Many of us can identify with that screaming child in the night suffering with an ear ache. Your sympathy from holding this child wears thin through the night as there is not an easy non-pharmaceutical approach to quell the discomfort. Eventually, acetaminophen takes the edge off and you schedule a chiropractic appointment in the morning.
Since the last time we addressed ear infections and chiropractic,there have been some changes in the care and guidelines for acute and chronic otitis media in both the medical and chiropractic approaches. The earache accounts for approximately ⅓ of all visits to the pediatrician according to the CDC, decreasing the past 5 years. The CDC totals that to 30 million visits annually in the United States. It is also one of the top 10 reasons parents bring their children to the chiropractor at 11.3% of chiropractic pediatric clientele.
Medical Pediatric visits result in 6 million prescriptions for antibiotic therapy each year in the United States. Yet, the American Academy of Pediatrics guidelines yield that the preferred course of action for an acute otitis media (or middle ear infection) is to yield a “wait and see” approach. The guidelines in 2011 from the Agency for Healthcare Research and Quality found that 66% of Acute Otitis Media episodes will recover without antibiotic use within 24 hours, and 80% will recover after several days without antibiotics. With only two new studies available in the literature, by 2014 the AAP realized that Pediatricians were not following this new recommendation.
Why continue to prescribe antibiotic therapy for ear aches? It may be that the parents are looking for some help, and daycare regulations promote it. Unfortunately, one recourse that antibiotic therapy carries with it is the destruction of fragile normal flora or good bacteria in the gut and mucus tissue that protects the child from further infection. Often times antibiotic therapy leads to stronger antibiotic therapy and eventually to antibiotic resistance. Eventually if these infections recur and it becomes a chronic issue (presently defined as 3 infections in a calendar year), the parents are instructed to consult with the ENT for surgical intervention of tympanostomy tubes. Below is a photograph of gradually infected ear drums.
A, Normal TM. B, TM with mild bulging. C, TM with moderate bulging. D, TM with severe bulging. Courtesy of Alejandro Hoberman, MD.
A normal appearance in an otoscopic evaluation reveals a reflex of light, and identification of normal middle ear anatomy. As pressure builds up behind the eardrum, in the eustachian tube it changes to a mottled light reflex, can become red, fluid can be visualized, and then the bulging of the eardrum becomes progressive. Because of the progressive nature of an ear infection, the provider may develop a different protocol that varies in the “wait and see” approach. Some medical providers may give an antibiotic prescription “just in case” it progresses. This is most commonly an oral prescription, but can also be prescribed locally as a drop in the ear canal. Some, adhere to the guidelines of waiting 48-72 hours. Statistically most don’t as 6 million decided to prescribe the antibiotics this year.
As Chiropractors, we are not in the business of treating infection. However, we are devoted to helping people pursue and maintain optimal health. We think it is imperative to strengthen the immune system to defend against and conquer infection of any kind. We believe that the body has the best laboratory to come up with illness fighting agents. We do this by stimulating of the nervous system, circulatory system and lymphatic system with Chiropractic adjustments. By detecting and removing mechanical interference at the joint and cranial sutures, we Chiropractors help the body to expedite the healing process. In the case of ear infection, we simply stimulate the upper cervical spine and cranial motion. This will help the body to drain out fluid normally through the eustachian tube and thereby relieve that terrible pain and crying.
Chiropractic research supports this philosophy for those suffering with ear infections. Remembering that 80% of children who do not use antibiotic therapy will recover from otitis media in a few days, let’s compare Roseann M Froehle’s study that touts that 93% of children who get adjusted are able to resolve an episode of otitis media within a few days in an article submitted to JMPT. Joan M Fallon wrote extensive research for the Journal of Clinical Chiropractic Pediatrics. She studies 332 children who saw improvement via tympanography of ALL children with in 6 days under chiropractic care. Van Breda reported in a “Comparative Study in the Health Status of Children Raised Under Chiropractic Models of Health Care and Allopathic Models of Health Care” a statistically significant decrease in many childhood illnesses, specifically ear infections in those children who were raised with Chiropractic care.
