Not Even Wrong: Chiropractic and Bedwetting

Not Even Wrong: Chiropractic and Bedwetting

The Joint Chiropractic has an article called Childhood Bed-wetting: Could Chiropractic Be the Answer?

Betteridge's law rules again: "Any headline that ends in a question mark can be answered by the word no."

The understanding by chiropractic as to the pathophysiology of bedwetting?

There's a bit of an explanation for why it happens, so bear with me. Infants and young children have very slow respiration (breathing) patterns. Because breathing slows, carbon dioxide rises and triggers something called the phrenic reflex. The phrenic reflex then stimulates the diaphragm to fire. The diaphragm is the main breathing muscle, so the child takes a breath. If this reflex isn't functioning optimally, the smooth muscles in the body (unlike the skeletal muscles) relax because carbon dioxide gets so high. The valve of the urinary bladder is a smooth muscle; when it relaxes, the child wets the bed. This reflex matures more slowly in boys than girls.

If you search Pubmed for "nocturnal enuresis" and "hypercapenia", "phrenic", or "CO2" you find? Nothing.  Zip. Nil. Nada.

For a more complete explanation of why this is complete baloney see Separating Fact from Fiction in Pediatric Medicine: Nocturnal Enuresis, but the chiropractic understanding is the fiction part of the article.

Of course, when all you have is a hammer, everything is a nail, and they suggest chiropractic adjustment of the neck

There is a nerve called the phrenic nerve which plays a role in the phrenic reflex. This nerve exits the spine between the third, fourth and fifth cervical vertebrae. Chiropractic adjustments can focus on the vertebrae that affect the bladder and can help to improve function of the nervous system by relieving the subluxations that impede on proper communication and function.

Is there any reason reason to suspect chiropractic would be effective? Nope and nope.

The success of each therapeutic option must, in part, be attributed to the natural history of enuresis, as well as any educational or placebo aspects of treatment. Conditioning therapy utilizing the urine pad alarm may be the most reasonable initial mode of intervention. Spinal manipulative therapy has been shown to possess an efficacy comparable to the natural history.

And chiropractic is not without risk. And while usually mild, occasionally there are more severe complications. Just what a child needs: a stroke after a useless chiropractic intervention.

And not only do chiropractors not understand bedwetting, they show little understanding of other causes

Despite hours of reading chiropractic claims regarding bedwetting, I failed to find any legitimate discussion of the potentially serious causes of nocturnal enuresis. Parents could likely search hundreds of chiropractic websites without coming across any mention of red flags for conditions that would need evaluation and treatment by a real physician or surgeon. These are the people that want to work as primary care providers to children.

These alternative chiropractic facts on the cause and treatment of bedwetting are, in my opinion, not only not right, it is not even wrong, a Billy Madison understanding of bedwetting.

What you've just said is one of the most insanely idiotic things I have ever heard. At no point in your rambling, incoherent response were you even close to anything that could be considered a rational thought. Everyone in this room is now dumber for having listened to it. I award you no points, and may God have mercy on your soul.

Points of Interest 01/26/2017
Points of Interest 01/25/2017

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