What Is Bell’s Palsy?

Bell’s palsy is a condition in which the muscles on one side of your face become weak or paralyzed. It affects only one side of the face at a time, causing it to droop or become stiff on that side.

It’s caused by some kind of trauma to the seventh cranial nerve. This is also called the “facial nerve.” Bell’s palsy can happen to anyone. But it seems to occur more often in people who have diabetes or are recovering from viral infections.

Most of the time, symptoms are only temporary.

If it happens to you, you may fear you’re having a stroke. You’re probably not. A stroke that affects your facial muscles would cause muscle weakness in other parts of your body, too.

What Causes It?

Most doctors believe that it’s due to damage to the facial nerve, which causes swelling. This nerve passes through a narrow, bony area within the skull. When the nerve swells — even a little bit — it pushes against the skull’s hard surface. This affects how well the nerve works.


Researchers have long believed that viral infections may also play a role in the development of Bell’s palsy. They’ve found evidence that suggests the herpes simplex 1 virus (a common cause of cold sores) may be responsible for a large number of cases.

What Are the Symptoms of Bell’s Palsy?

The symptoms of Bell’s palsy tend to come on all of a sudden. You may go to bed one night feeling fine. But when you look in the mirror the next morning, you see that part of your face seems to be drooping.

Some people feel pain behind their ear 1-2 days before they notice any weakness. Others say that sounds seem much louder than normal in the days before they see any other symptoms.

ou might also notice the following things before the onset of Bell’s palsy (remember that these symptoms will probably only happen on one side of your face):

  • You’re unable to close your eyelid or blink
  • Your eye waters more or less than usual
  • Drooling
  • Difficulty chewing
  • Decreased sense of taste
  • Your facial muscles twitch
  • Pain or numbness behind your ear

Facial weakness and drooping typically reach their peak within a day or two. Most people start to feel better within a couple of weeks. They usually recover completely within 3 months. Some people who develop Bell’s palsy have a longer recovery period. In rare cases, they may have some permanent symptoms.

Source Credit: 
WebMD Medical Reference Reviewed by Neil Lava, MD on October 21, 2018
Interesting side note:

Angelina Jolie Was Diagnosed With Bell’s Palsy

Celebrate International Day Of Older Persons

On Monday, October 1, 2018 join us in celebrating International Day Of Older Persons. Thank them for their wisdom and love and remind them that a regular exercise program and a healthy eating plan can do wonders for any person regardless of age or ability.


Senior Exercise and Fitness Tips

No Matter Your Age, It’s Never Too Late to Get Started

There are many reasons why we tend to slow down and become more sedentary with age. It may be due to health problems, weight or pain issues, or worries about falling. Or perhaps you think that exercising simply isn’t for you. But as you grow older, an active lifestyle becomes more important than ever to your health. Getting moving can help boost your energy, maintain your independence, protect your heart, and manage symptoms of illness or pain as well as your weight. And regular exercise is also good for your mind, mood, and memory. No matter your age or your current physical condition, these tips can show you simple, enjoyable ways to become more active and improve your health and outlook.

What are the benefits of exercise for older adults?

A recent Swedish study found that physical activity was the number one contributor to longevity, adding extra years to your life—even if you don’t start exercising until your senior years. But getting active is not just about adding years to your life, it’s about adding life to your years. You’ll not only look better when you exercise, you’ll feel sharper, more energetic, and experience a greater sense of well-being.

Physical health benefits

Helps you maintain or lose weight. As metabolism naturally slows with age, maintaining a healthy weight is a challenge. Exercise helps increase metabolism and builds muscle mass, helping to burn more calories.

Reduces the impact of illness and chronic disease. People who exercise tend to have improved immune and digestive functioning, better blood pressure and bone density, and a lower risk of Alzheimer’s disease, diabetes, obesity, heart disease, osteoporosis, and certain cancers.

Enhances mobility, flexibility, and balance. Exercise improves your strength, flexibility and posture, which in turn will help with balance, coordination, and reducing the risk of falls. Strength training also helps alleviate the symptoms of chronic conditions such as arthritis.

Mental health benefits

Improves sleep. Quality sleep is vital for your overall health. Regular activity can help you fall asleep more quickly, sleep more deeply, and wake feeling more energetic and refreshed.

