Bell's palsy

[gcoe]

Hi jjose_01

I think the questions you are raising are really valid. In the face of evidence that does not show a treatment works what should we do? Here are a couple of issues we need to consider:

* Patient's with Bell's Palsy are often traumatised and distressed by what has happened to them. We need to treat them sympathetically. We are able to give them some reassurance about the likelihood of recovery which is one good thing we can do. We need to be mindful of the psychological support a caring phsyio can offer. However we shouldn't fool ourselves or our patients about ineffective treatments. It is unethical to raise hopes about a treatment that isn't likely to work.

* I see no problem in giving these patients an exercise programme that they can carry out themselves. As the review stated exercise may speed up recovery. However given the resources involved maybe we would consider more of a home programme that could be supervised rather than active treatment. And there are also some practical issues such as hygene and managing eating that we can advise patients on

* I don't think this needs to be the last word in research on physio for Bell's Palsy. We should lobby for better quality trials and think carefully about the type of treatments that may be fruitful. However we probably need to be mindful that the prospect of our treatments being effective is not very high.

[jjose_01]

so what are the "supposed-to-be" authorities that can give us guiding lines in treating patients with bell's palsy?

maybe one to three sessions of educating the patients about the disease process and the exercises that "may" hasten up recovery will do and a follow-up after 1 month, every month?

[macrylinda1]

Hi jjose_01

I think the questions you are raising are really valid. In the face of evidence that does not show a treatment works what should we do? Here are a couple of issues we need to consider:

* Patient's with Bell's Palsy are often traumatised and distressed by what has happened to them. We need to treat them sympathetically. We are able to give them some reassurance about the likelihood of recovery which is one good thing we can do. We need to be mindful of the psychological support a caring phsyio can offer. However we shouldn't fool ourselves or our patients about ineffective treatments. It is unethical to raise hopes about a treatment that isn't likely to work.

* I see no problem in giving these patients an exercise programme that they can carry out themselves. As the review stated exercise may speed up recovery. However given the resources involved maybe we would consider more of a home programme that could be supervised rather than active treatment. And there are also some practical issues such as hygene and managing eating that we can advise patients on

* I don't think this needs to be the last word in research on physio for Bell's Palsy. We should lobby for better quality trials and think carefully about the type of treatments that may be fruitful. However we probably need to be mindful that the prospect of our treatments being effective is not very high.

gcoe, thank you for shedding light on this. I question myself too everytime i handle patients with bell's palsy. am i doing the best thing for my patient that is worth compensating?
shall we abandon our patients with bell's palsy is another question. how are we gonna treat them after that high quality research?
shall i say to my patients..."doing nothing is the best thing"?