Chiroblog

Pediatric Autoimmune Neuropsychiatric Disorders Associated with Streptococcal Infections (PANDAS) and Pediatric Acute-Onset Neuropsychiatric Syndrome (PANS) are conditions that can cause sudden behavioral disturbances in children. PANDAS is specifically linked to streptococcal (“strep”) infection while PANS can result from a broad number of potential triggers, such as other viruses, bacteria, fungi, mold, and even allergic reactions. Experts believe these conditions to be linked to inflammation in certain parts of the brain, particularly in the area that controls movement, decision-making, and emotion [1,2]. If infection leads to an abnormal immune response — where the immune system mistakenly attacks neural cells — it can result in causing a significant change in the child’s behavior that is known as PANDAS or PANS.

Children’s symptoms manifest seemingly overnight, and an episode causes personality or behavioral changes. These may show up in the form of obsessive-compulsive behaviors, motor or verbal tics, nervousness, separation anxiety, motor or sensory abnormalities, irritability, difficulty focusing, and appetite changes. These symptoms can be severe, affecting performance in school and dynamics at home [1,2].

Awareness of these conditions and their triggers is important for parents, caregivers, and healthcare providers to prepare for and manage symptoms in the best way possible. So many families are affected by this sudden change in behavior and have no idea what is going on with their child.  PANDAS or PANS might be the explanation, and pediatric chiropractic care combined with improved diet and neurological exercises can be the difference maker in these kids.  We have taken care of many children with PANDAS and PANS and have watched their little brains and nerve systems calm down and they become themselves again. 

References

[1] PANDAS/PANS in childhood: Controversies and evidence

[2] Current Research Updates on PANDAS and PANS - Springer

Tourette's syndrome is a neurological disorder characterized by involuntary tics and is becoming more prevalent among children and teens. Recent studies have shown an increase in the diagnosis of Tourette's syndrome and tic disorders, with estimates suggesting that around 1 in 100 school-aged children have this disorder [1]

This rise is in part due to better awareness and improved diagnostic analysis. Tourette's syndrome is rooted in the nervous system characterized by abnormalities in certain brain regions and neurotransmitter systems that control movement and behavior [2].  These neurological differences can lead to the sudden, repetitive movements or sounds known as tics, which can vary in severity and frequency.

Chiropractic care is a non-invasive approach that could help calm the symptoms of Tourette's syndrome by focusing on spinal alignment and nervous system function. Chiropractors use manual or instrument-based adjustments to correct spinal misalignments and therefore, improve nerve communication and overall body function. Some studies have shown that chiropractic care may reduce the frequency and intensity of tics in individuals with Tourette's syndrome [3].

Chiropractic care may potentially provide relief and improve the quality of life for those affected. By addressing the neurological aspects of the disorder, chiropractic care offers a conservative approach to managing Tourette's syndrome and its associated symptoms.  We have seen children with both tic disorders as well as Tourette's syndrome show significant improvement through gentle pediatric chiropractic adjustments combined with neurological exercises.  

References

[1] Tourette Syndrome and Tic Disorders | Pediatrics In Review ...

[2] Tourette Syndrome - National Institute of Neurological Disorders

[3] Reduction of Motor Tics in Two Male Patients Undergoing Chiropractic Care: A Case Series

Scoliosis is a condition where the spine curves abnormally and it is becoming more common, especially among children and teenagers. Recent studies have shown a significant increase in the incidence of scoliosis diagnoses, rising from 107 per 100,000 individuals in 2015 to 161 per 100,000 in 2022[1].  This rise could be attributed to better screening and awareness, but it also shows the need for effective management strategies. Scoliosis is not just a structural issue; it has a neurological foundation. Research indicates that individuals with scoliosis often have impaired balance and altered sensory integration, relying more on visual and proprioceptive information to stay upright[2].  These neurological factors can potentially lead to the development and progression of abnormal spinal curves.

Chiropractic care provides a non-invasive approach to managing scoliosis by focusing on spinal alignment and improving nervous system function. Chiropractors use gentle manual adjustments and other techniques to improve spinal misalignments, which can decrease pain and improve mobility. Studies have shown that chiropractic care, when combined with exercises and lifestyle modifications, can help manage scoliosis symptoms and potentially slow the progression of the curve[3].   By taking care of both the structural and neurological aspects of scoliosis, chiropractic care offers a holistic approach to managing this condition.

