Chiropractic and Ear Infections (otitis media)
As recent as the eighteenth century scientists believed in spontaneous (re)generation. This means when they saw maggots multiplying in a pile of garbage they concluded that the maggots spontaneously appeared out of thin air. Although we laugh about how ridiculous this seems today, the theory that bacteria mysteriously appears within the ear and causes ear infections still prevails.
Contemporary science knows differently. Like the maggots in the pile of garbage, bacteria thrive in unhealthy tissue. They, like bacteria, are nothing more than scavengers. While antibiotics may temporarily kill some bad bacteria (as well as good bacteria), antibiotics do not get to what is causing the garbage in the first place.
Ear infections plague millions of families each year and are the most frequent reason for outpatient antibiotic therapy. In fact, the number one reason parents take their children to the pediatrician is to investigate an earache. The cost of this treatment has been estimated to exceed $3.5 billion annually.
An ear infection or Otitis Media (OM) is an inflammation of the area behind the eardrum called the tympanic membrane, within the middle ear. Common symptoms are ear pain, ear fullness, or hearing problems. Infants and toddlers may be irritable or experience difficulty sleeping, eating or hearing. A fever may also be present.
The most common medical approach in treating OM is oral antibiotics to treat the bacteria accumulation in the ear. As antibiotic effectiveness wanes many children undergo a surgical procedure to insert tympanostomy tubes into the eardrum, which helps drain the fluid build-up. A small percentage of children will undergo surgery to remove the adenoids after repeated bouts of OM.
Researchers believe that the cause of OM is eustachian tube dysfunction. The eustachian tube connects the middle ear to the throat; it ventilates and equalizes pressure to the middle ear. If poor drainage exists, fluid can build up, and the eardrum will appear inflamed and bulging. At that point, the fluid-filled middle ear can become a breeding ground for bacteria.
If the actual cause of OM is from inadequate drainage, treating an ear infection with antibiotics is like trying to rid your back yard of mosquitoes by pouring poison into the puddles of standing water in your yard. If the watery breeding grounds were emptied instead of poisoned, the pests would not be able to exist in the first place.
Countless studies are now showing that the medical method of treating OM with antibiotics, tubes and adenoid surgeries is not an effective means of treatment. According to the Journal of the American Medical Association, children who took Amoxicillin for chronic OM were 2-6 times more likely to develop a recurrence than the children who received a placebo. The author of the study Erdem Cantekin Ph.D., stated "children are being abused by the antibiotic treatment in this country."(1)
Another study published in the British Medical Journal concluded that antibiotics are not the best treatment for OM and doctors should stop routinely prescribing drugs for them. Further evidence shows that antibiotics may hinder the healing process, and that recovery rates were better for the group of children who were not given the drugs.(2)
The heavy use of antibiotics in this country has many concerned about the growing number of drug-resistant bacteria. A researcher from the University Of Colorado School Of Medicine noted that "few issues in clinical medicine are as controversial as the efficacy and risks associated with antibiotic treatment of otitis media." ? He goes on to suggest that the over diagnosis of OM should be avoided; rather I would suggest that the inappropriate treatment of OM be avoided. (3)
If the problem is poor drainage it seems to make sense to insert tubes into a child's eardrum in order to release the fluid with in the ear. Although tubes do help release inner ear fluid and pressure, they fail to address the cause of the fluid build-up, eustachian tube dysfunction. Surgical tube usage is like bailing the water out once it has reached the sinks edge, instead of clearing the clogged drain.
Like antibiotics, research has indicated that tubes are often expensive, ineffective and potentially harmful. "It is concluded that the use of ventilation tubes in children with primary secretory OM is not justified. Observation has shown that only a small portion will require surgical treatment of the middle ear. A ventilation tube may be indicated in order to combat hearing loss, but it should be kept in mind that its use involves a high risk of complications and sequelae which may result in chronic middle ear disease." (4)
When parents are armed with knowledge and recognize the risks involved with antibiotics and surgeries, what are their options? How can Chiropractic care treat OM? I have been asked this question many times. The answer is that Chiropractic does not directly treat the inflammation, the fluid build up, or the bacteria accumulation in OM like medical treatments do. It works by bringing proper function back to the nervous system. As the nerves exit between the bones of the spinal column, proper alignment is vital for a person to function normally and optimally. A misaligned vertebra can result in nerve dysfunction. If spinal nerves are irritated and they relate to drainage of the ear, Chiropractic care helps by realigning the spine with gentle adjustments specifically designed for children. This restored nervous system function aids in correcting the eustachian tube dysfunction and revitalizing the immune system to heal the middle ear.
A study published in the Journal of Clinical Chiropractic Pediatrics shows the effectiveness of Chiropractic care for OM. 332 children aged from 27 days to 5 years all suffering with OM participated in the study. The study found that nearly 89% of these children no longer had OM after undergoing Chiropractic care.(5) Another study found similar results, but with a 93% rate of improvement. The author of the study concluded: "this study's data indicates the limitation of medical intervention and the addition of chiropractic care may decrease the symptoms of OM in young children."(6)
How a child's spine becomes misaligned is often unknown. It could be from the child's position in utero or from the birth process. The child may fall while learning how to walk or during play. Sitting all day in school or carrying a heavy backpack may also contribute to spinal misalignment. The causes of spinal misalignments are often found in normal daily activities. A Chiropractic check-up before the child starts exhibiting the symptoms of OM could prevent a child and his parents from years of suffering through sleepless nights and thousands of dollars in ineffective therapies.
Given the information we now have about the dangers and ineffectiveness of typical medical treatment, we are faced with an important decision. Indeed, Chiropractic's approach is different; it seeks to correct the underlying problem of impaired nervous system function, rather than treating the resulting symptoms. As parents we strive to do the very best for our children. We can choose to continue down the old path of 'sick care' or move into the future of 'health care' by having our children evaluated by a Chiropractor.
1 Cantekin EI. Antibiotics to prevent acute otitis media and to treat otitis media with effusion. JAMA 1994; 272(3):203-4 / Medline ID: 94293436
2 Del Mar C, Et Al. Are antibiotics indicated as initial treatment for children with acute otitis media? A meta-analysis., BMJ 1997; 314(7093):1526-9 / Medline ID: 97326380
3 Berman S. Management of acute and chronic otitis media in pediatric practice. University of Colorado School of Medicine, Denver, USA. Curr Opin Pediatr. 1995 Oct;7(5):513-22.
4 Lildholdt T. Ventilation tubes in secretory Otitis media. A randomized, controlled study of the course, the complications, and the sequelae of ventilation tubes. Acta Otolaryngol Suppl (Stockh) 1983 (398): 1-28 / Medline ID: 84076229
5 Fallon, JM. Journal of Clinical Chiropractic Pediatrics. Vol. 2 No. 2 1997 p.167-183.
6 Froehle RM. Ear Infection: A retrospective study examining improvement from chiropractic care and analyzing influencing factors. J of Manipulative Physol Ther 19(3): 169-177 (Mar 1996)
