During my first day of clinical placement, I shadowed Prof Yang Lu at the Acupuncture Department of Nanfang Hospital. (1) His specialised areas include bloodletting therapy, auricular acupuncture, and embedding needle therapy for the treatment of neck, shoulder, lower back, and leg pain, Bell’s palsy, stroke rehabilitation, neurological disorders, and internal conditions such as asthma, vertigo, stomach pain, constipation, and obesity. Although the time was limited, the knowledge I gained from him was extremely valuable.
The Acupuncture Clinic was always fully packed and busy. I remember one morning when around 20 patients were queuing outside the treatment room waiting to be seen. The room contained 10 treatment beds, six electroacupuncture devices, TDP lamps, and three fully equipped trolleys containing various TCM tools. It was a simple medical setting, yet it consistently delivered effective care, as each professor had unique techniques and approaches to treating patients efficiently and successfully.
During my clinical practice, I encountered a wide range of conditions, including Cervical Spondylosis, Sciatica, Bell’s Palsy (BP), post-stroke symptoms, Parkinson’s Disease, cataracts, and emotional disorders. However, the most unforgettable case was a four year-old girl suffering from Bell’s Palsy. She was not the only patient with this condition; even among the adults, around six out of fifteen patients that morning were receiving treatment for Bell’s Palsy.
Honestly, I had never imagined that Bell’s Palsy could occur at such a young age. In my private practice in the UK, I have encountered only a handful of patients with chronic Bell’s Palsy, most of them were middle aged women. Some cases developed following facial surgery, while others were associated with post-stroke complications.
During a case discussion, Professor Yang explained that in younger patients, Bell’s Palsy is often associated with flu-like infections affecting the ear region, and that such cases are relatively common in China. This observation prompted me to reflect on possible contributing factors. In densely populated environments, viral and respiratory infections can spread more easily among children at school, potentially increasing the number of infection-related Bell’s Palsy cases encountered in clinical practice. It is important to note, however, that Bell’s Palsy itself is not contagious. While some viral infections have been linked to its development, the facial paralysis is not transmitted between individuals.
From a TCM perspective, Bell’s Palsy is often categorised under ‘Wind-Stroke’ or ‘Deviation of the Mouth and Eye’. When it develops following a viral illness, such as herpes simplex infection, Ramsay Hunt syndrome, influenza-like infections, or an immune flare-up, TCM does not describe the condition in biomedical terms. Instead, it interprets the disorder as the invasion of external pathogenic factors, most commonly Wind, which obstruct the channels and collaterals of the face and disrupt the normal circulation of Qi and Blood. The resulting imbalance leads to weakness, asymmetry, and impaired movement of the facial muscles.
How Does TCM View Virus-Associated Bell’s Palsy?
1. Wind-Heat Toxin: In a TCM perspective, external wind combined with Heat or Toxic Heat invades the channels, causing inflammation and obstructing the flow of Qi and Blood within the facial meridians. The common signs and symptoms include cold or flu symptoms, sore throat, fever, swollen glands, ear pain, and facial inflammation. The treatment principles are to expel Wind, clear Heat, resolve toxicity, and open the channels.
2. Damp-Heat or Toxic Heat: Patients may present heaviness, swelling, redness, ear vesicles (such as shingles), yellow phlegm, and digestive sluggishness. In a TCM perspective, dampness and heat combine with toxin, obstructing circulation within the channels and collaterals. The treatment principles are to clear damp-heat, detoxify, and transform phlegm.
3. Zheng-Qi Deficiency: In a TCM perspective, Wei-Qi becomes weakened, leaving the body more vulnerable to external pathogenic invasion. Patients may experience chronic stress, exhaustion, poor sleep, and overwork. The treatment principles are to strengthen Wei-Qi (defensive Qi) is crucial, support Spleen and Lung function, and prevent recurrence.
4. Blood Deficiency with Channel Malnourishment: When Blood is deficient, the channels and facial muscles become undernourished, weakening the body’s ability to support normal movement and tissue recovery. As a result, residual pathogenic factors may remain within the meridians, delaying healing and prolonging facial weakness or stiffness. Patients may present with fatigue, pale complexion, dizziness, dry skin, numbness, muscle weakness, poor circulation, pale tongue, and thready pulse. The treatment principles are to nourish Blood, regulate Qi and Blood circulation, and nourish the channels and sinews.