An eleven year old female started care last year with a mild curve that was found by their health provider.  When the mother asked what they should do about it, the response was, ‘let’s see her next year and we can assess then.’  The mom was not satisfied with a ‘wait-and-see’ approach, so sought chiropractic care, and in 4 months time, we saw significant reduction in the degree of scoliosis. 

If you dentist said, “there’s a big cavity in your molar.  Let’s wait til next year so we can assess it,” would that make sense?  Better to work on something when you find it than to wait until it gets worse!

References

[1] The burden of scoliosis: a nationwide database study on demographics

[2] Neurophysiological, balance and motion evidence

[3] Chiropractic treatment of scoliosis; a systematic review

Childhood ear infections are becoming more common, raising concerns for both parents and healthcare professionals. Studies show that by their third birthday, five out of six children will have at least one ear infection. One reason for this is that children have narrower and more horizontal Eustachian tubes than adults, which makes it easier for fluid to become trapped and which may lead to more susceptibility to infections.

As a result, many parents are seeking alternative treatments due to concerns about the overuse of antibiotics and the potential side effects of interventions like ear tubes. One natural, non-invasive option gaining attention is pediatric chiropractic care, which focuses on addressing the root causes of recurrent ear infections. Chiropractic adjustments, particularly in the upper neck area, aim to restore proper spinal alignment. How does alignment affect the ears? When the spine is misaligned, it can disrupt communication between the brain and the body, affecting important nerves like the Vagus nerve, which may play a key role in regulating ear drainage.

This misalignment can lead to issues such as poor drainage of the Eustachian tubes, increased inflammation in the ear, and a weakened immune system—all of which make it easier for infections to develop. By correcting these misalignments, which can increase the communication of the nerves in and around the ears, chiropractic care can improve the function of the Eustachian tubes, promote better fluid drainage, and reduce the frequency and severity of ear infections. Additionally, research suggests that chiropractic care can strengthen the body’s immune response, making it more effective at fighting off infections.

Starting practice in 1989, ear infections were the most common reason why we saw children in the practice, followed by GI issues in infants such as colic/reflux. That hasn’t changed much in over 35 years!  Multiple times per month we have a new child whose chief complaint is ear infections.  They range from infants to toddlers to preschoolers and even school age kids who are prone to swimmer’s ear!

By considering pediatric chiropractic care, parents can take a more holistic approach to managing their child’s ear health. Chiropractic may address the underlying issues contributing to frequent ear infections, providing help for children and peace of mind for parents.

References:

1. The Diagnosis and Management of Acute Otitis Media

2. Chiropractic Care in Children: A Review of Evidence and Safety

Attention-Deficit/Hyperactivity Disorder (ADHD) is on the rise, with more children being diagnosed each year. According to recent studies, nearly one in ten children in the United States is diagnosed with ADHD, making it the most common mental health condition among children. This recent increase may be in part due to better awareness and diagnosis, but we cannot discount the potential of environmental and dietary concerns. Common treatments for ADHD often involve medication and behavioral therapy, but worries about side effects and long-term use have made many parents explore alternative options.

One such option is pediatric chiropractic care, which offers a natural, non-invasive approach to improving nerve system function. A pilot study found that chiropractic care, when combined with usual care, showed improvements in ADHD symptoms in children. Pediatric chiropractic care provides a promising complementary approach for parents seeking holistic solutions for ADHD.  We have seen many children who were having significant difficulties in school becoming straight A students because their ability to focus increased, reading grade levels jumped significantly, and overall behavior improved. 

References:

What’s behind the increase in ADHD?
The effects of chiropractic adjustment on inattention, hyperactivity, and impulsivity in children with attention deficit hyperactivity disorder: a pilot RCT

The Polyvagal Theory, developed by Dr. Stephen Porges, explains how our nervous system responds to stress and safety through three levels: social engagement, fight/flight, and freeze. The social engagement system, governed by a part of the cranial nerves called the Ventral Vagus, helps us connect with others and feel safe. When we feel threatened, our sympathetic nervous system activates the fight/flight response, preparing us to either confront or escape danger. If the threat is overwhelming, the dorsal portion of the vagus nerve triggers the freeze response, causing us to shut down and conserve energy[1][2].

