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The subject of chiropractic treatment for the care of adult problems is well known. It seems, however, that some people fail to recognize the potential benefits that children and adolescents can gain from chiropractic. Numerous studies published in the scientific journals suggest that chiropractic care may be a natural management option for children suffering from such common conditions as headache, otitis media (middle ear infection), colic, nocturnal enuresis (bedwetting) and asthma. A leading medical practitioner in conservative orthopedics in Germany has gone so far as to suggest that manual therapy can play a role in re-directing the nervous system of infants to adapt to the presumed trauma of the birth process.

Below we will focus on 4 common conditions that may be favorably managed with chiropractic care---otitis media (middle ear infection), infantile colic, headache, and low back pain.

Otitis media

Otitis media is the clinical term for middle ear infection, characterized by a child tugging at the ear, poor sleep, fever, irritability, ear and nasal discharge, decreased appetite, and crying. It is suspected that misalignments in the cervical spine (neck) may affect the function of the eustachian tube in the middle ear (see Figure 1).

Manipulation, which can alleviate this vertebral misalignment and presumably improve the function of the eustachian tube to promote drainage, appears to be a rational treatment of otitis media. In fact, studies of spinal manipulation for the treatment of otitis media support its continued use as an option. The research suggest that the majority of otitis media cases treated with spinal manipulation appear to be resolved within 10 days, most resolving with fewer than 5 adjustments and many requiring only one or two treatments. When compared together in a study, the mean time requeired for otitis media resolution in a group of children receiving chiropractic care was less than half of the time needed for resolution in a group of children receiving antibiotics.

Infantile Colic

Infantile colic is described as "unexplainable and uncontrollable crying in babies aged 0-3 months for more than 3 hours per day, more than 3 days a week, and more than 3 weeks." Additional symptoms of colic include the baby's knees pulled up to the chest, clenched fists, and extension of the trunk or extremities. Several studies of spinal manipulation for the treatment of colic suggest that it holds promise as an effective treatment, with results indicating a reduction in the number of hours crying and symptoms. This contrasts sharply with current medical treatment which may include over-the-counter medications and simply "waiting it out." Because the condition can be extremely frustrating to parents, the possibility of reducing the duration of colic is important to the parent/child relationship.

Headache

While generally considered an "adult" problem, headaches are actually very common in children as well. And, like adults, headaches in the pediatric population are the result of similar causes ---physiological problems (such as neck and back problems due to poor postures), stress, reaction to foods and food additives, and others. While there are numerous quality studies of chiropractic treatment for adult headaches, there are fewer for the pediatric population. Due to the nature of headaches, and the commonality of causes for adults and children, it is reasonable to predict that adult study results would be applicable to children. There are, however, several case studies and small studies which support manipulation as an option for the mangement of pediatric tension-type, cervicogenic, and migraine headache.

Low Back Pain

It is estimated that about 50% of children will experience low back pain at some point in their childhood, with nearly 15% reporting frequent or continual pain. Back pain may be associated with other conditions (asthma and headache) and in pre-adolescent children appears not to be self-limiting. Chiropractic researchers sought to determine how beneficial chiropractic management of pediatric cases can be. Canadian chiropractors provided the researchers with data on 54 patients with low back pain, all between the ages of 4 and 18. The average patient was 13.1 years old, 57% were boys, 61% were acute cases, 47% were caused by a traumatic event (most sports-related), and 24% had pain for longer than 3 months. All patients were managed with spinal manipulation. Using the pediatric visual analog scale ( a scale patients use to describe level of pain), 62% of the patients reported "important" improvement within 6-weeks of treatment. The researchers concluded that "patients responded favorably to chiropractic management, and there were no reported complications."

 

According to the American Chiropractic Association, 31 million Americans have low back pain at any given time, half of Americans suffer from back pain every year, and one-third of Americans over the age of 18 had pain severe enough to require professional care in the past 5 years.

In addition, back pain is the second leading cause of lost work days, with an estimated 100 million lost work days per year, and work related back injuries are the number one occupational hazard in the United States.

At some time during our lives, 80 percent of us can expect to have back pain.

There's really nothing new about backaches. In fact, the potential for back troubles would almost seem to be built into the spine. As intricate and magnificent a design as our spines are, it is still better suited to a horizontal position than a vertical one. When humans stand erect, the downward pull of gravity causes pressure and wear-and-tear on the vertebrae and discs separating them. It also strains the back's muscles and the ligaments that hold the spine in position.

