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Otitis media and spinal manipulative therapy: a literature review
Katherine A Pohlman1, Monisa S Holton-Brown
1Clinical Project Manager II, Palmer Center for Chiropractic Research, Palmer College of Chiropractic, Davenport, IA.
Insights
Spinal manipulation therapy (SMT) shows limited evidence for treating otitis media (OM) in children. While no serious adverse effects were noted, more rigorous research is needed to determine SMT
Area of Science:
- Pediatrics
- Integrative Medicine
- Evidence-Based Practice
Background:
- Otitis media (OM) is a frequent reason for pediatric doctor visits.
- Spinal manipulation therapy (SMT) is explored as a conservative treatment option for OM.
Purpose of the Study:
- To review existing literature on OM in children.
- To outline OM diagnosis, SMT, and adverse events.
- To assess the evidence base for SMT in pediatric OM.
Main Methods:
- Comprehensive literature search across multiple databases.
- Inclusion criteria: English language, OM focus, pediatric participants (≤6 years), SMT.
- Independent screening and quality evaluation of identified studies.
Main Results:
- 49 articles reviewed (commentaries, case reports, reviews, trials).
- Lower effect magnitude observed in higher-quality studies.
- No serious adverse events reported; minor transient effects noted in some studies.
Conclusions:
- Limited high-quality evidence supports SMT for pediatric OM.
- Current evidence neither supports nor refutes SMT for OM.
- Further rigorous research is necessary to clarify SMT's role and safety in pediatric OM.
Objective:
Otitis media (OM) is one of the common conditions for doctor visits in the pediatric population. Spinal manipulation therapy (SMT) may be a potential conservative treatment of OM. The purpose of this study is to review the literature for OM in children, outlining the diagnosis of OM, SMT description, and adverse event notation.
Methods:
Databases (PubMed, Cochrane Library, Cumulative Index to Nursing and Allied Health, Index to Chiropractic Literature, The Allied and Complementary Medicine, and Alt Health Watch) were queried and hand searches were performed to identify relevant articles. All potential studies were independently screened for inclusion by both authors. The inclusion criteria were as follows: written in the English language, addressed OM, involved human participants 6 years or younger, and addressed SMT. Studies were evaluated for overall quality using standardized checklists performed independently by both authors.
Results:
Forty-nine articles were reviewed: 17 commentaries, 15 case reports, 5 case series, 8 reviews, and 4 clinical trials. Magnitude of effect was lower in higher-quality articles. No serious adverse events were found; minor transient adverse effects were noted in 1 case series article and 2 of the clinical trials.
Conclusions:
From the studies found in this report, there was limited quality evidence for the use of SMT for children with OM. There are currently no evidence to support or refute using SMT for OM and no evidence to suggest that SMT produces serious adverse effects for children with OM. It is possible that some children with OM may benefit from SMT or SMT combined with other therapies. More rigorous studies are needed to provide evidence and a clearer picture for both practitioner and patients.