Boosts mood and self-confidence. Exercise is a huge stress reliever and the endorphins produced can actually help reduce feelings of sadness, depression, or anxiety. Being active and feeling strong naturally helps you feel more self-confident.

Does amazing things for the brain. Activities like Sudoku or crossword puzzles can help keep your brain active, but little comes close to the beneficial effects of exercise on the brain. It can help brain functions as diverse as multitasking and creativity and can help prevent memory loss, cognitive decline, and dementia. Getting active may even help slow the progression of brain disorders such as Alzheimer’s disease.


Overcoming obstacles to getting active as you age

Starting or maintaining a regular exercise routine can be a challenge at any age—and it doesn’t get any easier as you get older. You may feel discouraged by health problems, aches and pains, or concerns about injuries or falls. If you’ve never exercised before, you may not know where to begin, or perhaps you think you’re too old or frail, can never live up to the standards you set when you were younger. Or maybe you just think that exercise is boring.

While these may seem like good reasons to slow down and take it easy as you age, they’re even better reasons to get moving. Becoming more active can energize your mood, relieve stress, help you manage symptoms of illness and pain, and improve your overall sense of well-being. And reaping the rewards of exercise doesn’t have to involve strenuous workouts or trips to the gym. It’s about adding more movement and activity to your life, even in small ways. No matter your age or physical condition, it’s never too late to get your body moving, boost your health and outlook, and improve how you age.

Six myths about activity and aging

Myth 1: There’s no point to exercising. I’m going to get only anyway.


Fact: Regular physical activity helps you look and feel younger and stay independent longer. It also lowers your risk for a variety of conditions, including Alzheimer’s and dementia, heart disease, diabetes, certain cancers, high blood pressure, and obesity. And the mood benefits of exercise can be just as great at 70 or 80 as they were at 20 or 30.


Myth 2: Exercise puts me at risk of falling down.


Fact: Regular exercise, by building strength and stamina, prevents loss of bone mass and improves balance, actually reducing your risk of falling.


Myth 3: It’s too frustrating: I’ll never be the athlete I once was.


Fact: Changes in hormones, metabolism, bone density, and muscle mass mean that strength and performance levels inevitably decline with age, but that doesn’t mean you can no longer derive a sense of achievement from physical activity or improve your health. The key is to set lifestyle goals that are appropriate to your age. And remember: a sedentary lifestyle takes a much greater toll on athletic ability than biological aging.


Myth 4: I’m too old to start exercising.


Fact: You’re never too old to get moving and improve your health! In fact, adults who become active later in life often show greater physical and mental improvements than their younger counterparts. If you’ve never exercised before, or it’s been a while, you won’t be encumbered by the same sports injuries that many regular exercisers experience in later life. In other words, there aren’t as many miles on your clock so you’ll quickly start reaping the rewards. Just begin with gentle activities and build up from there.

Myth 5: I can’t exercise because I’m disabled.


Fact: Chair-bound people face special challenges but can lift light weights, stretch, and do chair aerobics, chair yoga, and chair Tai Chi to increase range of motion, improve muscle tone and flexibility, and promote cardiovascular health. Many swimming pools offer access to wheelchair users and there are adaptive exercise programs for wheelchair sports such as basketball.


Myth 6: I’m too weak or have too many aches and pains.

Fact: Getting moving can help you manage pain and improve your strength and self-confidence. Many older people find that regular activity not only helps stem the decline in strength and vitality that comes with age, but actually improves it. The key is to start off gently.

What if you hate to exercise?

If you dread working out, you’re not alone. But you don’t have to exercise until you’re soaked in sweat or every muscle aches to make a big difference to your health. Think about activities that you enjoy and how you can incorporate them into an exercise routine:

  • Listen to music or an audiobook while lifting weights.
  • Window shopping while walking laps at the mall.
  • Get competitive while playing tennis.
  • Take photographs on a nature hike.
  • Meet new people at a yoga class or fitness center.
  • Watch a favorite movie or TV show while on the treadmill.
  • Instead of chatting with a friend over coffee, chat while walking, stretching, or strength training.
  • Walk the golf course instead of using a cart.
  • Walk or play fetch with a dog. If you don’t own a dog, offer to take a neighbor’s dog for a walk or volunteer at a pet shelter or rescue group.
  • Go for a run, walk, or cycle when you’re feeling stressed—see how much better you feel afterwards.
  • Find an exercise buddy, someone whose company you really enjoy, and try activities you’ve never tried before—you may find something you love. At worst, you’ve spent time with a good friend.


