By Dr. Risa M. Sloves

Just as parents concerned about their children’s teeth take them to the dentist for a checkup, many parents are now bringing their children to pediatric chiropractors to have their spinal development checked.

A young spine usually develops perfectly by the end of a pregnancy. However, the birth process itself often alters the normal functioning of a child’s spine. Even the position of the baby in the womb can misalign the spinal bones, known as vertebrae. The baby can also develop problems during the trip through the birth canal or from the birth process itself. Assuming the baby makes an uneventful and stress-free entrance into the world, other events, such as a fall from a changing table or a bed, or even a sudden stop in a car, can cause these small spinal vertebrae to misalign. Likewise, the reach for such a childhood milestone as learning to walk is invariably accompanied by many falls, which may also cause trauma to the child’s spine.

Signs to Watch For

Some of the more noticeable signs that may be indicators of spinal misalignment in a newborn or infant are: the child’s head being consistently tilted or turned to one side, decreased mobility of the head or neck on one side, or difficulty in nursing, particularly on one side. One such condition that creates these signs is known as torticollis, and when it affects newborns and infants it is referred to as congenital torticollis.  It is significant to note that torticollis is not a diagnosis, but rather a sign of some other underlying disorder. Documentation sited in leading obstetric and pediatric medical journals states that most torticollis seen in new babies is due to birth trauma, and will typically appear at birth or within the first several weeks later. Such torticollis is usually due to misalignment (subluxation) of the first few bones in the neck and/or an injury to neck muscles, resulting in a knot or spasm in one of the neck muscles. Although even a normal vaginal delivery without intervention can be traumatic for the newborn’s head and neck, breech delivery, forceps and vacuum extraction aids cause even more traumatic effects. Even a prolonged abnormal position in the womb during pregnancy (intra-uterine constraint) can cause injury, resulting in torticollis at birth or shortly thereafter. According to recent medical research, this misalignment of spinal bones in the neck, subluxation, is responsible for up to 50% of congenital torticollis. The subluxation irritates nearby nerve structures and causes the muscle spasm and postural changes characteristic of torticollis. Doctors of Chiropractic correct these misalignments by applying gentle corrective forces to the appropriate areas of the spine. Special infant and toddler techniques are utilized, ensuring that the chiropractor’s approach is particularly gentle, with only a fingertip used to make this corrective spinal adjustment. There are pediatric chiropractors specifically trained to care for this tender age group.

Success With Gentle Corrections

The Journal of Manual Medicine recently published a European medical doctor’s study reporting that 43 of 44 infants with torticollis responded favorably to this type of conservative spinal care. If torticollis is allowed to persist for greater than a year, however, surgical intervention may be necessary. In 1998, the medical journal Spine reported that the major factor predicting failure of conservative management was the duration of subluxation before initial care was rendered. That is, children with longstanding subluxation were more likely to experience recurrences and require surgery.

The most common conventional medical therapy for torticollis involves physical therapy to stretch the spasmed muscles. However, addressing solely the muscular component of torticollis is not often successful. According to a 1993 medical report, failure to detect and correct subluxation will likely result in residual head posture problems, even after “successful” neck muscle therapy. A chiropractic physician may also recommend or perform soft tissue manipulation, stretching and cranial adjustments as an adjunct to spinal adjustment.

The longer torticollis persists, the more likely it is that a patient will develop scoliosis and the facial/head asymmetry known as plagiocephaly. What causes this is a chronic muscle spasm pulling on the mastoid process, which is the bone behind the ear. The longer this pulling occurs, the more distorted and flattened the head appears. It is interesting to note that we are seeing more and more cases of head shape asymmetry, such as flattening of the back of the skull, in part due to the recommended placement of babies on their backs as a sleep position.

How Parents Can Help at Home

7516741_mOne of the current conventional medical solutions for plagiocephaly is the use of a helmet known as the “DOC Band,” a five-to-six-ounce open-topped helmet that applies light, steady pressure to the distorted areas of the infant’s head. Not only does the child need to wear this device for 23 hours a day, and perhaps for as long as many months, but also the child must be re-evaluated either weekly or every other week for follow-up treatment. It is important to note that while this solution may help in changing the shape of the infant’s head, it does not correct the underlying subluxation that caused the torticollis in the first place.

It is critically important to inform parents of children suffering from torticollis and/or plagiocephaly that there are alternative treatments available. Like torticollis, plagiocephaly has also been successfully addressed by gentle chiropractic adjustments to the spine and cranium, in conjunction with gentle stretching and soft-tissue manipulation. In addition, it is essential that we teach parents how to stretch and massage the spasmed muscle and to give parents such home-care recommendations as changing the positions used for feeding, sleeping, sitting in a car seat, looking at toys, and so on.

It should be stated that chiropractic is not intended as a treatment for any particular disease or symptom. The primary purpose of chiropractic is to improve nervous system function through the detection and correction of structural imbalance. In cases of torticollis resulting from subluxation, chiropractic often produces a rapid resolution.