But we can't just blame gravity---we are primarily responsible for our back troubles. Most of us don't keep our spines in proper physical condition. We exercise erratically (if at all) and without adequate warm up or cool down. We gain too much weight and develop potbellies and swaybacks that put added strain on our backs. We sprawl on soft chairs and sofas. We subject our backs to unnecessary pressures, twists, and jolts by bending and lifting things improperly.

Thus, we injure already weakened back muscles and sometimes throw off the spinal alignment. Severe stress can cause the actual tearing of muscles or ligaments, causing instant, acute pain. Even more frequent is the muscle spasm, which may "lock up" the back and produce agonizing pain. Emotional stress, with its muscle tension, also causes spasms in the back.

What Causes Low Back Pain?

Doctors of Chiropractic will tell you that the most common causes of low back pain---among more than 100 identified---are muscle and ligament injuries, injuries to facet joints, disc problems, and vertebral subluxation (defined as "a complex of functional and/or structural and/or pathological changes that compromise neural integrity and may influence organ system function and general health").

Facet joints help connect the vertebrae to each other, allowing the spine to move easily while keeping it from bending too much. Facet joint problems occur when the facets grind against each other or when they produce bony spurs, irritating nerves and causing pain.

"Slipped disc" is a misnomer for the degenerative disc condition we all face sooner or later. Spinal discs are positioned between vertabrae and provide cushioning shocks when we bend, twist, or receive a jolt. But gravity, aging, and wear-and-tear may rob discs of some of their elasticity, causing them to become weaker and partially collapse or bulge out, impinging upon a nerve root. In a few cases, the disc ruptures.

Subluxations are spinal joints that don't move properly within their normal range of motion or are out of alignment.

How is Back Pain Diagnosed and Treated?

The specialized training and clinical experience of Doctors of Chiropractic qualify them to conduct a sharply focused physical examination that may include orthopedic and neurological tests, posture and gait analysis, static and motion palpation (examination by touch), and x-rays if clinically necessary. This thorough chiropractic examination enables the Doctor of Chiropractic to provide a differential diagnosis, pinpoint the abnormalities causing the pain, and outline a treatment plan.

Relieving the pain is the first goal of chiropractic treatment. The second objective is to correct and normalize spinal segment relationships and thus relieve the resulting nerve, muscular, and vascular disturbance. A third goal is to precent recurrence.

Doctors of Chiropractic use spinal manipulation or adjustment as their primary treatment method. These precise, delicate maneuvers require a great deal of skill, training, and experience, and should only be performed by highly trained professionals. And spinal manipulation has proved effective in numerous scientific studies. In fact, spinal manipulation was recommended as a first line of treatment for acute low back pain by the Agency for Health Care Policy and Research, an arm of the US Department of Health and Human Services.

 

This period of rapid development, hormonal changes, the laxity of connective ligaments, and shifting of weight-bearing structures, may cause many pregnant women to experience low back pain.

Chiropractic care can be quite helpful!

Besides helping to relieve the discomfort many expectant mothers experience, chiropractic care helps normalize nervous system function. This is an important component of overall good health.

The benefits of chiropractic care may also be noticed during delivery. Many chiropractic patients report that their deliveries were faster and more comfortable than their deliveries prior to chiropractic care!

Your Doctor of Chiropractic will take special precautions with you during your pregnancy.

Modifications to the table or adjusting techniques are made during each stage of pregnancy. Your chiropractor is a specialist in the location, reduction and stabilization of the vertebral subluxation complex, which can be related to many of the uncomfortable symptoms associated with pregnancy and labor. Pamper yourself and your baby with regular chiropractic checkups.

Begin or continue healthy habits.

Women who exercise moderately, quit smoking, eat healthy foods, and avoid alcohol during their pregnancies are to be congratulated. Those receiving prenatal chiropractic checkups can increase their nervous system capacity to function at its very best. This is an important element in creating a healthy foundation for developing babies.

Constant structural changes, physical and emotional stresses provide the opportunity for beneficial chiropractic care during all stages of pregnancy.

 

It is estimated that 90% of men and 95% of women had at least one headache last year. Studies have also suggested that despite this large number of headaches, about half of sufferers fail to seek treatment. Unfortunately, this means that a large portion of those with headaches are either suffering needlessly or they are self-treating with medications --- neither of these "solutions" addresses the cause(s) of the headaches and, therefore, there is no prevention of future pain. This is not control. To take control of your headaches, seek care from your Doctor of Chiropractic.