When working with children with autism, having an understanding of these levels can be insightful. Many children on the spectrum may have a heightened sensitivity to their environment, causing their nervous system to frequently shift into fight, flight or freeze. This can manifest as anxiety, avoidance, or turn into them shutting down. When you recognize these responses as natural reactions to perceived threats, caregivers and educators can create more supportive environments, which helps to promote feelings of safety and social engagement. This approach can help children with autism feel more secure and connected, ultimately enhancing their ability to interact and learn[3][4].  That is why in designing our office we structurally took into account the Polyvagal perspective to prepare the environment that is more suitable to children with autism, and also changed the way we approach our examinations and adjustments based on making the best possible experience for someone who is neurodivergent.

References

[1] What is Polyvagal Theory? - Polyvagal Institute

[2] The polyvagal perspective - University of Arizona

[3] International Journal of Psychophysiology

[4] How the Polyvagal Theory Inspired My Parenting - Psychology Today

Infantile colic is a common condition in otherwise healthy babies that cry for long periods, often intensely. It affects up to 40% of infants and typically peaks around six weeks of age[2]. While this can be distressing for both babies and parents, some researchers believe it could be linked to an immature nervous system. The nervous system plays a key role in controlling a baby’s digestive system and how they react to different stimuli[1]. If the nervous system isn’t fully developed, it can lead to digestive issues or discomfort, which may explain the excessive crying.

One theory behind colic is that the baby’s nervous system is overwhelmed, which can also lead to gastrointestinal problems. Signs of this include babies arching their backs and clenching their fists, which suggest they’re experiencing neurospinal tension[1]. This tension can be caused by misalignments or stress in the nervous system, such as from birth trauma or even the mother’s stress during pregnancy[1].  A recent study of 120 colicky babies indicated that there might some neurological dysregulation in these infants that leads to their not being able to easily digest food [3].

Understanding colic as a neurological issue opens up new ways to manage it. For example, gentle chiropractic care can help relieve the neurospinal tension by addressing the underlying cause, not just the crying[1]. This approach focuses on easing the root problem, which may offer relief for some babies.

References:

[1] What is a Colic Baby? Understanding the Signs and Root Causes of Colic

[2] Infantile Colic: Recognition and Treatment - AAFP

[3] Clinical Evidence of Vestibular Dysregulation in Colicky Babies Before and After Chiropractic Treatment vs. Non-colicky Babies

Children with autism often have retained primitive reflexes, which are automatic movements that babies typically outgrow as they develop. These reflexes, such as the Moro reflex (startle response) and the palmar grasp reflex (grabbing with the hand), are essential for early development but should go away as the brain matures. However, in children with autism, these reflexes can stick around, potentially causing issues with their motor skills, coordination, and even cognitive functions[1]. Studies have shown that retained primitive reflexes can cause trouble when it comes to a child's ability to perform everyday tasks and may lead to difficulties in social interactions and learning[2].

Research suggests that addressing these retained reflexes through specific therapies can help improve the symptoms of autism. For example, modalities like sensory stimulation and physical exercises aimed at reducing these reflexes have shown good results, especially when coupled with gentle, brain-based chiropractic care [3]. Combining therapies (such as chiropractic) with neurological exercises can boost brain connectivity and improve cognitive and motor functions in children with autism[1][2]. By focusing on these underlying neurological issues, it is possible to give better overall development and quality of life for children with autism.

References

[1] Identification and reduction of retained primitive reflexes by sensory ...

[2] Retained Primitive Reflexes and Potential for Intervention in Autistic ...

