Asthma
This once rare disorder has exploded in incidence
and is now the most common chronic disease of children. It
causes more time to be lost from school than any other pediatric
disorder. Asthma was almost never a fatal disease, but now
it’s attributed to causing up to 5,000 deaths a year.
“There
are possibly millions of asthmatic children who are destined
to a life dependent upon medication; these children may never
have the chance to see if chiropractic spinal adjustments can
help their asthma and provide them with a better quality of
life.”
Peter Fysh, D.C. Dynamic Chiropractic. Sept. 25,
1995, p.16.
Upper Cervical Chiropractic Care For A Nine-Year-Old
Male With Tourette Syndrome, Attention Deficit Hyperactivity
Disorder, Depression, Asthma, Insomnia, and Headaches: A Case
Report Elster EL, J Vertebral Subluxation Research July 12,
2003, p 1-11
Upper cervical care was used for a nine-year old
male with Tourette Syndrome (TS), Attention Deficit Hyperactivity
Disorder (ADHD), depression, asthma, insomnia, and headaches
since age 6. Forceps were used during his delivery. His medications
included Albuterol™, Depakote™, Wellbutrin™,
and Adderall™.
Chiropractic care using an upper cervical
technique corrected and stabilized the patient’s subluxation. After 6 weeks
of care, all 6 conditions were no longer present and all
medications were discontinued with the exception of a half-dose
of Wellbutrin™. At the conclusion of his case at 5
months, all symptoms remained absent. The response to care
suggests a link between the patient’s traumatic birth,
the upper cervical subluxation, and his neurological conditions.
Chronic
pediatric asthma and chiropractic spinal manipulation, a
prospective clinical series and randomized clinical pilot
study. Bronfort, G, Evans RI, Kubic P, Filin P. Journal of
Manipulative and Physiological Therapeutics 2001;24(6):369-77.
Thirty-six
children aged 6 to 17 with chronic, mild or moderate asthma
were observed over a three-month period. They received either
a true or “sham” adjustment.
Those who received
adjustments rated their quality of life substantially higher
and their asthma severity substantially lower. These improvements
were maintained at the 1-year follow-up assessment. There were
no important changes in lung function or hyperresponsiveness
at any time.
Chiropractic management of 47 asthma cases. Amalu
WC. Today’s
Chiropractic Vol. 29 No. 6 November/December 2000
Forty-seven
patients with asthma that ranged from mildly persistent to
severely persistent not only improved dramatically under chiropractic
care but maintained that improvement for a two year follow-up
period.
The patients ranged in age from 7 to 42 and were seen
between 14 and 44 times with most beginning care at 3 visits
per week for the first 4 to 8 weeks. Improvement was based
on the patient's subjective and objective symptoms as well
as their use of asthma medication.
All 47 of the patients showed
significant improvements from 87 to 100 percent. At a two-year
follow-up, all 47 patients reported maintaining the improvements.
Upper
cervical chiropractic care of a pediatric patient with asthma:
a case study. Hunt JM Journal of Clinical Chiropractic Pediatrics
Vol 5, No 1, 2000.
This is the case of a four-year-old girl
who accompanied her mother for chiropractic evaluation following
a motor vehicle accident and also began chiropractic care.
At
the initial consultation the girl’s asthma and
breathing symptoms had been progressively worsening.
Chiropractic
orthospinology examination revealed atlas right 1° with 3° anteriority.
Axis and C6 also showed some misalignment. Adjustment to the
right transverse process in the side-lying position was performed.
Since
care was initiated, the patient has had one minor episode of
nasal congestion. Child also seemed to experience a “growth
spurt” or rapid improvement in height
and weight. The asthma symptoms have all but completely disappeared.
Mother states, “She had to constantly run the humidifier
and there is no need to do that now."
The types and frequencies
of nonmusculoskeletal symptoms reported after chiropractic
spinal manipulative therapy. Leboeuf-Yde C, Axen I, Ahlefeldt
G, et al. Journal of Manipulative and Physiological Therapeutics
Nov/Dec 1999:22(9) 559-64.
