Letters to the Editor

Acupuncture for the Treatment of Bell Palsy


Am Fam Physician. 2014 May 1;89(9):702.

Original Article: Common Questions About Bell Palsy

Issue Date: February 1, 2014

Available at: https://www.aafp.org/afp/2014/0201/p209.html

TO THE EDITOR: I appreciate the authors' brief review on Bell palsy, but I am curious why they did not mention the benefits of acupuncture for treating this condition.1,2 Before reaching for my prescription pad to prescribe steroids, I refer my patients to one of the many qualified and licensed acupuncturists in my area. These patients often achieve dramatic improvements without the adverse effects that commonly occur with steroid use (e.g., weight gain, worsening of blood glucose control).

Author disclosure: No relevant financial affiliations.


1. Xu SB, et al. Effectiveness of strengthened stimulation during acupuncture for the treatment of Bell palsy: a randomized controlled trial. CMAJ. 2013;185(6):473–479.

2. Tong FM, et al. A prospective randomised controlled study on efficacies of acupuncture and steroid in treatment of idiopathic peripheral facial paralysis. Acupunt Med. 2009;27(4):169–173.

IN REPLY: Acupuncture has a growing evidence base, and further research is warranted. Current evidence indicates that early treatment with prednisolone significantly improves chances of complete recovery from Bell palsy1; therefore, steroid treatment should not be delayed to initiate acupuncture or any other alternative therapy. There are no evidence-based recommendations for the initiation of acupuncture for Bell palsy.2 A Cochrane systematic review found no harm from acupuncture, but also could not establish effectiveness secondary to the poor quality and insufficient power of existing studies.3

Most patients with Bell palsy achieve dramatic improvements without any treatment. In one study evaluating 1,011 patients, 85% showed signs of remission within a three-week period.4 The primary purpose of steroid therapy is to prevent long-term sequelae, and there is a higher degree of success if it is initiated as soon as possible.5

Author disclosure: No relevant financial affiliations.


show all references

1. Sullivan FM, et al. Early treatment with prednisolone or acyclovir in Bells palsy. N Engl J Med. 2007;357(16):1598–1607....

2. Kim JI, et al. Acupuncture for Bell's palsy: a systematic review and meta-analysis. Chin J Integr Med. 2012;18(1):48–55.

3. Chen N, et al. Acupuncture for Bell's palsy. Cochrane Database Syst Rev. 2010;(8):CD002914.

4. Peitersen E. The natural history of Bell's palsy. Am J Otol. 1982;4(2):107–111.

5. Marsk E, et al. Early deterioration in Bell's palsy: prognosis and effect of prednisolone. Otol Neurotol. 2010;31(9):1503–1507.

Send letters to afplet@aafp.org, or 11400 Tomahawk Creek Pkwy., Leawood, KS 66211-2680. Include your complete address, e-mail address, and telephone number. Letters should be fewer than 400 words and limited to six references, one table or figure, and three authors.

Letters submitted for publication in AFP must not be submitted to any other publication. Possible conflicts of interest must be disclosed at time of submission. Submission of a letter will be construed as granting the AAFP permission to publish the letter in any of its publications in any form. The editors may edit letters to meet style and space requirements.

This series is coordinated by Kenny Lin, MD, MPH, Associate Deputy Editor for AFP Online.



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