[3] Combining Chiropractic Care with Extinguishing of Primitive Reflexes: A Case Series of 8 Children

Interoception, the sense of internal body signals such as hunger, thirst, and heartbeat, plays a crucial role in self-regulation and emotional awareness. For children with autism, improving interoception can significantly enhance their ability to understand and respond to their body's needs. One effective strategy is engaging in interoceptive awareness activities. For example, the "Feel Your Heartbeat" challenge involves children performing physical activities like jumping jacks and then pausing to notice their heartbeat. This helps them become more attuned to their internal signals[1]. Additionally, mindfulness exercises such as deep breathing and body scans (such as fully describing a painful sensation) can help children recognize and interpret various bodily sensations, promoting better self-regulation and emotional control[2].

Another approach is incorporating sensory activities that stimulate interoceptive awareness. Activities like playing with textured materials, engaging in yoga, or using weighted blankets can help children with autism become more aware of their internal states[3]. By consistently practicing these strategies, children can develop a stronger connection between their internal signals and their emotional responses, leading to improved self-awareness and overall well-being[4]. Supporting children in this journey not only enhances their daily functioning but also empowers them to navigate their emotions and physical needs more effectively.  For example, a mom of a child with autism recently told me after several chiropractic adjustments that their child is now more open to describing when they are hungry and is more open to trying new foods (since textures and smells are often significant detractors).  Pediatric, brain-based chiropractic can be helpful for kids (and adults) with autism.  

References

[1] How to Improve Interoception: 5 Proven Strategies for your Child

[2] Interoception: Knowing Yourself Inside and Out - Reframing Autism

[3] Strategies to improve interoception in autistic individuals

[4] Interoception and mental wellbeing in autistic people

[5] A Systematic Review of Associations Between Interoception, Vagal Tone, and Emotional Regulation: Potential Applications for Mental Health, Wellbeing, Psychological Flexibility, and Chronic Conditions, Pinna T & Edwards D, https://www.frontiersin.org/journals/psychology/articles/10.3389/fpsyg.2020.01792/full

A study in 2015 discussed the link of trigeminal neuralgia (TN) with dysfunction of the autonomic nervous system. ¹
Method: 12 patients with classical TN and 12 healthy control patients. Patients are asked to submerge right arm for 5 into 10*C water to trigger pain. Patients rated their pain every 30 seconds on a 0-100 scale. Electrocardiograms were taken before and during experimental pain test. Heart rate was also analyzed in frequency domain, differentiating low frequency components ( HR fluctuations in the LF range reflect baroreflex-mediated sympathetic activity associated with Mayer waves of blood pressure) and high frequency components (HRV in the HF range is generated by respiratory sinus arrhythmia and
constitutes a sensitive measure of cardiac vagal parasympathetic activity).

Result: No difference in pain perception or heart rate between TN group and control group. No one in TN group experienced facial pain. All patients experienced an increase in low frequency oscillations (increased sympathetic activity) and decrease in high frequency (decrease in parasympathetic activity), but the changes were more pronounced in the TN group.

Conclusions: “Results indicate that TN patients and healthy controls have comparable
autonomic cardiac responses at rest, but that in response to a tonic experimental pain challenge, TN patients show greater sympathetic arousal and parasympathetic withdrawal than healthy controls.” “The exact reason for the negative association between sympathetic reactivity and the number of pain paroxysms experienced by TN patients remains unclear and surely merits future attention.”

The Vagus nerve has clear parasympathetic connections, but the jury is still out on the trigeminal nerve. However, one thing noticed frequently in chiropractic practices is how the temporomandibular joint (TMJ), when not functioning, will usually be associated with increased tension in that person, whether they are a child or an adult ².  Reducing the alignment issues in the TMJ often reduces that person’s stress as well.

References 

1. Léonard, G., Chalaye, P., Goffaux, P., Mathieu, D., Gaumond, I., & Marchand, S. (2015). Altered
Autonomic Nervous System Reactivity to Pain in Trigeminal Neuralgia. Canadian Journal of
Neurological Sciences / Journal Canadien Des Sciences Neurologiques, 42(2), 125-131.
doi:10.1017/cjn.2015.10

2. Santos, E. et al.  (2022). Association between temporomandibular disorders and anxiety: A systematic review. Frontiers in Psychiatry.  https://www.frontiersin.org/journals/psychiatry/articles/10.3389/fpsyt.2022.990430/full