Ear infections and Chiropractic

Chiropractic Treatment on Ear Infections in Children

By Dr. Daniel Clements D.C.

            Since the very first adjustment from D.D. Palmer who corrected a young man’s hearing lost, chiropractic has been thought to have some impact on keeping the integrity of the inner ear and it’s many important functions.  There has been some skepticism that this phenomenon has never been reported in present research.    However, many case studies have mentioned astonishing effects of a cervical adjustments decreasing ear infections and allowing children to use less antibiotics to treat the infections.  Most ear infections have been treated in the past with antibiotics, however not all the infections were due to a bacterial infection; some are viral infections were antibiotics are ineffective.   Many different variables determine if a child will obtain an ear infection such as, lymphatic flow, angle of eustachian tube, and nerve flow to the ear. 

            Ear problems in children are very prevalent in the United States today; there are 10 million new cases every day where otitis media infections are the most common illness effecting babies and young children.[1]  This accounts for more then 35 percent of all pediatric visits making it the number one reason for a pediatric visit.  The statistics show that nearly 50 percent of all children will have at least one middle ear infection before they’re one year old and 70 percent will have had at least one episode of earache by age 3.  The symptoms that a child will demonstrate during such an event include ear pain, fever, and irritability.[2]  If the middle ear infection is recurrent enough surgery is prescribed most of the time for a myringotomy or tympanostomy (tubes). 

            Children will be exposed to many different types of bacteria and viruses throughout their childhood.  When a middle ear infection comes on with the child most parents will immediately take their little one to the family doctor or pediatrician where he/she will give them a course of antibiotics for treatment.  However, if the culprit of the middle ear infection is not bacteria but some kind of virus, then the antibiotics will not be an effective treatment for the child.  This may answer the question of why some children develop chronic ear infections.  In addition, not all bacteria can be treated with antibiotics and some may need many different rounds of antibiotics so the child can regain homeostasis.  If the child is infected in the middle ear with bacteria that can be effectively treated with antibiotics, the antibiotics may leave behind a residual fluid that may be retained inside the ear due to impaired drainage from the middle ear cavity.  This fluid may become an excellent source of fuel for the next coming bacterium to infect and thrive in.  “Research and statistics is now showing that repeated use of antibiotics is contributing to future infections by creating drug-resistant infections.”[3]    Previous ENT research has shown that children with chronic ear infections also have restrictions of the natural lymphatic drainage from the middle ear.[4] To include, the anatomy of a pediatric patient is different of that of an adult in the middle ear.  The eustachian tubes are somewhat more horizontal making drainage of fluid more difficult then that of an adult.  On the other side, some chiropractors believe that the birthing process of a child has a link to recurrent ear infections.  Through the birthing process the cervical vertebrae can become misaligned disrupting nerve function, which in turn can affect the eustachian tube causing fluid buildup in the middle ear. 

            Conservative treatment through chiropractor care has demonstrated high effectiveness in treating middle ear infections caused by either bacteria or viruses.  With that said, earaches are the most common reason for children under the age of five years presenting to the chiropractor’s office.[5]  A survey was conducted in 1992 stating that children with an earache attending the chiropractor will usually respond within about three visits.[6]  Many of these children being treated have had recurrent middle ear infections and many courses of ineffective antibiotic treatments.  Also, in an article in the Ladies Home Journal the statement is made that, “Chiropractic care is thought to prevent recurrent infections by correcting misalignments (called subluxations) and allowing normal fluid drainage from the middle ear."  More importantly the article continue to state that 6 months after the chiropractic care was administered to the children in the study, 80 percent had not suffered a recurrence of another ear infection. 

