The fact is Chiropractors receive training to treat all people, from babies to the elderly.  And many children have benefited from chiropractic care, including teenagers. Moreover, Chiropractic care is among the most common complementary and integrative health care practices used by children in the United States (US National Center for Health Statistics Report, 2015) and internationally.


So children with musculoskeletal conditions often seek chiropractic treatment.  Also, parents seeking a non-drug, “non parent-intensive” approach to bed-wetting seek a chiropractor’s help.  One study published in the Journal of Manipulative and Physiological Therapeutics involved 46 children who were diagnosed with nocturnal enuresis. Findings showed that one-quarter of the participants engaging in chiropractic treatment had reduced their bedwetting incidences by half or more. Additionally, there was no change at all in the control (non-chiropractic treated) group.


What is Nocturnal Enuresis in Children and Teens?


Firstly, nocturnal enuresis is involuntary voiding of urine during sleep in the absence of disease/physical disorders. Associated diseases/physical disorders causing night time bed wetting could be urinary tract infections (UTI), diabetes, or seizures. The frequency is two or more incontinent (involuntary voiding) occurrences in a month between the ages of 5 and 6 or one or more occurrences after age 6.


Secondly, nocturnal (occurring at night) enuresis is a distressing disorder for parents and children. It is hard on families due to increased bedding changes and the expense of replacements for mattress and covers. Certainly, the child involved may have greater issues with self-esteem. Children may have a more difficult time establishing relationships with peers and at school activities.


Thirdly, nocturnal enuresis is often categorized into primary and secondary causes. Primary nocturnal enuresis is the involuntary discharge of urine at night by children old enough to be expected to have bladder control. Secondary enuresis is defined as the presence of a prior history of continence (voluntary control of voiding) for more than a 6-month period. Many times, the regression in secondary enuresis is due to a stressful emotional event in the early years of life. Approximately 80% to 90% of childhood enuresis is the primary type.


Fourthly, primary nocturnal enuresis occurs in the developmental ages of 5 years or older. 5-7 million children in the United States are affected.  It is more common in boys than in girls. And an estimated prevalence of around 15% to 20% of 5-year-olds, 5% of 10-year-olds, and 1% of those 15 years and older have nocturnal enuresis.


What Causes Nocturnal Enuresis?


Nocturnal enuresis is a complex problem which involves several mechanisms.  Certain physical, mechanical, nutritional, as well as psychosocial (e.g. stress) problems can all cause forms of nocturnal enuresis.  Furthermore, nocturnal enuresis can be inherited.


Food allergies may play a role in detrusor muscle instability (functioning problems) leading to nocturnal enuresis. The walls of the bladder are mainly formed by the detrusor muscle.  This muscle allows the bladder to contract to excrete urine or relax to hold urine. Dairy products, carbonated drinks (e.g. cola), chocolate, and citrus may be the culprit.


Normal micturition (action of urinating) maturation occurs paralleling changes in bladder capacity and neural development (nervous system development). In the first 2 years, a child has little control over urination, yet senses when the bladder is full. By age 3, a child should have some development of daytime control. Next, by ages 4 and 5, the child should be able to control urination in mid-stream with starting and stopping at will. A delay in this normal maturation and a small bladder capacity (less than 50% of normal in 85% of enuretic children) seem to be a major factor.  


Abnormal diurnal rhythm (varying with time of day) of antidiuretic hormone (ADI-I) secretion.  Antidiuretic hormone (ADH) helps regulate the amount of water in your body. And if there is a decrease or absence during sleep, excessive amounts of unconcentrated urine accumulate. Interestingly, this maybe the cause for enuresis in older children, since one study found the bladder capacity of these children to be normal.



Chiropractic Care for Bedwetting (Nocturnal Enuresis) in Children and Teens


Chiropractic treatment and management of nocturnal enuresis deals with treating and correcting chiropractic subluxations or misalignments in the spine.  With correction, there is an improvement in mobility and overall function throughout the body.  Many chiropractors have shown through case studies that treating not only the lower lumbar spine and sacral spines (low back and tail- bone), but also the lower thoracic (midback) and upper cervical (neck) spines are very beneficial in management of nocturnal enuresis.


Research today focuses on the combination of chiropractic as well as psychosocial and nutritional/natural therapies.  In conclusion, a combination of therapies is very beneficial.  Chiropractic helps with the musculoskeletal/nervous system dysfunctions that accompany those with enuresis. Additionally, the psychosocial and nutritional therapies go one step further in addressing other problems. For instance, this maybe the child’s home-life or their diet and intake of fluids.


Contact Meiri Chiropractic in West Palm Beach Today


Dr. Natalie Meiri has treated babies and children utilizing chiropractic adjustments, soft tissue techniques, cranial sacral therapy, and homeopathy. She has helped children and teens with nocturnal enuresis, infantile colic, ear infections, attention deficit hyperactivity disorder (ADHD), autism, scoliosis, sports injuries and various growing problems.  Contact her at 561-253-8984 for further information on Chiropractic Care for Bedwetting (Nocturnal Enuresis) in Children and Teens or to make an appointment.