Twenty consecutive patients from
87 Swedish chiropractors answered questionnaires on return
visits. A total of 1,504 questionnaires were completed and
returned. Twenty-three per cent of patients reported improvement
in nonmusculoskeletal symptoms, including:
- Easier to breathe (98 patients)
- Improved digestive function (92)
- Clearer/better/sharper vision (49)
- Improved circulation (34)
- Less ringing in the ears (10)
- Acne/eczema better (8)
- Dysmenorrhoea better (7)
- Asthma/allergies better (6)
- Sense of smell heightened (3)
- Reduced blood pressure (2)
- Numbness in tongue gone (1)
- Hiccups gone (1)
- Menses function returned (1)
- Cough disappeared (1)
- Double vision disappeared (1)
- Tunnel vision disappeared (1)
- Less nausea (1)
A comparison of active and simulated chiropractic
manipulation as adjunctive treatment for childhood asthma.
New England Journal of Medicine 1998; 339:1013-1020 Balon
J, Aker PD, Crowther ER, et al.
It is reported that chiropractic
care did not benefit individuals with asthma in this study.
Such
a conclusion is at variance of over 100 years of clinical
experience.
This paper has many flaws, among them the “chiropractic” care
used was really not chiropractic and there was no objective
measurement of the presence or correction of the vertebral
subluxation. But, as my mother would say, “Consider
the source”: The New England Journal of Medicine. Medical
journals have historically printed defamatory articles on
chiropractic care that are little more than junk science.
An
impairment rating analysis of asthmatic children under chiropractic
care. Graham, RL and Pistolese RA. Journal of Vertebral Subluxation
Research, Vol. 1, No. 4, 1997. 1-8.
In this study eighty-one
children under chiropractic care took part in this self-reported
asthma related impairment study. The children were assessed
before and two months after chiropractic care using an asthma
impairment questionnaire.
Improvement was reported for 90.1%
of subjects 60 days after chiropractic care in comparison to
their pre-chiropractic scores. In addition, 30.9% of the children
voluntarily decreased their dosage of medication by an average
of 66.5% while under chiropractic care.
Twenty-four of the patients
who reported asthma attacks 30-days prior to the study had
significantly decreased attacks by an average of 44.9%.
Six
different chiropractic techniques were used by the different
chiropractors who participated in this study.
Case study: eight-year-old
female with chronic asthma. Peet JB. Chiropractic Pediatrics,
1997; 3(2) 9-12.
This is the case study of a patient diagnosed
with asthma three years prior to presentation. She was medicated
with Beclovent ™ and Albyterol ™ one to three times
per day.
After eight chiropractic adjustments over a period
of 2 ½ weeks,
the mother stated that the child had not used her inhaler
for two days, her wheezing had ceased and she could run without
gasping.
At the time of the publication of this article, the
child has been free of asthmatic attacks for four months without
medication.
Treatment protocols for the chiropractic care of
common pediatric conditions: otitis media and asthma. Vallone
S and Fallon JM Journal of Clinical Chiropractic Pediatrics
Vol 2, No.1 1997. P. 113-115
This paper presents the results
of a survey of chiropractors enrolled in the first year of
a three year postgraduate course in chiropractic pediatrics.
The
survey sought to establish if consensus existed with respect
to the modalities these doctors used to care for two of the
most common childhood disorders seen by chiropractors: otitis
media and asthma.
Thirty-three doctors of chiropractic participated
in the survey. “Of the primary therapeutic modalities
employed by the chiropractor, spinal adjusting was the most
commonly used for both asthma and otitis media. Certain areas
of the spine were addressed most frequently for each of the
two conditions.
Osteopathic manipulative treatment applications
for the emergency department patient. Paul, FA, Buser BR
Journal of the American Osteopathic Association, 1996;96:403-409.