Building a balanced exercise plan

Staying active is not a science. Just remember that mixing different types of physical activity helps both to keep your workouts interesting and improve your overall health. The key is to find activities that you enjoy—based on the four building blocks of fitness. These are:

1: Balance

What it is: Maintains standing and stability, whether you’re stationary or moving around. Try yoga, Tai Chi, and posture exercises to gain confidence with balance.

Why it’s good for you: Improves balance, posture, and quality of your walking. Also reduces risk of falling and fear of falls.

2: Cardio

What it is: Uses large muscle groups in rhythmic motions over a period of time. Cardio workouts get your heart pumping and you may even feel a little short of breath. Includes walking, stair climbing, swimming, hiking, cycling, rowing, tennis, and dancing.

Why it’s good for you: Helps lessen fatigue and shortness of breath. Promotes independence by improving endurance for daily activities such as walking, house cleaning, and errands.

3: Strength and power training

What it is: Builds up muscle with repetitive motion using weight or external resistance from body weight, machines, free weights, or elastic bands. Power training is often strength training done at a faster speed to increase power and reaction times.

Why it’s good for you: Strength training helps prevent loss of bone mass, builds muscle, and improves balance—both important in staying active and avoiding falls. Power training can improve your speed while crossing the street, for example, or prevent falls by enabling you to react quickly if you start to trip or lose balance. Building strength and power will help you stay independent and make day-to-day activities easier such as opening a jar, getting in and out of a car, and lifting objects.

4: Flexibility

What it is: Challenges the ability of your body’s joints to move freely through a full range of motion. This can be done through stationary stretches and stretches that involve movement to keep your muscles and joints supple and less prone to injury. Yoga is an excellent means of improving flexibility.

What’s the Best Exercise Plan for Me?

Why it’s good for you: Helps your body stay limber and increases your range of movement for ordinary physical activities such as looking behind while driving, tying your shoes, shampooing your hair, and playing with your grandchildren.

Types of activities beneficial to older adults

Walking. Walking is a perfect way to start exercising. It requires no special equipment, aside from a pair of comfortable walking shoes, and can be done anywhere.

Senior sports or fitness classes. Keeps you motivated while also providing a source of fun, stress relief, and a place to meet friends.

Water aerobics and water sports. Working out in water reduces stress and strain on the body’s joints.

Yoga. Combines a series of poses with breathing. Moving through the poses works on strength, flexibility and balance, and can be adapted to any level.

Tai Chi and Qi Gong. Martial arts-inspired systems of movement that increase balance and strength. Classes for seniors are often available at local YMCA or community centers.


Getting started safely

Getting active is one of the healthiest decisions you can make as you age, but it’s important to do it safely.

Get medical clearance from your doctor before starting an exercise program, especially if you have a preexisting condition. Ask if there are any activities you should avoid.

Consider health concerns. Keep in mind how your ongoing health problems affect your workouts. For example, diabetics may need to adjust the timing of medication and meal plans when setting an exercise schedule.

Listen to your body. Exercise should never hurt or make you feel lousy. Stop exercising immediately and call your doctor if you feel dizzy or short of breath, develop chest pain or pressure, break out in a cold sweat, or experience pain. And put your routine on hold if a joint is red, swollen, or tender to the touch—the best way to cope with injuries is to avoid them in the first place. If you regularly experience pain or discomfort after exercising, try exercising for less time but more frequently throughout the day.

Start slow and build up steadily. If you haven’t been active in a while, build up your exercise program little by little. Try spacing workouts in ten-minute increments twice a day. Or try just one class each week. If you’re concerned about falling or have an ongoing heart problem, start with easy chair exercises to slowly increase your fitness and confidence.

Prevent injury and discomfort by warming up, cooling down, and keeping water handy.

Commit to an exercise schedule for at least 3 or 4 weeks so that it becomes habit, and force yourself to stick with it. This is much easier if you find activities you enjoy.

