick fix — nerve recovery takes time. ### How long does Bell’s palsy last? Most people improve within two to three weeks and recover fully within three to four months. A minority take up to nine months, and about three in ten are left with some lasting effect such as mild weakness or synkinesis. ### What facial exercises can I do at home? In the early “floppy” stage, gentle massage is preferable to forceful exercises, which can encourage synkinesis. Movement retraining is usually introduced only after about three months and should be guided by a therapist. Never push your face to move harder or faster, and seek professional guidance before starting. ### Does electrical stimulation (TENS or EMS) help? The evidence is mixed and specialist UK bodies do not currently recommend electrical stimulation for Bell’s palsy. Facial Palsy UK advises it is not generally used, as it may be less effective than other approaches and could increase the risk of synkinesis. We therefore do not offer it for facial palsy. ### Can Bell’s palsy back? Recurrence is uncommon — around 7% of people have a further episode, often years later. If you have recurrent facial weakness, or weakness on both sides, see your GP, as further investigation may be needed. ### How is Bell’s palsy different from a stroke? Bell’s palsy affects the whole of one side of the face, including the forehead. A stroke usually spares the forehead and often comes with arm weakness or slurred speech. If in any doubt, remember FAST and call 999 immediately. **A note on this article:** this guide is for general information and does not replace personalised medical advice. Bell’s palsy should always be assessed by a doctor. If you have sudden facial weakness, contact your GP or NHS 111 urgently, and call 999 if a stroke is possible. ## References 1. NHS. [Bell’s palsy](https://www.nhs.uk/conditions/bells-palsy/). National Health Service. 2. Facial Palsy UK. [Bell’s palsy — causes, symptoms and recovery](https://www.facialpalsy.org.uk/causes/bells-palsy/). 3. Facial Palsy UK. [Management of flaccid facial paralysis (self-help)](https://www.facialpalsy.org.uk/support/self-help-videos/management-of-flaccid-facial-paralysis-floppy-face/). 4. Facial Palsy UK. [Facial rehabilitation](https://www.facialpalsy.org.uk/support/treatments-therapies/facial-rehabilitation/). 5. Warner MJ, et al. [Bell Palsy](https://www.ncbi.nlm.nih.gov/books/NBK482290/). StatPearls, NCBI Bookshelf. 6. Sullivan FM, et al. [Early treatment with prednisolone or aciclovir in Bell’s palsy](https://pubmed.ncbi.nlm.nih.gov/17942872/). New England Journal of Medicine, 2007. 7. Teixeira LJ, et al. [Physical therapy for Bell’s palsy (Cochrane systematic review)](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7156819/). 8. Gilden DH. [Bell’s Palsy: clinical review](https://www.aafp.org/pubs/afp/issues/2007/1001/p997.html). 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Most people recover completely on their own, and a course of steroid tablets started within 72 hours improves the chances of a full recovery. Around 70% of people recover fully even without treatment, and this rises to over 90% with early steroids." }, "name" : "Is Bell's palsy curable?" }, { "@type" : "Question", "acceptedAnswer" : { "@type" : "Answer", "text" : "The single most effective step is to see a GP or call NHS 111 urgently so that steroid tablets can be started within 72 hours of your symptoms beginning. Alongside this, protect the affected eye day and night, rest, and once your face begins to recover, work with a Chartered Physiotherapist on gentle, guided facial rehabilitation. There is no quick fix — nerve recovery takes time." }, "name" : "What is the fastest way to recover from Bell's palsy?" }, { "@type" : "Question", "acceptedAnswer" : { "@type" : "Answer", "text" : "Most people notice improvement within two to three weeks and recover fully within three to four months. Around 70% of people improve within three weeks. A minority take up to nine months, and about three in ten are left with some lasting effects such as mild weakness or synkinesis." }, "name" : "How long does Bell's palsy last?" }, { "@type" : "Question", "acceptedAnswer" : { "@type" : "Answer", "text" : "In the early 'floppy' stage, gentle facial massage is preferable to forceful exercises, which can encourage unwanted linked movements (synkinesis). Movement retraining is generally introduced only after about three months and should be guided by a therapist. Never push your face to move harder or faster — gentle is better. 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If you have recurrent facial weakness, or weakness affecting both sides, see your GP, as further investigation may be needed." }, "name" : "Can Bell's palsy come back?" }, { "@type" : "Question", "acceptedAnswer" : { "@type" : "Answer", "text" : "Bell's palsy affects the whole of one side of the face, including the forehead, so you cannot raise the eyebrow on that side. A stroke usually spares the forehead — you can still wrinkle it — and often comes with arm weakness or slurred speech. If in any doubt, treat it as a stroke: remember FAST (Face, Arms, Speech, Time) and call 999 immediately." }, "name" : "How is Bell's palsy different from a stroke?" } ] } ```