Once the patient’s condition has stabilised, acupuncture treatment (2) should be considered as early as possible (3). The first seven days are especially crucial for recovery. Shallow needling is generally preferred, particularly on the affected side of the face. Daily treatment is considered ideal, although treatment three to four times per week may still be effective.
However, electroacupuncture is usually avoided during the first seven days, as the facial nerves are already inflamed and damaged, and excessive stimulation is not recommended during the acute stage.
Case Study
Primary Complaint: Bell's Palsy following a flu-like illness and ear infection.
TCM Diagnosis: Wind-Heat toxin obstructing the facial channels, with Phlegm impeding the free flow of Qi and Blood.
Treatment Principles: Clear Heat, resolve toxicity, transform Phlegm, unblock the channels and collaterals, and promote the circulation of Qi and Blood to restore facial function.
Acupoints: Shallow needling was performed on Du-20 (Baihui), Du-29 (Yintang), St-4 (Dicang), St-6 (Jiache), St-8 (Touwei), Li-20 (Yingxiang), and Si-19 (Tinggong) on the affected side. Treatment was supplemented with TDP lamp therapy for 30 minutes.
I spoke with the little girl's mother to gain a better understanding of the onset and progression of her condition. In April, the child experienced a fever that lasted for three days. On the fourth day, she developed paralysis on the left side of her face. She was unable to blink her left eye, and the muscles around her mouth became difficult to control. Following assessment by her local GP, a course of antibiotics was prescribed.
The recovery process may take approximately 20 days with daily treatment, although outcomes vary depending on the severity of the condition and the individual's constitution. During my placement, I witnessed encouraging progress by her sixth treatment session, which took place on the fifteenth day after onset. The facial muscles on the affected side had become noticeably more relaxed, particularly around the left eye and mouth, which were beginning to regain more natural movement.
According to her mother, the only remaining noticeable symptom was a slight deviation of the mouth when smiling or crying. Initially, she had received treatment twice weekly from the end of April until mid-May.
On my final day of placement, I had the opportunity to see the little girl again. She appeared significantly more cheerful, talkative, and relaxed than when I first met her in the Acupuncture Department, reflecting not only her physical improvement but also her growing confidence and comfort during recovery.
Seven Key Lifestyle Suggestions for Patients
1. Consume more vegetables and fibre-rich foods in your diet, including tofu, bean products, sweetcorn, lean meat, onions, seaweed, red dates, hawthorn (Shanzha), bitter melon, winter melon, bananas, aubergines, pumpkins, and blackberries.
2. Avoid spicy and overly sour foods, hot-natured foods, strong tea, alcoholic drinks, lamb, and animal organs such as liver and kidneys.
3. Soak your feet in warm water before bedtime for 10–20 minutes to promote circulation and relaxation.
4. Minimise overstimulation from activities such as excessive phone use, television, and laptop screen time.
5. Moderate exercise is beneficial for recovery. Listening to calming music, maintaining a regular sleeping pattern, and keeping emotions stable may also support healing.
6. Perform gentle facial muscle exercises regularly, such as raising the eyebrows, tightly closing the eyes, puffing the cheeks, opening the mouth, wrinkling the nose, and smiling gently. Applying a warm damp towel to the neck and facial area may help relax the muscles. Avoid washing the face with icy cold water, as cold stimulation may aggravate the condition. During windy or cold weather, keep the face and neck well protected.
7. When facial muscles feel weak or difficult to control, practise gently closing the eyes and mouth tightly to improve muscle coordination and awareness.
In a TCM perspectives, the importance of early intervention, patient reassurance, and consistent treatment throughout the recovery process is crucial. Furthermore, I learned that electroacupuncture should be used with caution during the acute stage, as treatment within the first seven days is generally not recommended. Most importantly, this experience reminded me that healing is not only about restoring physical movement, but also about rebuilding confidence, comfort, and hope in a patient's daily life.
An updated version of this article was published in The Clinician, a UK magazine on Traditional Chinese Medicine, on 4 November 2026.
References:
1) Nanfang Hospital:
https://www.smu.edu.cn/english/info/1026/1068.htm
2) Cochrane Review: ‘Acupuncture for Bell’s Palsy’:
https://www.cochrane.org/evidence/CD002914_acupuncture-bells-palsy
3) Compare the efficacy of acupuncture with drugs in the treatment of Bell's palsy- A systematic review and meta-analysis of RCTs:
https://pubmed.ncbi.nlm.nih.gov/31083225/
© 2026 Kit Li. All rights reserved. Please obtain permission before reproducing this article. Referenced materials remain the property of their respective rights holders.