Experiment with mindfulness. Instead of zoning out when you exercise, try to focus on how your body feels as you move—the rhythm of your breathing, the way your feet strike the ground, your muscles flexing, for example. You’ll improve your physical condition faster, better help to relieve stress and anxiety, and more likely to avoid accidents or injuries.

If you have an injury, disability, weight problem, or diabetes…

How to Exercise if You Have Limited Mobility

While there are challenges that come with exercising with mobility issues, by adopting a creative approach, you can overcome any physical limitations and find enjoyable ways to get active and improve your health and well-being.

Support activity levels with the right diet

Diet as well as exercise can have a major impact on energy, mood, and fitness. Many older adults don’t get sufficient high-quality protein in their diets despite evidence suggesting they actually need more than younger people to maintain energy levels and lean muscle mass, promote recovery from illness and injury, and support overall health. Older adults without kidney disease or diabetes should aim for about 0.5 grams of protein per pound of body weight.

  • Vary your sources of protein instead of relying on just red meat, including more fish, poultry, beans, and eggs.
  • Reduce the amount of processed carbohydrates you consume—pastries, cakes, pizza, cookies and chips—and replace them with high-quality protein.
  • Snack on nuts and seeds instead of chips, replace a baked dessert with Greek yogurt, swap out slices of pizza for a grilled chicken breast and a side of beans.


Tips for staying motivated

It’s easy to become discouraged when illness, injury, or changes in the weather interrupt your routine and seem to set you back to square one. But there are ways to stay motivated when life’s challenges get in the way:

Focus on short-term goals, such as improving your mood and energy levels and reducing stress, rather than goals such as weight loss, which can take longer to achieve.

Reward yourself when you successfully complete a workout, reach a new fitness goal, or simply show up on a day when you were tempted to ditch your activity plans. Choose something you look forward to, but don’t allow yourself to do until after exercising, such as having a hot bath or a favorite cup of coffee.

Keep a log. Writing down your activities in an exercise journal not only holds you accountable, but is also a reminder of your accomplishments.

Get support. When you work out with a friend or family member, you can encourage and motivate each other.

How to stay fit when your routine changes
You’re on vacation
  • Many hotels now have fitness centers. Bring along your exercise clothing or equipment (resistance band, bathing suit, or walking shoes).
  • Get out and see the sights on foot rather than just by tour bus.
Caring for an ill spouse is taking up too much of your time
  • Work out to an exercise video when your spouse is napping
  • Ask a family member or friend to come over so you can go for a walk
Your usual exercise buddy moves away
  • Ask another friend to go with you on your daily walk.
  • Reach out to other older adults in your area—many are in the same boat as you so be the one to break the ice.
  • Join an exercise class at your local community center or senior center. This is a great way to meet other active people.
You move to a new community
  • Check out the fitness centers, parks, community websites, and recreation associations in your new neighborhood.
  • Look for activities that match your interests and abilities.
Illness keeps you out of action for a few weeks
  • Wait until you feel better and then start your activity again.
  • Gradually build back up to your previous level of activity.
You’re recovering from injury or surgery
  • Talk with your doctor about specific exercises and activities you can do safely.
  • Start slowly and gradually build up your activities as you become stronger.

Related videos


Recommended reading

Exercise and Aging: Can you walk away from Father Time? – While aging is inevitable, exercise can help you to age with grace and vigor. (Harvard Health Publications)

How Exercise Can Help You – Covers the benefits of exercise for seniors, safe exercises to try, an FAQ, and charts to track your progress. (Go4Life NIH)

Benefits of Aquatic Fitness – Discusses the benefits of water exercise for people with medical conditions like osteoporosis, diabetes, and back problems. (Aquatic Exercise Association)

Protein intake and exercise for optimal muscle function with aging – Details how exercise and protein intake can help limit and treat age-related declines in muscle mass, strength, and functional abilities. (The European Society for Clinical Nutrition and Metabolism)

Wheelchair Yoga – Sample poses that can be performed in a wheelchair. (May All Be Happy)

Locate Chair Yoga Teachers – Find chair yoga classes and instructors in the US., Canada, England, Ireland, and several other countries. (Get Fit Where You Sit)

Chair Tai Chi – Video demonstrating Tai Chi for chair-bound individuals. (YouTube)

Authors: Lawrence Robinson, Melinda Smith, M.A., and Jeanne Segal, Ph.D. Last updated: September 2018.


