Dr. Lisa Goodman, DC, ICSC, CACCP
Have you ever wondered why children suffer a higher number of ear infections than adults? It may even seem like a right of passage, as very few babies and toddlers escape them. According to the National Institutes of Health five out of six children will experience at least one ear infection before their third birthday. It is also the most common reason parents bring their child to a doctor. In fact, it is the second most common reason our Chiropractors see children under age three in our practice. The very reason that young children suffer ear infections, is what makes chiropractic care successful in treating them. It has to do with the anatomy of the head including the ears, jaw, cranial bones and even the upper neck. If you would like an alternative to antibiotics and surgically implanted tubes, read on.
What causes ear infections?
Ear infections, also known as otitis media, are generally caused by bacteria, similar to any other infection. However in the case of an ear infection it is the location that makes them difficult to treat, chronic and potentially reoccurring. Bacteria and fluid can become trapped in the middle ear behind the ear drum causing pain. In many cases, antibiotics will take care of the infection, however fluid can be left behind making it more difficult to fight future infections and affect hearing. In addition to killing the bacteria in an ear infection, there also needs to be ample drainage for remaining bugs. This is where the shape and biomechanics of the anatomy makes a difference.
Anatomy of an ear infection
In adults, the Eustachian tube is oriented at a downward angle which allows drainage of the ears into the upper part of the throat. In infants and toddlers, the cranium has not elongated yet, which means Eustachian tubes are oriented in a more horizontal fashion (click here to view the infant and adult Eustachian tubes). This means that if there is bacteria (from a cold, sinus or upper respiratory infection) that finds itself inside the Eustachian tube with poor drainage, it can become trapped there. In addition to drainage, it is important for the Eustachian tube to remain unblocked as it also provides fresh air and maintains the pressure between the nose and the ear. Hence if you find yourself trying to equalize your pressure, a chiropractic adjustment can also go along way to reestablishing balance.
Long term damage from ear infections
In addition to being incredibly painful, there can also be long term consequences of ear infections including hearing loss. This occurs when the tympanic membrane ruptures or scars after surgical intervention. In fact, I have a few adult patients who in their 30s require a hearing aid due to a childhood history of chronic ear infections that lead to significant scarring.
Medical approach to ear infections
Thanks to modern medicine, ear infections can be treated with a number of different antibiotics. In some stubborn cases, a few rounds of antibiotics may be necessary. If a child suffers from chronic (3 episodes in 6 months or 4 episodes in one year) ear infections they may end up needing tubes implanted into the tympanic membrane surgically. While this is a relatively simple surgery, we always want to avoid putting kids under general anesthesia when possible. Notably, in 2013 The American Academy of Pediatrics issued guidelines that encourage doctors to observe and closely follow children with ear infections that can’t be definitively diagnosed, especially those between the ages of 6 months to 2 years. Which is great news! And it is also leading pediatricians to recommending medical intervention less, and chiropractic intervention more.
Chiropractic approach to ear infections
Chiropractors are experts in movement of bones and joints. It is our job to ensure that every joint in the body is gliding easily, allowing freedom of movement. This approach, with the cranial bones, jaw and upper neck is what is extremely effective at clearing up ear infections in children and adults. When we suspect an ear infection is related to poor drainage of the Eustachian tube (which is quite often), our approach is to take a thorough history followed by evaluation of the orientation of the cranial bones, position and function of the jaw and range of motion of the upper neck. Pediatric chiropractors have extensive training in gentle manipulation of each of these tiny bones and joints. By manipulating joints around the Eustachian tube, drainage is enhanced. While studies in our field are limited, a 2021 literature review of otitis media and manipulation reveals the safety and likely efficacy of chiropractic manipulation in children with OM. It is for this reason, that our office successfully co-treats our patients with area pediatricians to ensure the best possible outcomes with the fewest possible side effects.
How would a baby/toddler have a biomechanical problem in their head or neck?
We hear this question a lot. To us the answer is pretty obvious, birth! Whether a delivery was uncomplicated, or required intervention, birth is extraordinarily stressful on the newborn’s head and neck. The physical pressure a newborn endures can result in joint fixations in the cranial bones, jaw or upper neck. These are easily identified through a thorough history of his or her birth, current symptoms, observation/inspection and palpation.
Chiropractic treatment for ear infections
Our doctors will typically treat a child 2-4 times over 1-2 weeks for an active ear infection. We perform an otoscopic exam at each visit to monitor progress. Additionally, in kids who are at higher risk, we recommend preventative adjustments monthly until the age of 4 or 5 years old. We maintain communication with pediatricians and refer for medical intervention when necessary. For an inside look at what a newborn chiropractic exam and treatment look like, see this video on our You Tube page.
Lastly...
You may be wondering, if ear infections are the second most common reason we treat kids, what is the most common? Torticollis (a persistent head rotation/tilt following birth) is the most frequent reason kids present to our office. For more information or specific questions, please email me at lgoodman@washparkchiro.com or schedule an appointment for your little one with one of our pediatric chiropractors at Washington Park Chiropractic.
Lisa Goodman, DC, CCSP, CACCP founded Washington Park Chiropractic in 2006 in Denver, Colorado. Dr. Goodman is a Certified Chiropractic Sports Physician (CCSP) and Certified Prenatal and Pediatric Chiropractor (CACCP). She is a CrossFit L1 and CrossFit Kids Certified Trainer. Dr. Goodman incorporates sports chiropractic techniques with prenatal and pediatric patients, she teaches mobility and taping classes locally, and is a contributor to POPSUGAR and Urban Life Wash Park. She is an instructor at Logan University's Masters of Science in Integrative Pediatrics program. She is a member of the ACA Pediatrics Council and the ACA Sports Council. Areas of special interest include prenatal care, ankle and wrist injuries, instrument assisted soft tissue techniques, strength training, and pediatric fitness. Stay connected with Dr. Goodman on Instagram @washparkchiro or @lisakgoodman