While the pharmaceutical management of earaches varies, it is a welcome sight to know Chiropractic is available to help resolve the fluid build up. The “wait and see” approach can be frustrating to the one holding a crying child. Chiropractic is a safe and effective enrichment for these families. Did you know that Coulter touted the risk of a negative side effect from chiropractic adjustments to the neck at 6.39 in 10 million and to the low back 1 in a hundred million? I think you will find that pain relievers and antibiotic use would struggle to compete with these numbers, and certainly the risk for a child undergoing anesthesia to have a tube insertion is quite a bit more daunting.
Hopefully, this article has sparked your interest in helping generations of families pursue optimal health with Chiropractic. Always remember the tenants of health care that we espouse and educate families with every day. Get enough sleep, drink enough water, exercise, eat your vegetables, pursue your purpose in life and get adjusted regularly. If you have further interest or questions regarding the specifics of chiropractic care and ear infections, please don’t hesitate to call our office. We are here to serve you and those you love.
March 2013, VOLUME 131 / ISSUE 3 From the American Academy of Pediatrics Clinical Practice Guideline
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.
Coulter ID. Efficacy and Risks of Chiropractic Manipulation: What Does the Evidence Suggest? Integrative Medicine 1998;1:61-66
Tal Marom ,1 Johanna Nokso-Koivisto ,2 and Tasnee Chonmaitree 1 Viral–Bacterial Interactions in Acute Otitis Media Curr Allergy Asthma Rep. 2012 Dec; 12(6): 551–558. doi: 10.1007/s11882-012-0303-2 PMCID: PMC3493715NIHMSID: NIHMS407352
Please be aware of our Saturday provider schedules. Each provider will be taking at least one Saturday off per month. Each provider rents a cooperative space at Riverview Chiropractic Health, and we prefer if at all possible to keep your regularly scheduled chiropractic visits with one provider. This helps to keep consistency in your care, strengthen the Dr-Patient relationship and maintain the overall goals of helping you to pursue optimal health. However, if for your convenience you are in need of having chiropractic or massage care scheduled with another provider, we have qualified professionals available to assist you for a short term. It is our goal to keep the primary provider aware of any changes in your chiropractic or massage needs.
We Celebrate our Founder’s Day on June 21st. This is the birthday of our Founder, Dr. William B Davis. We are pleased to have Dr. Davis continue to practice here at Riverview Chiropractic Health on Tuesdays and Fridays. He has been providing Chiropractic Care to generations of families for over 50 years!
You may have noticed an increasing presence of Chiropractic interns at our offices. We employ part-time Chiropractic Interns from New York Chiropractic College in the last year of their education. We train them in every aspect of patient care and office management. In exchange, they are very helpful in assisting in documentation, third party reimbursement and office communication. If at any time, you would prefer to NOT have an intern attend an adjustment, please alert the front desk. It is absolutely no problem to excuse them. This is not a learning institution. We have found this is a mutually beneficial relationship for the providers, but is not necessary. Your chiropractic care will always be our primary attention and we respect your privacy.
Feel free to refer friends and family to our website if they are considering Chiropractic care.Riverviewchirohealth.com. Appoointments can be made on it and we post our newsletters monthly.
Recipe Of The Month
Strawberry Garbanzo Bean and Raw Kale Salad
1 Tbs lime or lemon juice
2 Tbs olive, almond or avacado oil
1 Tsp Stevia/ Sweetener
1 Tbs Balsalmic, Rice, Red Wine or your favorite vinegar
Salt and pepper
1 Head of Kale, torn into small pieces (Or the pre-cut bag)
1 Can Garbanzo beans, rinsed and drained
1 to 2 tablespoons red onion, finely diced
1/2 cup red bell pepper, diced
1 Cup of finely sliced strawberries
Put dressing ingredients in a medium sized bowl and mix well. Start with the kale in the dressing and massage the dressing into the kale with your hands. Add garbanzo beans, Strawberries, red onion and red bell pepper and mix well. Serve or refrigerate until serving.