Can A Chiropractor Help Asthma?

Patients often ask me about the potential usefulness of chiropractic treatment for things other than the usual conditions people associate with the profession, such as back and neck pain.

Asthma is one that came up this past week, and I figured I’d share my thoughts on it.

Let me start by saying that every case is different and there’s no guarantee that chiropractic will help any condition for a given person. By licensure in Texas, chiropractors cannot treat asthma per se, but rather by treating underlying conditions that cause it, asthma may improve or resolve as a happy side-effect of chiropractic adjustments and other treatments chiropractors use.

There’s two main types of triggers for asthma symptoms:

Neurological and inflammatory.

The part of the nervous system that controls organs, including the lungs and the airways in them, is known as the autonomic nervous system. It, in turn, has two subdivisions: the sympathetic and parasympathetic nervous systems.

"File:The Autonomic Nervous System.jpg" by Geo-Science-International is marked with CC0 1.0.

Under normal circumstances, these two systems balance each other and allow the body to adapt to changing conditions and physiological needs.

The sympathetic nervous system kicks into gear when the body needs to react to stresses and is the main controller of the “flight or fight” response.

For example, if you were to be attacked by an animal or another person, the sympathetic nervous system will stimulate your heart to beat faster, your breathing rate to increase, and the airways in your lungs to expand so they can take in more oxygen to prepare you to run for your life or fight your attacker.

Once the threat has passed, the sympathetic nervous system quiets down and the parasympathetic nervous system becomes more active to slow everything back down to normal.

In some cases of asthma, an imbalance occurs and the parasympathetic system becomes too active relative to the sympathetic. This results in excessively constricted airways and the difficulty in breathing associated with an asthma attack.

The other main trigger of asthma symptoms is inflammation. This is typically associated with allergies. Allergic reactions may cause inflammation and swelling of the airways, and the swelling reduces the air flow through them.

Some asthma sufferers have predominantly neurological triggers, some primarily inflammatory triggers, and some have a mixture of both.

So how can chiropractic potentially help?

In terms of the neurological issues, sometimes they stem from mechanical issues in the spine. Some areas of the spine (mostly in the lower neck and upper to mid back) are associated with the function of the sympathetic nervous system, while others (the very upper neck and very lower back ) are more associated with the parasympathetic nervous system.

In some cases, it appears that mechanical dysfunction in the spine may either irritate and increase the firing of the associated neurological structures, or inhibit them – in either case, potentially causing an imbalance between the sympathetic and parasympathetic function.

It follows then that chiropractic correction of the mechanical issues may also help to restore the balance and in turn, relieve any sympoms produced by that imbalance.

This effect can be remarkably fast.

The most dramatic case I’ve seen personally goes all the way back to when I was doing my internship in chiropractic school. One of my clinic patients was a young boy who had been medically diagnosed with “treatment-resistant” asthma, which means he didn’t respond very well to the usual medical treatments for asthma.

His father had previously found that his son had fewer asthma issues when under chiropractic treatment and he would bring him in for both preventive care and during actual asthma attacks. I “inherited” both of them as patients from a graduating intern, and because of the changeover, there had been a bit of a lapse in the boy’s preventive care.

So, the first time I saw him, he was in the midst of a full-blown asthma attack – gasping for breath and in obvious distress – no pressure at all for me as a brand new intern!

Nervous as I was, I did what I was trained to do. I assessed, documented, and got approval to treat from one of the supervising doctors and proceeded to perform an adjustment on the boy’s lower neck. I was thankful to get a good release on my first attempt and was absolutely shocked when the boy’s breathing returned to normal – immediately!

When I say immediately, I’m not talking about a few minutes later, nor a gradual improvement. He went from gasping for air to normal breathing as soon as my hands stopped moving after performing the adjustment!

This is the speed at which the nervous system can correct!

Most patients with asthma I’ve seen over the years have not been in the midst of an attack when I treated them. I can only recall one other, and while her breathing also returned to normal, it happened more gradually. She was mostly fine at the end of her appointment and later reported that she was 100% within a couple of hours after she left. Still very impressive, but not quite as exciting as my clinical internship patient.

But what about the other big trigger for asthma – inflammation?

Chiropractic adjusting of the spine has some general anti-inflammatory effects in some cases as well, but I actually use a more direct approach to deal with the primary source of asthma-related inflammation – allergies.

"texas mountain cedar pollen" by micklpickl is licensed under CC BY-SA 2.0.

Years ago, I was introduced to a variation of NAET (Nambudripad’s Allergy Elimination Technique), an acupuncture/acupressure based technique for reducing sensitivity to allergens. I will confess, when I first learned about it, it seemed incredibly weird and hokey to me. But after seeing what it could do, I eventually incorporated it into my practice.

It’s one of those things you kind of have to experience, but the short explanation is that allergens that create symptoms for a given individual create energetic imbalances in the body that actually weaken your muscles. We can use muscle strength as an indicator of what a person is reacting to and then use acupressure or acupuncture (I primarily use laser acupuncture which is completely painless and does not require the patient to disrobe) to re-set the body to reduce its reactivity to those allergens.

This technique typically restores muscle strength related to the allergic sensitivities and also tends to greatly reduce other allergy-related symptoms.

Again, every case is different, but if the underlying neurological and/or inflammatory triggers of a person’s asthma can be eliminated or effectively managed, it has been my experience that their asthma attacks can be greatly reduced in both frequency and intensity.

But what does the research show?

Well, admittedly there’s not much formal research in this area, and what has been done has shown mixed results. One of the confounding factors in research on chiropractic treatment has always been providing some sort of placebo to compare to.

In some of the asthma studies I’ve read, chiropractic adjustments are compared to supposed placebos (treatments without any actual therapeutic benefits) such as massage therapy, or “fake” adjustments which are gentle thrusts that don’t cause joint popping. Such placebos are not necessarily non-therapeutic, and although such studies typically conclude that chiropractic is ineffective as compared to placebo for asthma, these study results have typically shown it to have beneficial effects (just not significantly better than the supposed placebo).

In addition, some studies of chiropractic treatment for asthma have limited the area of treatment – for example one study I read only allowed chiropractic adjustments to the thoracic spine. In the real world, chiropractors treat whatever mechanical dysfunction we find and probably have a better chance of fixing the underlying problem when addressing a broader range mechanical issues.

Ultimately, I think the most reasonable and prudent approach to utilizing chiropractic and other holistic forms of treatment for asthma (such as allergy desensitization) is using a co-management approach with conventional medical treatment.

For those cases in which chiropractic and holistic treatments are helpful, the use of medications and their risk of side-effects can be reduced and the patient’s quality of life can be improved. If their medical doctor wants to claim credit for it, that’s fine with me (sort of)!

Until next time…

George Best, D.C.