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Bell’s palsy is one of the most common causes of sudden, temporary facial paralysis. While it can occur at any time of the year, many clinicians notice a clear rise in cases during the winter months. Cold winds, sudden temperature changes, viral infections, and weakened immunity all contribute to this spike.
In this blog, we explore why Bell’s palsy increases during winter, the physiotherapy approach at CB Physiotherapy, and essential precautions to support faster and safer recovery.
Why Is Bell’s Palsy More Common in Winter?
1. Increased Viral Infections
Winter brings a jump in viral illnesses—cold, flu, respiratory infections, and herpes virus reactivation.
These viruses can trigger inflammation of the facial nerve, leading to facial weakness or paralysis.
2. Cold Exposure & Vasoconstriction
Sudden exposure to cold air causes the facial blood vessels to constrict.
Reduced blood flow can irritate the facial nerve, making it more vulnerable to inflammation and swelling.
3. Low Immunity in Winter
Winter months often lead to:
- Poor vitamin D levels
- Reduced physical activity
- Poor sleep
- Increased stress
- A weak immune system increases the likelihood of nerve inflammation and viral reactivation.
4. Sudden Temperature Shifts
Moving from a warm indoor space to cold outdoor air can create stress on the facial nerve, especially if the face is uncovered.
5. Dry Air & Dehydration
Winter air is dry, and dehydration affects nerve function, making recovery slower and symptoms more intense.
Physiotherapy Treatment for Bell’s Palsy at CB Physiotherapy
At CB Physiotherapy, treatment focuses on nerve healing, muscle activation, facial symmetry, and preventing complications like synkinesis.
1. Detailed Assessment & Grading
Therapists evaluate:
- House–Brackmann scale
- Facial symmetry
- Muscle strength
- Eye closure ability
- Severity of nerve involvement
- This helps customize an evidence-based treatment plan.
2. Facial Neuromuscular Re-Education
Very specific exercises help retrain facial muscles to:
- Improve symmetry
- Increase voluntary control
- Prevent abnormal movement patterns
- This includes guided exercises for:
- Eyebrows
- Eye closure
- Smile muscles
- Lip pursing
- Cheek puffing
3. Electrical Stimulation (When Indicated)
Low-frequency stimulation may be used cautiously to activate weak muscles and prevent excessive atrophy.
Not recommended for all patients—therapists at CB Physiotherapy decide after assessment.
Mirror Biofeedback
Real-time visual feedback helps patients re-learn correct facial movements and eliminate compensations.
4. Manual Therapy & Soft Tissue Techniques
Gentle massage is used to:
- Improve circulation
- Relax tight muscles
- Reduce nerve compression
5. Heat Therapy
Moist heat improves blood supply and reduces muscle stiffness.
6. Eye Protection Guidance
Since incomplete eye closure is common, therapists guide:
- Lubricating eye drops
- Eye taping
- Night protection
- Blink training
Precautions for Bell’s Palsy — Especially in Winter
Avoid Direct Cold Exposure
Always protect the face with:
- Scarves
- Caps
- Masks
- Avoid stepping into cold wind immediately after washing your face.
Do NOT Overdo Facial Exercises
Excessive or incorrect exercises can cause synkinesis (unwanted muscle contractions).
Follow only your physiotherapist’s prescribed routine.
Don’t Apply Ice
Many people mistakenly apply ice for swelling—but it worsens facial nerve constriction.
Protect Your Eyes
If your eye doesn’t close fully:
- Use lubricating drops
- Tape eye at night
- Wear sunglasses outdoors
Maintain Good Immunity
- Stay hydrated
- Eat nutritious meals
- Maintain vitamin D levels
- Sleep 7–8 hours
- Manage stress
Avoid Facial Massage by Non-professionals
Untrained massage can worsen nerve irritation.
When to Consult CB Physiotherapy
Seek physiotherapy if you experience:
Difficulty closing the eye
Drooling
Reduced taste
Ear pain
Facial twitching
Early physiotherapy—ideally within the first few days—helps maximize recovery and reduces long-term complications.
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