Here is Shamim guiding a very dedicated Noelene Henkel through some easy to do movements

Stay strong, be safe, and maintain your independence by integrating these top fitness options into your training plan. No matter your age, the best exercise for you is the one you enjoy the most…

Scans, surgeries and opioids rarely the right answer for back pain

Most people suffer back pain at one point or another in their lives.

Back pain is now the leading cause of disability worldwide, yet the way it is often treated makes it worse, according to a team of international health experts and backed by leading Perth physiotherapist Professor Peter O’Sullivan.

“In the western world, what we know is a lot of people with back pain have been offered surgery and opioid injection before they are offered high quality, non-interventional care,” says Professor O’Sullivan, a specialist musculoskeletal physiotherapist.

The Curtin University professor’s views are in line with a series of global studies released earlier this year.

Published in the medical journal The Lancet, the three papers by a group of 31 international authors — led by Monash University’s Professor Rachelle Buchbinder — draw attention to the massive impact of low back pain, and call for the removal of harmful and ineffective practices in treating it.

The authors found there is an over-reliance on scans, surgeries and opioid prescriptions to treat low back pain, which could be more effectively treated through self-management and less-invasive physical and psychological therapies.

Physiotherapist Professor Peter O'Sullivan.
Physiotherapist Professor Peter O’Sullivan.Picture:The West Australian, Iain Gillespie

Professor O’Sullivan says low-risk, high-value interventions which potentially offer significant benefit are not being offered as a first line.

Instead, expensive and risky intervention procedures without great outcomes are proffered-up instead.

“For someone without private health insurance, it would be cheaper through the public system for someone to have spinal surgery than to see a physiotherapist for a course of education and progressive exercise and that’s just completely crazy,” he says.

A WA Department of Health spokesperson says surgery for back pain is regarded as an option of last resort and in the WA health system is treated as such.

“At Sir Charles Gairdner Hospital, only a quarter of patients referred for back pain go on to have surgery,” the spokesperson says.

Is back pain a damaged back?

Jumping to scans, surgeries and opioids stem from the belief that back pain equals a damaged back and a scan is required to identify a problem, says Professor O’Sullivan.

“The problem is most people have stuff on the scan, so it triggers this ripple effect where the next step is to try and fix the structure. We know there is a strong relationship with having been scanned and going for injections and ending up with surgery. It creates this spiralling effect,” he says.

Professor O’Sullivan is not anti-scanning.

He says scans are required in some cases, say following a major trauma, but he says that is only about one per cent of presenting cases.

While it’s easy to lay the blame on the doorstep of one set of health professionals, Professor O’Sullivan says it is much more complex.

“We know there is a stepped approach that normally happens in clinical care. Even that first step is not well managed and that is a reflection on our profession that we are not adequately dealing with people that are distressed with pain. They rapidly jump to the next step or they just miss the first step completely and I think that is happening quite a lot in the care setting,” he says.

Societal beliefs also play a big part. “If you ask people in the community, ‘what do you think back pain means?’, usually they say ‘God, there is something damaged in your back and it probably means you need a scan, and it probably means you shouldn’t be active, and you should have bed rest and take a day off work’.”

Contradicting this, the Lancet papers state bed rest and not remaining active actually delays recovery.

Do you have the right expectations?

Australian Medical Association (WA) president Dr Omar Khorshid says part of the problem with treating back pain is there is little high-quality evidence to guide treatment.

Are there people that surgery is the right thing for? Yes, there are, but how do you identify those people? I think that is where the research needs to go.

Dr Omar Khorshid

“How we target our interventions, who does benefit from surgery, who doesn’t, because it is clear some people do, but how do we pick them and avoid inappropriate referrals?” explains Dr Khorshid.

He says while doctors have known for decades the best treatment for mechanical back pain is “maintaining activity, minimising rest, keeping the muscles strong and trying to get back to normal life” and of which the majority of presenting patients are advised, patient expectations are a whole different ball game. “We do have a problem in our society where people will be going to doctors expecting an intervention, investigation or treatment and doctors are under a lot of pressure to do that and that is partly behind the rates of investigation that we see,” Dr Khorshid says.