            Dr. Joan M. Fallon, D.C, conducted study published in the Journal of Clinical Chiropractic Pediatrics where she indicates a strong correlation between chiropractic adjustments and the resolution of ear infections.  In the study, “332 children with chronic ear infections participated in the study. Each child, ranging in age from 27 days to 5 years, was given a series of chiropractic adjustments. The results show that close to 80% of the children did not experience another ear infection within the six-month period following their initial visits. The six-month period included maintenance treatments every four to six weeks.[7]” (Jane Sheppard).  Dr. Fallon uses primarily upper-cervical manipulation on the children with otitis media focusing on the occiput and atlas “Adjusting the occiput, in particular, will get the middle ear to drain. Depending on how chronic it's been and on where they are in their cycle of antibiotics, children generally need to get through one bout of fluid and fight it off themselves."[8]  Dr. Fallon has two large pediatric groups that refer her patients and they are mostly referred in the winter season when ear infections are more prevalent.   She comments, “Once they fight it themselves, my kids tend to do very well and stay away from ear infections completely. Unless there are environmental factors like smoking in the house, an abnormally shaped Eustachian tube, or something like that, they do very well."[9]  Even though this is only one study it makes a fairly important statement that chiropractic care has its role with ear infections. 

            The Treatment of ear infections by means of chiropractic care is performed by decreasing the amount of irritation of small nerves (free nerve endings) in the spine, so the body is able to combat the infection with its own immune system.  Dr. Peter Fysh D.C. states, “When these nerve endings are irritated, an abnormal tension is produced in the small muscles of the neck. This muscle tension can place pressure on the lymphatic drainage ducts resulting in inadequate drainage from inside the ear, thus preventing the body from being able to naturally correct the problem.”  He further concludes that the identification of such a problem is made by detecting increased tension in the neck and paraspinals, with more of the tension being on the side of the earache most of the time.   In addition, the chiropractor also looks for any vertebral subluxations in the cervical spine that may have been caused by a number of things such as; birth trauma, active play, falls, etc.   Dr. Fysh states that the treatment is “swift” seeing resolution quickly after only 3 visits.  He admits that caution should be taken if the child is not progressing with the chiropractic care that antibiotics then be administered. 

            Treating children through chiropractic care can make a big impact on the many pediatric patients that are suffering from middle ear infections saving them from unneeded antibiotic therapy.  To conclude, chiropractic adjustments have a significant impact on the body’s immune system by increasing it and allowing less foreign antigens to attack and prevail.  

If you have any questions on this topic please contact our office at 714-614-3195 or go to our website at www.twinschiropractic.com

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[1] ACA, Chiropractic Approach to Ear Infections

[2] ACA, Chiropractic Approach to Ear Infections

[3] Fallon and Edelman, Chiropractic Adjustments for Chronic Ear Infections, Ladies Home Journal, 1998 edition of Alternative Therapies

[4] Pulek J, et al: Eustachian tube lymphatics. Ann. Oto., 84:483, 1975.

[5] Fysh P: Kids Need Chiropractic Too -- What For? Dynamic Chiropractic, Dec 4, 1992.

[6] Fysh P: Pediatric Patient Survey. National Conference on Chiropractic & Pediatrics, Colorado, November 1992.

[7] Fallon JM. The Role of the Chiropractic Adjustment in the Care and Treatment of 332 Children with Otitis Media. Journal of Clinical Chiropractic Pediatrics. 1997; Volume 2, No. 2:167-183.

[8] Fallon JM. The Role of the Chiropractic Adjustment in the Care and Treatment of 332 Children with Otitis Media. Journal of Clinical Chiropractic Pediatrics. 1997; Volume 2, No. 2:167-183.

[9] Fallon JM. The Role of the Chiropractic Adjustment in the Care and Treatment of 332 Children with Otitis Media. Journal of Clinical Chiropractic Pediatrics. 1997; Volume 2, No. 2:167-183.

Bedwetting and Chiropractic

Bedwetting and Chiropractic

Bedwetting and the Chiropractic Approach

            There are many different childhood diseases that can make life difficult, not only for the child but the parents as well.  Among these disease we have bedwetting, which is a very common problem, it influences somewhere between five and six million kids.  The dilemma of bedwetting can cause a child to have less self confidence, a feeling of failure and embarrassment.  As children reach the ages of 6 and 7 they start sharing their lives with different friends and family, and sometimes have to hide this humiliation of a disease and keep it a secret in fears of ridicule.  Making different arrangements for sleepovers, sleeping on plastic sheets or trying to fit in oversize diapers, these are just some of the life adjustments kids may have to face.  At this age children can be very vulnerable and lose their self confidence, creating the parents to do anything possible to help their child. 