From
the abstract:
The emergency department (ED) setting offers osteopathic
physicians multiple opportunities to provide osteopathic
manipulative treatment (OMT) as either the primary therapy
or as an adjunct to the intervention. In doing so osteopathic
physicians can decrease or eliminate the morbidity and symptoms
associated with protracted dysfunction. Low back pain, chest
pain, torticollis, asthma and sinusitis are some of the illnesses
in which OMT should be implemented as part of the management
plan….
Asthma and chiropractic Bronfort G European Journal
of Chiropractic 1996;44:1-7.
From the abstract:
This paper provides a brief overview of the
current understanding of chronic asthma and its treatment in
adults and children and discusses the potential role of chiropractic
in the management of this condition.
Case history of asthmatic
child. Matthews, NC. Et al. International Chiropractic Pediatric
Association Newsletter. July 1996.
This is the case of a four-year-old
female patient.
“Since birth she had problems with her respiratory
system...clinical diagnosis of asthma. She had shortness
of breath, hard and labored breathing, inability to run from
shortness of breath...had become reliant on antibiotics for
constant respiratory infections...had taken lots of steroidal
drugs. This ‘conventional’ drug therapy had not
prevented her from spending every Christmas in the hospital
on a breathing machine.
“Chiropractic examination revealed
vertebral subluxation of the atlas right, sixth cervical posterior,
and right posterior sacrum. Specific chiropractic adjustments
were given...patient responded to the care immediately and
was able to suspend using the drugs within two weeks.
Within
two months, she was able to play with her friends with no symptomatology.
Her 5th Christmas was the first at home in her life.”
Chiropractic
response in the pediatric patient with asthma: a pilot study.
Peet, JB. Marko SK, Piekarczyk W. Chiropractic Pediatrics Vol.
1, No. 4, May 1995, pp. 9-13.
From the abstract:
This paper reviews the correlation between
reducing/correcting vertebral subluxations in the asthmatic
pediatric patient utilizing Chiropractic Biophysics Technique
(CBT) and symptomology generally associated with this condition.
A further objective will be to determine what areas of vertebral
subluxation, if any, are commonly seen in this group. The children
used for this study had never received any chiropractic care
or manipulative care prior to participation in this study.
Seven
of the eight patients who completed the study were able to
reduce/discontinue medication. All participants showed measurable
improvement on radiographs, which correlated with an improvement
in asthma symptoms in seven of the eight cases.
This paper also
includes an interesting discussion on the innervation of the
lungs and its relationship to the vertebral subluxation complex.
Chronic
asthma. The side-effects of the chiropractic adjustment. Burnier,
A Chiropractic Pediatrics Vol. 1 No. 4 May 1995.
Case #1: J.P., 11-year-old male
Medical diagnosis: Chronic asthma
Medication: Theolair, Alupent
Chiropractic results: Off asthma
medication after first visit. Child is now a multidiscipline
athlete with aspirations to become an Olympic athlete. Six
years later, the child is still free of asthma and medication.
Presenting
Vertebral Subluxation: Occiput/C1 with an Atlas ASR.
Original
Adjustments: Structural manual adjustment of Atlas.
Case #2:
F.H., 9-year-old male
Medical diagnosis: Chronic asthma
Medication: Nasalcron
Chiropractic results: Off his medication
at onset of care. Clear of symptoms since first adjustment
eight years prior.
Presenting vertebral subluxation: CO/C1 with
atlas ASRP
Original Adjustment: Atlas in lateral flexion and
rotation supine
Chiropractic care in the treatment of asthma.
Killinger LZ. Palmer Research Journal 1995; 2(3):74-7.
This
is the case report of an 18-year-old subject with a two year
history of asthma and monitored for a five year period. The
subject received Palmer upper cervical specific technique adjustments.
The
result was a marked improvement in the subject’s
health status. The greatest improvements were reported in
the weeks following the chiropractic adjustments.
This was an
unusual case because trauma to the cervical vertebrae coincided
with the occurrence of asthma and spinal care was directed
to the traumatized segments.
Asthma in the Pediatric Patient.