“Like many Western countries we have an over-dependence on opiate medications. Someone presents to the doctor in a lot of pain, the doctor who is a compassionate person feels they need to relieve that pain and offers amongst other things opiate treatment to help the patient get through their acute problem. But what we have realised is in the long-term it makes the pain more difficult to manage as patients become dependent on opiates and their pain overall gets worse.”

A new understanding on backs

A large part of Professor O’Sullivan’s solution to back pain is education, empowering patients with clear, practical strategies to put them “back in charge of their lives”.

Having back pain very rarely means you are damaged or it is something serious, therefore it is really important that we engage with the things that are most likely to be related to your pain … like you are under stress, you are not sleeping well, your mood, or you are not active and that can trigger a pain event. We know those factors are commonly linked to a flare up of back pain.

Professor Peter O’Sullivan

“And those things are really important to reassure the patient that it is really safe to go to work, it is really safe to get active and it is really important you get moving very quickly and then to map out a plan for that.”

Intervention is the key

Chiropractors Association of Australia WA president Joshua Tymms says not all back pain can be self-managed. He says if treatment is needed to help recovery for back pain, early intervention is key.

“Certainly patients are still not getting the right advice 100 per cent of the time as Professor Buchbinder points out. Research constantly strengthens the case for conservative care of back problems rather than medications and surgery,” Dr Tymms says, adding people should seek out a chiropractor if they are unsure how to manage a back pain problem.

Professor O’Sullivan says what is healthy for the back is movement, loading and physical activity. There is no ideal exercise, just one the person enjoys and will do regularly, and preferably engages movement in all directions.

He also points out it is typical to have aches and pains. “It’s kind of normal but what is not normal is to freak out about your pain and stop working and not engage with activity.

I think it is important to understand that it is not possible to eradicate pain out of people’s lives but it is absolutely possible to provide people with strategies to go about their lives in a very normal way so pain doesn’t disrupt it.

Professor Peter O’Sullivan

Traditional thinking under fire

It’s a common story told by back pain sufferers — one that starts with an everyday activity.

Three years ago, firefighter Joe Laurence, 30, was hauling a fire hose over a fence. It was something he had done hundreds of times before. The fence shifted and he felt a shooting pain go down his foot.

It pulled up OK, but a week later as he was walking along the beach, he stepped in a hole… and spent the next week and a half immobile in bed.

“I didn’t have a day for the next three years where I didn’t consider my back and it was just a nightmare,” Joe says.

Firefighter Joe Laurence.
Firefighter Joe Laurence.Picture: The West Australian

What followed were physiotherapists, chiropractors, rehabilitation and a scan where he was told he had the back of a 60-year-old.

“After the scan, in my head I was thinking there were these bulges and fissures and to me that meant; hold on, you have to take it easy,” explains Joe.

“I was always bracing, always sitting bolt upright with a so-called good posture and now I see, those things are probably what caused it to become the chronic problem it was. If I had just kept moving naturally, not thinking I was damaged, I would have been able to keep moving well.”

Joe’s mental health suffered too. With a physical job, he thought he had a career expiry date. “I really love being a firey, so it really played with my mental health.”

When a second incident put Joe back at square one after three years, he visited physiotherapist Professor Peter O’Sullivan for a different perspective.

“The message I got from everyone else was that you have to protect your back and brace your core. Pete just said your back is designed to bend, so bend it. Your back is designed to twist, so twist it. It’s safe to load your back in a flexed position… within about a month, I went from being worried about tying up my shoelaces or lifting the toilet seat, to this pain-free range of motion which I then strengthened up like you do with any other joint in the body,” he says.

“He literally gave me a licence to move. He said ‘look, pain doesn’t mean damage, if you keep moving, you’ll get better at it and the pain will subside. Your body will realise it is not a threatening action… these actions are perfectly healthy and normal and good for you and not dangerous’… and that was the difference.

“It’s absolutely amazing how effective this way of thinking was and I can’t believe how much resistance there is to it, to be honest.”

Source: https://thewest.com.au/lifestyle/health-wellbeing/scans-surgeries-and-opioids-rarely-the-right-answer-for-back-pain-ng-b88899127z

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