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Reccuring Ear Infections

Chiropractic Helps in Prevention of Recurring Ear Infections

In the October 1998 issue of the Ladies Home Journal appeared an article entitled, "Chiropractic Adjustments for Chronic Ear Infections." This article reviewed several studies showing the effectiveness of chiropractic care for preventing re-occurring ear infections known as Otitis Media or OM.

According to the article, reoccurring ear infections account for over 35% of all pediatrician visits in the United States. Sometimes these infections are due to bacteria and sometimes these are due to a virus. The most common medical care for this situation has been antibiotics, even though antibiotics have no effect on viruses. 

While the article mentions that the antibiotic may be effective in an acute bacterial infection, they do nothing to stop repeat infections. Research and statistics are now showing that repeated use of antibiotics is contributing to future infections by creating drug-resistant infections as well as generally lowering the immune system’s ability to fight infection. The surgical approach has met with little long term results as the "tubes" placed in children’s ears often come out and usually require a child to be put under general anesthesia to do the surgery. Although this is seen as “standard medical procedure” because it is performed with such frequency, it is rarely, truly indicated.

The reason children are more prone to ear infections is the orientation of the eustachian tube. This “tube” connects the middle ear to the back of the throat. Most people know it indirectly because we use it to equalize pressure between the outside and inside of our ears. For example, when you fly and hold your nose and blow to “pop” your ears. When the Eustachian tube is blocked, this can’t occur. Due to the shape and size of a child’s skull, the Eustachian tube lies almost horizontal and therefore doesn’t drain very well. If it gets clogged by mucous, then it creates an ideal place for bacteria or viruses to grow. Other contributing factors include a diet high in dairy consumption and subluxation complexes at the upper cervical (neck) vertebrae. The birthing process is a big culprit in the causation of subluxationof these vertebrae. 

There are now multitudes of research studies that show that antibiotics are usually ineffective, that resolution is as quick or quicker without the use of antibiotics, and that tubes in the ears are also predominately ineffective. For references, see www.icpa4kids.com and go to the research archives.

If your child has suffered with recurrent ear infections, give chiropractic a chance, before putting your child through surgery. Building your child's immune system will also help keep ear infections from recurring. 

Evaluation and Treatment of Children with Earache; Peter N. Fysh, DC 

Earache is the most common reason for office visits to pediatricians. By the age of three years, more than 70 percent of children will have had at least one episode of earache and about a third will have had more than three episodes. It is not surprising, therefore, that earache is also the most common reason for children under the age of five years presenting to the chiropractor's office(Fysh).

According to 1992 survey data, children with earache attending the chiropractor will usually respond within about three visits (Fysh). Many of these children with middle ear infections that respond to treatment by the chiropractor have had a long history of middle ear infections coupled with several courses of seemingly ineffective antibiotic treatment.

Middle Ear Infection 

When a child with earache is diagnosed with middle ear infection by the pediatrician, the usual treatment involves a course of antibiotics. Why then do some of these children continue to have ear problems? 

Well, there may be several answers to this question.

First, the cause of the child's middle ear infection may not be due to bacteria, and since antibiotics are only effective against bacterial pathogens, then frequently there will be no response. Since numerous cases of middle ear infection can be caused by a virus, and viruses do not respond to antibiotics, this may be the reason why children develop chronic ear infections. Also, not all bacteria will succumb to antibiotics, so several different formulations may have to be tried.

Next, even though the selected antibiotics may be quite effective in eliminating the invading bacteria, the residual fluid may be retained inside the ear due to impaired drainage from the middle ear cavity. This fluid may become an ideal culturing medium for the next pathogen which arrives on the scene. Previous ENT research has shown that children with chronic ear infections also have restrictions of the natural lymphatic drainage from the middle ear (Pulek).

Finally, the anatomy of young children is somewhat different in that they have shorter and more horizontal eustachian tubes, making drainage difficult.

The Chiropractor's Role 

What role does the chiropractor play in evaluating and treating these children?

The chiropractor's task is to ascertain if the reason for the body's inability to combat the infection is caused by irritation of the small nerves in the spine (called free nerve endings).

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.

Identification of such a problem is made by detecting increased tension in the neck and paraspinal muscles, usually more tension is felt on the side of earache. The chiropractor also looks for spinal vertebrae which are either slightly out of alignment or are not moving within their normal range. This problem may have been due to any one of the number of bangs, jolts and falls that most children experience in the early years of their life.

Experience 

The chiropractor is the doctor most experienced in identifying these spinal problems and in correcting them, usually with a very light finger-tip adjustment.

A most important task for the chiropractor is to carefully evaluate each child to ensure that the cause of the earache has been accurately identified. A previous diagnosis of middle ear infection, made by a pediatrician some weeks earlier, cannot be presumed to be still accurate. A thorough examination of the patient must include consideration of other possible complicating factors since earache can be caused by many disorders, including mastoiditis, sinusitis, tooth infections, tumors, temporomandibular joint dysfunction, pharyngitis, external canal infections, and foreign bodies in the ear.

Treatment 

Chiropractic management of the patient with earache involves a detailed and thorough evaluation, usually followed by a short course of spinal adjustment and manipulation of the neck muscles to help restore normal lymph drainage. Treatment is usually short and the resolution is frequently swift.

Patients who, at the time of examination, are on antibiotics probably don't have a high risk for serious complicating infections. Those patients who are not on antibiotics may need to be watched more closely and alternative treatments considered if no short-term response to spinal adjusting is apparent.

Reference 

Fysh P: Kids Need Chiropractic Too -- What For? Dynamic Chiropractic, Dec 4, 1992.
Fysh P: Pediatric Patient Survey. National Conference on Chiropractic & Pediatrics, Colorado, November 1992.
Pulek J, et al: Eustachian tube lymphatics. Ann. Oto., 84:483, 1975.

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