Fysh, P. Dynamic Chiropractic September 2nd, 1995. P. 16.
This
is the case history of Benny, 3 years old who had suffered
from bronchial asthma since infancy. Bennie was placed on increasing
doses of medication with attacks occurring several times a
week.
Chiropractic examination revealed a subluxation at C1
and T3-4. Anterior saucering of the spine in the mid-scapular
region (first described by Pottinger in 1910) was also observed.
After one month of care, Benny’s asthma completely
resolved. According to the author, “Benny’s case
is not an unusual one.”
Chronic ear infections, strep
throat, 50% right ear hearing loss, adenoiditis and asthma.
G. Thomas Kovacs, D.C. International Chiropractic Pediatric
Association newsletter. July 1995.
This is the case of a 4 ½ year-old female suffering
from chronic ear infections, strep throat, (on and off for
4 years), 50% right ear hearing loss, adenoiditis and asthma.
She had been on antibiotics (Ceclor ™), developed pneumonia
and was on bronchodilators and anti-inflammatory medication
for asthma. She had also been prescribed steroids.
Her ENT diagnosed
her with enlarged adenoids and scheduled surgery to remove
the child’s adenoids and to put tubes
in her ears.
Chiropractic analysis: cervical (C2), thoracic
(T3) and right sacroiliac subluxation. Numerous enlarged
lymph nodes and muscle spasm.
Chiropractic care of 2x/week for
6 weeks was scheduled. After 3 or 4 adjustments mother noticed “a
changed child, she has life in her body again...acting like
a little girl again for the first time in 4 years.”
After 6 weeks, the pediatrician and ENT could not find any
signs of ear infection or inflammation, “Her adenoids,
which were the worst the ENT has ever seen, were perfectly
normal and healthy. Hearing tests revealed no hearing loss
whatsoever. When the family was asked how long the child
was on antibiotics, her family responded ‘all medication
was stopped 6 weeks ago when chiropractic care started.’ Shocked
and confused by this answer, the family was told to continue
chiropractic care because it had obviously worked.”
Asthmatics Can’t
Relax
According to a new study, (Journal of Clinical Investigation,
November 1995) the wheezing of asthmatics is not due to an
excessive irritability of the breathing apparatus, but because
the smooth muscle in the bronchioles does not relax. The
scientists contend that everyone has similar brief spasms
when irritants come in contact with the breathing tubes,
but for some reason, the spasms persist in asthmatics.
Comment
from Dr. Koren: Maybe they should look for a subluxation?
Chronic
asthma and chiropractic spinal manipulation - a randomized
clinical trial Nielsen NH, Bronfort G, Bendix T et al Clinical
and Experimental Allergy 1995 Jan; 25 (1): 80-88.
This was a
blinded, randomized study of 31 patients aged 18-44 who were
all on bronchodilators and/or inhaled steroids and conducted
at the National University Hospital’s
Out-patient Clinic in Copenhagen, Denmark.
The patients received
either “sham” or real
manipulations. Non-specific bronchial hyperreactivity (n-BR)
improved by 36% and patient rated asthma severity decreased
by 34% in both groups. However the abstract says: “The
results do not support the hypothesis that chiropractic spinal
manipulative therapy is superior to sham spinal manipulation
in the management of pharmaceutically controlled chronic
asthma in adults when administered twice weekly for 4 weeks.”
Comments from Dr. Koren: These conclusions appear at variance
with over a hundred years of clinical observation (and many
papers) discussing chiropractic’s effectiveness with
asthmatics. How can that be?
This may be so because the paper
has a number of serious flaws. First is selection bias: the
subjects were all adults who had been on medication for years.
Why weren’t children
included in this study? Why weren’t those who had asthma
who were not on medication included?
Secondly, the asthma medication
was continued during the course of spinal adjustment. Continued
medication use could interfere with the patients’ healing.
