Middle Ear Infection – Causes, Risk Factors & Treatment Options

Ear infection is one of the most common reasons for pediatric visits to the doctor. For the purpose of this article, I’m talking about otitis media which is infection of the middle ear. Ear infections can be extremely uncomfortable producing symptoms such as ear pain and muffled hearing. School aged children with otitis media often have a difficult time concentrating in class.

Causes & Risk Factors:

Otitis media is caused by either bacterial, viral or fungal infection. Interestingly, it appears that for the majority of ear infections, both bacteria and viruses are present (1). Why do some children get ear infections and others do not? The main reason is that your child’s immune system is out of balance. If the immune system were functioning optimally, the body would fight off the infection with little difficulty before it truly becomes a problem. Below are a few risk factors or triggers for ear infection.

Recent cold: An upper respiratory tract infection often precedes an ear infection. (Cold and flu infections are both viral.)
Anatomical considerations: The eustachian tube of a child is oriented more horizontally than in an adult which anatomically can result in poorer drainage of fluid from the inner ear to the back of the throat.
Exposure to second-hand smoke & other environmental toxins: Toxins in the environment and foods (like certain preservatives) can hamper immune system function making one more susceptible to ear infection (and other infections).
Food allergies and sensitivities: Food allergies and sensitivities can thicken mucus and contribute to inflammation. One of the most common culprits is milk and milk products.
Eustachian tube dysfunction: The eustachian tube connects the inner ear to the back of the throat and is responsible for allowing the inner ear’s pressure to equalize with atmospheric pressure and to serve as a passageway for fluid to drain. Eustachian tube dysfunction is commonly implicated in inner ear infection.
Imbalance in overall immune system function: There are other physical, chemical and psychological factors that affect immune system function. Overall health and lifestyle choices will affect immunity.

Medical Management of Ear Infection:

The current literature supports that family doctors and pediatricians follow a “watch and wait” approach for acute ear infections. Certainly, if you suspect your child has an ear infection, he/she should be evaluated and appropriately diagnosed. That being said, most ear infections will heal on their own within a couple weeks (hence, the reason for initial watch and wait recommendation). In rare circumstances, symptoms can persist, become chronic or worsen.

The initial medical management for ear infections is antibiotic use. Keep in mind though, that antibiotics kill bacteria but not viruses and that most ear infections harbour both bacteria and viruses. So if there is a viral component, antibiotics are unlikely to work and may actually make things worse. In addition, antibiotics will destroy the healthy bacteria inhabiting the gut thus lowering one’s overall immunity (as the gut plays an important role in immune system function). Overall, the evidence suggests that antibiotics are poorly effective in treating otitis media (2).

Another option is tympanostomy tube or “ear tube” insertion. This is reserved for chronic cases whereby the infection is gone but fluid persists in the ear. The child is put under general anesthesia and small tubes are surgically attached to the ear drum allowing aeration of the middle ear. Similarly, the necessity and effectiveness of ear tubes is questionable.

Chiropractic Management of Patients with Ear Infection:

For the record, chiropractors do not diagnose or claim to cure ear infection. That being said, there are many benefits to chiropractic care for patients with ear infection. Chiropractic offers an alternative approach or an additional type of care for those who opt for co-management.

Chiropractic care, through natural means, seeks to optimize nervous system function and to correct any mechanical causes or contributors to the problem. It’s about putting your body in balance so that it may heal itself to its greatest potential. Healing comes from the inside.

How does chiropractic work? We know that the central nervous system controls and co-ordinates all systems and functions in the body. A nervous system free of interference will allow optimal communication and hence optimal healing. This is achieved by providing specific spinal adjustments to optimize spinal alignment and mobility. Chiropractic care has been shown to balance immune system function by reducing inflammation and stimulating antibody production (3, 4). A healthy spine = a healthy body.

Chiropractic care can often correct eustachian tube dysfunction as well. As mentioned earlier, it is often implicated in ear infection. Sometimes eustachian tube dysfunction persists after the infection is gone leading to persistence of muffled hearing and stuffiness. Correcting this dysfunction will allow the pressure to balance and the fluid to drain. Read my article about eustachian tube dysfunction.

Chiropractic care is very safe and for pediatric patients, gentle techniques are used. Kids enjoy their visits to the chiropractor!

To me, chiropractic care along with other approaches to boost natural immunity is a logical choice. Read my article about tips to boost immunity.

Has your child been diagnosed with acute or chronic otitis media? Are you searching for alternative care that is safe and effective? See a children’s chiropractor! Or, if you’re near North York, come see me.

Infectious Diseases Society of America (2006, November 6). Most Ear Infections Host Both Bacteria And Viruses, Study Shows.
Dowell, S, Marcy, M, Phillips, W, Gerber, M & Schwartz, B. (1998) Otitis media – participles of judicious use of antimicrobial agents. Pediatrics; 101(supplement)165-171.
Tedorzyk-Injeyan JA, et al. Spinal Manipulative Therapy Reduces Inflammatory Cytokines but Not Substance P Production in Normal Subjects. J Manipulative Physiol Ther 2006 (Jan); 29 (1): 14–21.
Teodorczyk-Injeyan JA, et al. Interleukin-2 regulated in vitro antibody production following a single spinal manipulative treatment in normal subjects. Chiropr Osteopat, 2010;18:26.