Asthma

In the United States asthma is now epidemic. This once rare disease causes more time to be lost from school than any other pediatric disorder.

"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. San Jose, California. Dynamic Chiropractic. Sept. 25, 1995. p.16.

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.

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.

Significantly lower impairment rating scores (improvement) were 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.

The patient had been diagnosed with asthma three years prior to presentation. Beclovent ™ and Albyterol ™ were used 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.

Asthma in the Pediatric Patient. Fysh, P. Dynamic Chiropractic Sept. 25, 1995. P. 16. Case history of Benny, 3 years old who had suffered from bronchial asthma since infancy. On increasing doses of medication, attacks occurred several times a week. Subluxation a C1 and T3-4. Anterior saucering of the spine in the mid-scapular region first described by Pottinger in 1910. After one month of care Benny’s asthma resolved. According to the author, “Benny’s case is not an unusual one.”

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 (CBP) 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.

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’s purpose 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 treat 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.

Chronic asthma: The side-effects of the chiropractic adjustment. Arno Burnier, D.C. 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 result: 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 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.

The asthmatic patient. Cessna R. American Chiropractor April 1989;48-50. Discusses chiropractic success with asthmatics.

Asthma in a chiropractic clinic: a pilot study. Jamison JR, Leskovec K, Lepore S, Hannan P. J Aust Chiropractic Association 1986; 16(4): 137-43.

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. 92% of the patients stated they were able to walk greater distances, had fewer colds, experienced less coughing, and had less dyspnea than before treatment. 95% of patients with bronchial asthma said they benefited from chiropractic care. Peak flow rate and vital capacity increased after the third treatment.

Chiropractic response in the pediatric patient with asthma: a pilot study. Peet JB, Marko SK, Piekarczyk. Chiropractic Pediatrics 1995; 1(4)9-12.

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 blinded, randomized study of 31 patients aged 18-44 who were all on bronchodilators and/or inhaled steroids was conducted at the National University Hospital’s Out-patient Clinic in Copenhagen, Denmark. They received either sham or real manipulations. Interestingly, non-specific bronchial hyperreactivity (n-BR) improved by 36% and patient rated asthma severity decreased by 34% in both groups. From the abstract: “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.”

Dr. Koren’s comment: These conclusions appear at variance with over a hundred years of clinical observation of chiropractic’s effectiveness with asthmatics. Upon study of the paper, we notice a number of weakness: subjects were all adults on medication for years. Medication was continued during the course of spinal adjustment. A total of 8 adjustments (2x week) were performed. So this paper shows that adult asthma sufferers, who are full of meds get as much relief as sham adjustments after 8 “manipulations.” Perhaps the sham manipulation was more manipulation than sham? Perhaps the technique used was defective or not specific enough for asthmatic sufferers? Further, many asthmatic sufferers in the real world discontinue or decrease their medications under chiropractic care. In this hospital study that was not permitted as part of the protocol. This research was poorly designed and not worthy of the term chiropractic research.

Chiropractic treatment of asthma – a controlled clinical trial. Bronfort G, Nielsen N, Bendix T, Madsen F, Weeks B. Proceedings of the 1989 International Conference on Spinal Manipulation. Washington, DC. Published by FCER Arlington, VA.

Case history of asthmatic child. Matthews, NC. Et al. A four year old female patient reported to the office . International Chiropractic Pediatric Association Newsletter. July 1996.

“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 Christman in the hospital on a breathing machine. “A complete chiropractic examination revealed vertebral subluxation of the atlas right, sixth cervical posterior, and right posterior sacrum. Specific chiropractic adjustment 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...I wonder if her asthma should have been diagnosed as SUBLUXATION. What would have happened to her if over the last two years she had been on steroids rather than chiropractic care?”

A comparison of active and simulated chiropractic manipulation as adjunctive treatment for childhood asthma. NEJM 1998; 339:1013-1020 Balon J, Aker PD, Crowther ER, et al.