Finally,
a total of 8 adjustments (2x week) were performed. That is
sloppy chiropractic. How can the authors assume that every
patient needed the same schedule of care? Did the patient need
subluxation correction twice a week? Some patients need no
adjustments and some do not hold their adjustments and may
need 3 times a week (or more) care.
All that this paper shows
is that adult asthma sufferers who are full of medication get
as much relief from 8 “sham
manipulations” than after 8 “manipulations.” Perhaps
the spinal care was not of the best quality. A manipulation
is not the same as a specific adjustment.
What was the sham
manipulation? If not properly performed sometimes sham manipulations
are more manipulation than sham? That is because even very
light forces, a small touch in the right area may cause profound
physiological changes.
Additionally, in the real world, people
discontinue or decrease their medications under chiropractic
care. That was not permitted as part of the protocol in this
hospital study.
In conclusion, this research was poorly designed
with serious flaws.
Asthma and chiropractic. Garde R. Chiropractic
Pediatrics. Vol 1 No.3 December, 1994.
From the abstract:
This is the case of a 6-year-old boy who
had asthma for three years.
The child was prescribed aerosol inhalers (Beclovert ™ and
Vertolin ™) using them every day, up to three times
a day.
Chiropractic intervention: Spinal adjustments were delivered
to the cervical, thoracic and lumbar areas. Significant progress
in his condition was noted. Child could now run during soccer
games and parent reports that he “almost never uses
his inhaler.” Child sleeps more soundly and “Hardly
ever has bouts with mucous clogged nasal passages,” according
to the parents.
Nasal inhalant use stopped.
Asthma in a 9-year-old girl International
Chiropractic Pediatric Association Newsletter June 1993.
This
is the case of a 9-year-old girl who had been suffering from
asthma for 7 years. She had been hospitalized several times
due to her condition and was on 3 different drugs and 3 inhalers
four times each day.
As a result of the medication she was taking,
she began to have headaches and stomach pains and was experiencing
difficulty in school.
After 3 months of chiropractic care, she
stopped taking 5 of the 6 drugs she had been prescribed. Her
teacher remarked that the girl’s changes had been remarkable.
The
young girl answered, “Chiropractic is awesome.”
A
holistic approach to the treatment of bronchial asthma in a
chiropractic practice. Lines DA. Chiropractic J of Australia
1993;23(1):4-8.
This is the study of two children (2 and 5)
and one adult (30) with asthma using thoracic and/or lumbar
adjusting.
The author of the paper writes: “Current medical
bronchodilator and inhaled steroid intervention may be contributing
to the rising mortality (of asthma), the conservative, holistic,
chiropractic approach presented here may well provide (a)...more
effective alternative intervention to present allopathic
(medical) therapy....It appears that the currently accepted
allopathic (medical) management regimes still remain consensus-based
rather than having been founded on actual clinical trials.”
The
patients have remained asthma-free six months to two years
at the writing of this paper.
Manipulative therapy an alternative
treatment for asthma: a literature review. Dennis D, Golden
D,J Manipulative Physiol Ther, Vol. 8 No.2 July 1992.
From the
abstract:
“Subjective studies show that manipulation of the
spine relieves the patients’ symptoms. However, objective
findings have yet to be compiled using respiratory indices.”
Mechanisms
and Chiropractic Management of Bronchial Asthma. Monti R. Digest
of Chiropractic Economics Sep-Oct 1991;48-51.
This paper describes
the pathophysiology of asthma and the author’s chiropractic
results.
Management of pediatric asthma and enuresis with probable
traumatic etiology. Bachman TR, Lantz CA Proceedings of the
National Conference on Chiropractic and Pediatrics (ICA),
1991: 14-22.
A 34-month-old boy with asthma and enuresis (bed
wetting) had not responded to medical care. More than 20 emergency
hospital visits had taken place for the asthma attacks during
a 12 month history.
Three chiropractic adjustments were administered
over an 11 day period and the asthma symptoms and enuresis
ceased for more than 8 weeks. The asthma and enuresis reoccurred
following a minor fall from a step ladder but disappeared
after another adjustment. After a two year follow-up, the
mother reports no reoccurrence of the asthma or the enuresis.