Most often parents will look towards taking different medication for the problem, which may or may not help the child stay dry at night.  However, this is just hiding the cause of the disease and the child may have to take medication for years and the meds may never work for the child either.  Until their body finally develops a correct urinary retention reflex is when the problem can be ultimately fixed.  What if there was a solution that could relieve your child of chronic medication? Would parents choose it?  Most likely they would if they were educated on the influence of what some medications have on a young developing body.  Chiropractic care seems to be the choice by parents after everything seems to have failed.  It should be the first choice because it is a healthy and safe approach to the child’s wellness and it will in most cases stop the problem, rather than waiting for the child to grow out of it.

            There are two different types of bedwetting, either primary or secondary nocturnal enuresis.  In primary nocturnal enuresis there is wetting at least twice a month and the child has never achieved complete nighttime control.  Secondary enuresis is related either: to a new psychological stress, such as divorce or a death in the family or something physical such as diabetes or a urinary tract infection, or even a situational change such as altered eating and sleeping habits.  The primary enuresis is the most common but the most uneducated to parents.  A survey was conducted by the ICR survey group in July 10, 1996 through August 6, 1996 of 9000 parents[1].  The survey found that 22% of parents thought bedwetting was due to laziness.  A research study has shown that primary enuresis is majority of the time inherited by an autosomal dominant gene called ENUR.  When both parents were bed-wetter 77% of their children were also, if only one parent was 44% chance their child will also be.  If neither parent was a bed-wetter than a 15% chance their child would be.

            Although the ENUR gene has been speculated to be the cause of whether a child can wake up to go urinate or not, it doesn’t mean that we need to wait until the child grows out of it.  The chiropractic approach has customarily adjusted the spine in the lumbar or sacrum.  As we know that the emptying of the bladder is controlled by the detrusor and trigone muscles, which are innervated by the S3 to S4 via the parasympathetic system.   Bladder function is also controlled by the urogenital diaphragm supplied by L2 spinal nerve.  If the phrenic reflex is just merely immature or underdeveloped then time can only help.  However, if the reflex is fully developed it may be obstructed by a spinal subluxations, which would prevent the correct sleeping process.  Since the sacrum is under developed and the five segments are not fully fused until the age of 20, it is very vulnerable to injury.  At this period of development the sacrum is subject to repeated falls as the infant begins to learn to walk. The early trauma to the sacrum could possibly be the grounds of why bedwetting stops after the spine is adjusted.

            While adjustments of the spine in the bed-wetter have had great results in resolving the problem, one study from Australia disagreed[2].  They concluded that spinal adjusting had little influence on enuresis.  A second study from Australia had different results, and discovered great results[3].  With two studies determining opposite results, one could suggest that there are several causes to bedwetting and one is spinal related. 

There are several studies published in the Journal of Manipulative and Physiological Therapeutics showing good results with the influence on adjustments and bedwetting.  A study[4] of 171 children who suffer from enuresis and averaged 7 nights of bed wetting per week were looked at.  After chiropractic treatment there was an average drop to 4 nights a week of bed wetting.  Outstanding enough 25% of the children had bed wetting reduction of 50% and 15% of the children were considered dry.

In addition, another study[5] was developed with 46 enuretic children, 31 placed under chiropractic care and 15 were in the control group receiving no care.  Close to 18% decreased in bed wetting in the chiropractic group and none had changed in the control grouped.  Shockingly, some kids were considered dry after the first adjustment.

There is lots of information providing evidence that chiropractic care can help those with enuresis caused by spinal subluxations.  On the other hand the percentages are relatively low concluding that there are other influential causes that create children to bed wet.  The majority of the general public moves to treating their children with medication. The top three meds given to those who bed wet are Sanofiaventis, Tofranil and Ditopan.  These three medications have some major side effects that some parents are not aware of such as a few listed: nosebleeds, headaches, stomach pain, seizures, blurred vision, low blood pressure, insomnia, personality changes, abdominal pain, nervousness, UTI, and asthma. 