True control will require your active participation in three easy steps:

• diagnosis
• treatment
• prevention

The Diagnosis

Diagnosis in your chiropractor's office will begin with thorough physical and spinal examinations, and, if clinically necessary, diagnostic tests (which may include X-rays, and the ordering of neurological, orthopedic, blood, and/or urine laboratory tests). In addition, be prepared for in depth discussion and questioning about your diet, health history, headache frequency and severity, accident history, habits and activities, and other factors that may play a role in causing your headaches. Keeping a daily diary will help you remember factors that may influence your headaches and will ensure a more accurate determination of factors that may precipitate your headaches.

The first determination will be whether your headache is secondary or primary. Secondary headaches are those caused by another physical condition --- and these are the ones that people worry about with a severe headache. Fortunately, these account for less than 10% of all headaches. That said, however, if your headache comes on suddenly, is accompanied by numbness, confusion, slurred speech, or other severe or unusual symptom(s), SEEK EMERGENCY CARE.

• Primary headaches include tension-type, migraine, and cervicogenic headache.
• Tension-type headaches, sometimes called muscle contraction, are by far the most common type, accounting for an estimated 85% of all head pain. Men and women suffer from tension headaches at equal rates. Pain is generally mild to moderate, can last for a few hours to a full day, and is usually felt in the back of the neck and on the scalp. They may be caused by stress and can become chronic, with some people suffering daily headaches.
• Migraine headaches are notorious for their severity and potential for unusual symptoms. Women are more likely to suffer from migraines than men, although before puberty and after menopause, males and females suffer at approximately equal rates. Migraines may run in families and can, therefore, affect children. The American Council for Headache Education (ACHE) believes that "if one parent has migraine, the child has a 50 percent chance of having migraine. If both parents have them, there is a 75 percent chance that the child will have them, too."
  
  Migraine pain is often severe and disabling, affecting work, family, and social lives. There are two types of migraine --- those with aura and those without. Both types are characterized by throbbing pain, typically on one side of the head (pain may alternate sides); nausea and vomiting, and light and sound sensitivity. Migraine with aura also includes visual disturbances (the "aura") such as jagged lines or flashing lights in the visual field, blind spots, or even visual or auditory hallucinations. Disruptions in smell, taste, and touch may also be experienced.
• Cervicogenic headaches are those caused by aberrations in the structures of the neck, including the joints, ligaments, muscles, or cervical spinal discs. In fact, cervicogenic means originating in the neck. Symptoms of cervicogenic headache can mimic both tension and migraine headache.

Fortunately, your Doctor of Chiropractic can differentiate between the types of headache and their causes. Research has shown that chiropractic management of these types of headache is effective and safe. Some research suggests that not seeking treatment for chronic headaches can lead to psychiatric disorders, such as depression. For this reason, it is important to go beyond diagnosis and follow up with the appropriate treatment.

The Treatment

Only after a diagnosis of your headache type and the determination of its causes will chiropractic treatment begin --- if it is determined that chiropractic is the form of care most appropriate for your case. If it is found that another type of treatment would be beneficial, you will be referred to the most suitable health care provider.

If chiropractic care will best meet your needs, treatment will begin after it is first outlined and explained to you. Chiropractic is a form of care that uses several means of treatment to reach the desired result. Treatment may include spinal adjustment (also called manipulation) to improve spinal alignment; physical modalities such as application of heat or ice, electric muscle stimulation, ultrasound, massage, or others may be used; and specific recommendations to improve your diet, exercise, posture, or sleeping habits will be discussed as they affect your headache frequency. Relaxation techniques may also be discussed.

The Prevention

Once your Doctor of Chiropractic has determined the cause(s) of your headaches, you will know how to avoid them in the future. For example, if it is found that your headaches tend to occur following a late lunch, future care to eat at regular intervals will prevent at least some of your headaches.

Follow all recommended changes to lifestyle (such as improvements in diet, nutrition, exercise, and posture) and keep all health care appointments. The bottom line is that they are your headaches --- you can be the one to control them.

The list of possible headache triggers is extensive. Some of the more common culprits are:

• chocolate
• caffeine
• food additives, such as: monosodium glutamate (MSG) or nitrates
• alcohol
• stress or anxiety
• hormonal changes associated with puberty, menstruation, pregnancy, and menopause
• changes in altitude, time zone, meal times, or sleep