Most children wet the bed or have wetting incidents following the toilet training stage, but by age 4 or 5, the majority establish complete bladder control.
Enuresis is the inability of a child to control his or her bladder resulting in involuntary urination. There are two types:
Primary enuresis occurs in a child older than 5 who has never been able to establish proper bladder control.
Secondary enuresis is the diagnosis for a child who has been able to establish proper bladder control, but who has since lapsed back to wetting the bed.
In most cases, bed-wetting is considered just an unfortunate childhood problem, and no outside treatment is sought.
Some parents are prepared to simply wait until the child grows out of it, and in most cases, these problems go untreated.
Others view it as bad or willful behavior. Desperate, many try scolding, prescription drugs, wetting alarm devices, restricting fluids or waking a child to urinate during the middle of the night. Generally, these do not help, cause emotional trauma to the child and may actually delay resolution. Therefore, these tactics should be discouraged.
I try my best to help families experiencing this to understand that enuresis is a problem that is out of the child’s conscious control and, furthermore, that there may be an underlying physical cause.
The chiropractic approach to treating a child with enuresis is to perform a series of adjustments to the spinal segments that correlate with the nerves that control bladder function, located in the lumbar spine or sacrum.
Most importantly, the chiropractic evaluation and adjustment processes are non-threatening and comfortable for the child, who may already be experiencing anxiety from the problem.
A review of the anatomy of the bladder and the related spinal nerves and their structures may help explain how chiropractic may help.
Bladder Anatomy
Emptying of the urinary bladder is controlled by the detrusor and trigone muscles. The nerve supply to these muscles is via the sacral parasympathetic nerves from S2 to S4. Appropriate bladder function is also controlled by the urogenital diaphragm which gets its nerve supply from the L2 spinal nerve.
Development of the Sacrum
As an infant, the sacrum — or tailbone — consists of five separate segments. These segments remain separated and mobile until a child reaches puberty, at which time fusion of one sacral segment to another begins. Eventually, the sacrum becomes a single bone with all five segments fused together, but this does not occur until the mid-20s.
Because the sacrum consists of separate segments during the early years of life, it is possible that misalignment of these segments can cause nerve interference. The interference of the nerves that control the bladder may cause involuntary bladder function.
During this period, the sacrum can be subjected to repeated twisting and trauma from childhood falls, for example, during the early attempts at walking. This early trauma to the sacrum may be the major reason why bed-wetting in some patients ceases after the spine is adjusted.
Adjustment of the sacral segments in a bed-wetting child is subjective from child to child. If the cause is spinal related, the child will respond, whereas if it is not, there will be no change. The conclusion would therefore appear to be to have all children who are experiencing enuresis evaluated for the possibility of spinal problems as the underlying cause.
It is important to note that pediatric chiropractic care is a specialty, requiring specific training and qualifications. Strelcheck Chiropractic Clinic has such qualifications to serve families.