Diagnosis
and treatment of TMJ, head, neck and asthmatic symptoms in
children. Gillespie BR, Barnes JF, J of Craniomandibular Practice.
Oct. 1990, Vol 8, No. 4.
From the abstract:
Pathologic strain patterns in the soft tissues
can be a primary cause of headaches, neck aches, throat infections,
ear infections, sinus congestion, and asthma.
A comparative
study of the health status of children raised under the health
care models of chiropractic and allopathic medicine. Van Breda,
Wendy M. and Juan M. Journal of Chiropractic Research Summer
1989.
In this survey which asked 100 chiropractors and 100 pediatricians
about their children’s health, it was found that the
children of chiropractors had a lesser incidence of asthma
than pediatricians’ children (3.5% for DC children
vs. 5% for children of MDs).
“Chiropractic” children also had significantly
less ear infections and less antibiotic use than “medical” children.
Prognostic
factors in bronchial asthma in chiropractic practice. Nilssen
N. Christiansen B. J Aust Chirop Assoc 1988;18:85-7.
In this
study of 79 subjects, those most likely to report the best
benefit had less severe asthma; were younger and responded
within one month (and had an average of five adjustments in
one month).
Case history: an eight-year-old asthmatic patient.
Cohen E. Today's Chiropractic. Jan-Feb 1988, p.81.
This paper
described the improvement in care of an 8-year-old asthmatic
that developed the condition at age two and successfully responded
after chiropractic care.
Adjustive treatment for chronic respiratory
ailment in a five year old.
Case reports in chiropractic pediatrics.
Case #2. Esch, S. ACA J of Chiropractic December 1988.
This
is the case of a 5 ½ year-old girl with a four-year
history of what the parents called “bronchial congestion.” She
had pneumonia “several times a year” since she
was 18 months old.
In addition to the attacks of “bronchitis”,
she suffered from congestion and was wheezy after running
and upon waking up in the morning. The father and mother
both reported having allergies.
Chiropractic examination revealed
subluxations at C-2, T-4 and L-5. By the time the second adjustment
was administered (two days after the first) the mother reported
the child was not coughing as much. By the third visit (one
week later) the mother reported that the child was breathing
normally.
A total of twelve adjustments were given over a three
month period and the chief complaint did not recur. A follow-up
call four years later revealed no recurrence.
Chiropractic and visceral disease: a brief survey. Wiles R,
Daikow P. J Calif Chiro Assoc, 16(4): 137-143, 1986.
This is
a survey of 17 DCs of whom 15 had cared for asthmatics. Areas
of the spine adjusted were reported as C0 (occiput)-C2 47%,
C3-C7 33%, T1-T6 80%, T7-T12 40%, Lumbar 7%, Sacro-iliac 13%,.
Asthma
in a chiropractic clinic: a pilot study. Jamison J et al J
Aust Chiro Assoc., 16(4):137-143, 1986.
In this study of 15
patients under chiropractic care, six patients reduced their
medications and one stopped them entirely. All patients reported
satisfaction with their chiropractic care. However, the lead
author, Dr. Jamison, concluded that respiratory function appeared
to be unaffected by chiropractic adjustments. This seems at
variance with the study’s
findings.
Treatment of visceral disorders by manipulative therapy.
Miller WD. In: Goldstein M, Ed. The Research Status of Spinal
Manipulative Therapy. Bethesda: Dept. HEW. 1975:295-301.
Patients
with chronic obstructive pulmonary disease were treated with
osteopathic manipulation. Ninety-two percent of the patients
stated they were able to walk greater distances, had fewer
colds, experienced less coughing, and had less dyspnea than
before care. Ninety-five percent of patients with bronchial
asthma said they benefited from chiropractic care. Peak flow
rate and vital capacity increased after the third osteopathic
manipulative therapy adjustment.
Copyright 2004 Koren Publications, Inc. & Tedd Koren, D.C.