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 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 adjustments. After a two year follow-up, the mother reports no reoccurrence of the asthma or the enuresis.

Mechanisms and Chiropractic Management of Bronchial Asthma. Monti R. Digest of Chiropractic Economics Sep-Oct 1991;48-51. Describes the pathophysiology of asthma and the author’s chiropractic results.

Asthma and chiropractic. Garde R. Chiropractic Pediatrics. Vol 1 No.3 Dec, 1994.
From the abstract: Case review of a 6-year-old boy who has had asthma since 1991 andhis condition since chiropractic intervention. Child was prescribed aerosol inhalers (Beclovert and Vertolin) using them every day, up to three times a day. Adjustments were delivered to the cervical, thoracic and lumbar areas. Significant progress. Could run during soccer games and “almost never used his inhaler.” Slept more soundly. “Hardly ever had bouts with mucous clogged nasal passages.” Nasal inhalant use stopped.

Chiropractic and visceral disease: a brief survey. Wiles R, Daikow P. J Calif Chiro Assoc, 16(4): 137-143, 1986.
A survey of 17 D.C.s of whom 15 had cared for asthmatics. Areas of the spine adjusted C0- 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.

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.
Improvement in care of an 8 year old asthmatic who developed the condition at age two and successful response after chiropractic care.

A holistic approach to the treatment of bronchial asthma in a chiropractic practice. Lines DA. Chiropractic J of Australia 1993;23(1):4-8.
Chiropractic care of two children and one adult (two-year-old, five-year-old and thirty-year old) with asthma. Thoracic adjusting was used in two cases and lumbar adjusting was used in two cases. The patients remained asthma free six months to two years at the writing of the paper. The author’s remarks are well stated: “With counting evidence that current medical bronchodilator and inhaled steroid intervention may be contributing to the rising mortality, 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.”

A wholistic approach to the treatment of bronchial asthma in a chiropractic practice.
Lines DH. Chiro J Aust 1993;23:4-8.

Prognostic factors in bronchial asthma in chiropractic practice. Nilsson N, Christiansen B. J of Australian Chiropractors’ Assoc, 1988;18:85-87.
In this study of 79 subjects, improvement was reported on average after five adjustments, after one month of care. Younger asthmatic sufferers usually had a better response than older subjects to spinal adjustments.

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.
Children of chiropractors had a smaller incidence of asthma than pediatricians’ children (3.5% for DC children vs. 5% for children of MDs).

Manipulative therapy an alternative treatment for asthma: a literature review. Dennis D, Golden D, JMPT, 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.”

Alternative medical approaches to the treatment of asthma. Altern Compel Ther Gamble A. 1995;1:92-97.

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, neckaches, throat infections, ear infections, sinus congestion, and asthma.”

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.

4 1/2 year old female. Chronic ear infections, strep throat, (on and off for 4 years) 50% right ear hearing loss, adenoiditis and asthma.

Had been on antibiotics (Ceclor), developed pneumonia, on bronchodilators and anti-inflammatory for asthma. Also given steroids.

ENT diagnosed child with enlarged adenoids. Surgery to remove child’s adenoids and to put tubes in her ears was scheduled.

Chiropractic history: cervical (C2)and thoracic (T3) and right sacroiliac subluxation. Numerous enlarged lymph nodes and muscle spasm. Chiropractic care of 2x/week for 6 weeks 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, pediatrician and ENT noticed no sign 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.”

Case #2 Adjustive treatment for chronic respiratory ailment in a five year old. Case reports in chiropractic pediatrics. Esch, S. ACA J of Chiropractic December 1988.
This is the story 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 he 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 reveal subluxations at C-2, T-4 and L-5.
At the second adjustment two days after the first the mother reported the child was not coughing as much and by the third visit a week later the mother reporting the child was breathing normally. Twelve adjustments were given over three months and the chief complaint did not recur. A follow-up call four years later revealed no recurrence.