The first step and the most natural healthiest step, is to bring your child to a chiropractor and have a consultation and exam done on the child to help identify any subluxations that might be causing the nerve interference.  If the adjustments do not help, there are other approaches the child can try such as the bed wetting alarm system which will wake the child up on a scheduled plan to help the child’s body to develop urination pattern.  A child should also be monitor on how much liquid he or she drinks two hour before bed.  By decreasing the amount of liquid the child drinks before nighttime will help decrease the amount of urine production at night.  Also check to see if the child is taking any diuretic medicine which would directly increase urine output.  And on that note, monitor the consumption of diuretic beverages such as caffeinated cola drinks and chocolate.  Another strategy that may help the child to overcome bed wetting is to allow them to have at least 30 minutes of extra sleep each day, which will aid in keeping them out of such a deep sleep.

Sometimes it can be the parents that cause part of the problem.  The kids may be drinking too much water.  In today’s society water is being pushed to adults more and more than ever, especially with the bottle water era.  The daily water intake of 64ozs for adults should not be the forced to the child, which most parents mistakenly do.  Children only need half of an adult’s water intake.  Also if a child is only wetting the bed on certain days, it may be good to take a diary of what the child is eating and drinking on those days.  If the kid is only wetting the bed on Fridays, then look at what he is eating on Fridays.  Is the family watching a movie and eating a lot of popcorn which in turn causes the child to drink more soda or did the child come back from a sports practice and rehydrate with a large Gatorade.  All and all if a child is bedwetting there are many different approaches a parent can do and choose before resulting to medication, which may not work either.

 For information on this please see our website at www.twinschiropractic.com or contact a doctor at 612-968-9807

Cheers,

Dr. Daniel Clements D.C.

Bibliography

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[1]Greene, Alan MD.  2001.  Fast Facts about Bed Wetting. http://www.drgreene.com/fact/fast-facts-about-bed-wetting

[2] LeBoeuf Leboeuf C, Brown P, Herman A, Leembruggen K, Walton D, Crisp TC. Chiropractic care of children with nocturnal enuresis: a prospective outcome study. Journal Of Manipulative And Physiological Therapeutics. 1991 February;14(2):110–115.

[3] Gemmell and Jacobson: Chiropractic Management of Enuresis. JMPT, 12(5):1989.

[4] Leboeuf C, Brown P, Herman A, Leembruggen K, Walton D, Crisp TC. Chiropractic care of children with nocturnal enuresis: a prospective outcome study. Journal Of Manipulative And Physiological Therapeutics. 1991 February;14(2):110–115.

[5] Reed WR, Beavers S, Reddy SK, Kern G. Chiropractic management of primary nocturnal enuresis. Journal Of Manipulative And Physiological Therapeutics. 1994;17(9):596–600.

Whiplash

It is hard to find people who have not been in a car accident at least once in their life time.  Motor vehicle accidents are becoming more popular as time goes on, and with accidents, there also comes whiplash injuries.  Whiplash is an injury that occurs when the neck goes through a rapid hyper-flexion and hyperextension motion caused by a sudden stop.  When this occurs the muscles and ligaments get stretched and acquire slight tears.  Most people claim not to feel much pain during the onset of the accident and even several days afterward.  This is caused because the person has had an influx of adrenaline caused by the traumatic event.  The adrenaline masks the pain that the person might be feeling so they become in a euphoric state.   In a result of this state many people do not get treatment for whiplash because they feel that there is nothing wrong with their body.  It's not until days or weeks later when they feel the real symptoms of whiplash, which begins with stiffness and loss of range of motion.  The muscles become tight and start to pull the lordotic curve of the cervical spine straight, changing the bio mechanics of the spine, which leads to degeneration in the future.  On x-ray a whiplash injury is shown to have a straight spine, if this spine is left untreated it goes through a cycle of spinal decay or degeneration.

A lot of people do not realized that degeneration is occurring in their body, without being checked by a doctor.  This is the reason why the worst accidents are actually the little fender benders and not the major roll overs.  When a person goes through a little fender bender they neglect to get treatment because they don't feel immediate pain even though they got whiplash.  Untreated whiplash injuries will slowly eat away at the spine until five to ten years down the road, the person will start to feel symptoms that they can't remember when or how they developed.  These symptoms consist of recurring headaches, neck and back pain, loss of range of motion, numbness and tingling in the hands and feet, and chronic muscle tension and spasms.

The treatment for whiplash is done through chiropractic care.  These doctors will be able to recover the curve in the spine by doing multiple adjustments.  These adjustments allow the muscles and ligaments to relax by taking the pressure off the surrounding nerves.  When the pressure is off the nerves not only does it stop the chronic pain, but allows all the tension to dissipate in the area.  If by any chance the patient has waited too long and degeneration has caused bony changes in the cervical spine, then those changes are permanent.  The doctors job then is still to recreate the curve in the spine but also to prevent anymore spinal degeneration.

In our clinic at Twins Chiropractic we deal with whiplash injuries on a daily basis and get great results from all type of patients.  We always ask our patients if they have been in a car accident in the past so that we can monitor any changes the previous injury has created in the spine.  We encourage people to get health check ups and become proactive with their bodies so that they can take preventative measures to keeping their body healthy. 

If you have any question about whiplash or would like a free evaluation see our website www.twinschiropractic.com

Cheers

Dr. Daniel Clements D.C.

Pinched Nerve

A pinched nerve can be very discomfort for anyone who has one.  So what is a pinched nerve anyway?  When a person feels pain of any sort, it is usually caused by some sort of pressure on a nerve.  Now most people think, when they feel pain that the area of pain sensation must be where the area of the nerve is being pinched.  This is a common fault, a nerve can be pinched anywhere from the place it leaves the spinal cord and all the way through its path of innervation, the pain felt can radiate anywhere below the pinched area making the symptoms appear in areas that it isn't being directly pinched.  A nerve can be pinched by a lot of different elements but the most common way a nerve can be pinched is either by a vertebra, bone or disc out of place or alignment, tight muscles around the nerve, or it could be simply swelling producing pressure on the nerve. 
When people feel a pinch nerve in their back, a lot of times it can be the disc between the vertebra putting pressure on the nerve.  Anytime a disc puts pressure on the nerve symptoms can be felt as far down as the hands and feet.  When a nerve gets pinched there is a chain reaction that happens.  If there is pressure on some part of the nerve it may cause a muscle spasm which then tightens the muscle up causing more pressure on the nerve which in turns causes more of a muscle spasm.  If this is the case the only way to fix this is to relieve the pressure off the nerve.  Chiropractic care is the best treatment for helping a pinched nerve.
Chiropractic care helps relieve the tension off the nerve by helping to align the spine and taking the pressure of the hard bone off the soft nerve.  It also relaxes the muscle tension and helps drain the swelling and inflammation in the area so that there is no pressure on the nerve.  Chiropractors should be the first doctors you think of when you feel that you have a pinched nerve.  If a pinched nerve is left on treated the influence that it has on the body can be very devastating.  For instance, if the disc is putting pressure on the nerve then that would mean that the disc as lost some height which puts the disc in a vulnerable state of possible degeneration because of loss of nutrient intake.  When this is the case the disc may decay and loose all its function of separating the vertebra causing the two bones to touch increasing pain and furthering the process of degeneration and bone deformity.  This in turn will decrease ones range of motion, joint functionality, and cause permanent nerve damage.  
At Twins Chiropractic my brother and I see this case on a daily basis.  It is relatively easy for us to diagnose any pressure on your nervous system and put you on systematic treatment plan.  We have scientific specific technology that is created by NASA to help us identify the nerves that are being impinged.  This nerve scan is used to monitor the patients progress throughout their treatment plan.  This allows the patient to see as well as the doctor, how the treatment is influencing the nerve being treated.  Not only do we help get the patient better in our office, we also help educate the patient on how to prevent this from ever occurring in the future.  
The definition of doctor is teacher and we take that very serious at our clinic.  No patient finishes their treatment without knowing the steps of prevention and leading a wellness based lifestyle.  Our job is to have affiliation with patients who come in for wellness check ups only, rather then constantly having to come in because their back flares up or goes out every other month.  These wellness check ups help identify any possible pinched nerves that may be developing but the patient has not yet felt any symptoms.  This is the most cost efficient health care, and allows all of us to stay healthy.
 
Dr. Daniel Clements D.C.