HealthNotes

A set of breathing exercises called Buteyko breathing techniques has been reported to significantly reduce the need for prescription drugs for people with asthma.¹⁰ Although the people in this controlled trial experienced an improved quality of life while doing these exercises, objective measures of breathing capacity did not improve, despite the decreased need for drugs.

Antibiotic use during the first year or two of life has been associated with an increased risk of asthma in preliminary studies.^{11, 12} Whether this association might result from allergic versus non-allergic effects remains unknown. However, the association does suggest that, until more is known, gratuitous use of antibiotics in early childhood (e.g., to inappropriately treat viral diseases) should be reconsidered. Of course, the appropriate use of antibiotics in the treatment of infections as necessary should not be avoided. Concerns should be discussed with the prescribing physician.

Acupuncture might be useful for some asthmatics. Case reports^{13, 14} and preliminary trials^{15, 16, 17} have suggested acupuncture may be helpful for people with asthma, either as a treatment for an acute attack or as a longer term therapy for reducing the number or severity of attacks, decreasing the need for medications, and so on. Placebo-controlled trials using sham (“fake”) acupuncture, however, have been quite contradictory, many of them showing a strong placebo effect that is not significantly improved upon by real acupuncture.^{18, 19, 20, 21} It is possible that needle insertion in non-acupuncture points has a stimulating effect that benefits asthma. The success of acupuncture may also depend on other factors, such as the type of asthma being treated and certain characteristics of the patient. Nonetheless, since some controlled research has demonstrated positive effects of real acupuncture, people with asthma may want to consider a trial of acupuncture treatment to see if it helps their individual cases.

Chiropractic physicians have reported that manipulation may be helpful for patients with asthma.^{22, 23, 24} In a controlled study, chronic asthmatics received either real or sham chiropractic manipulations for four weeks, after which the treatments were switched for another four weeks. No improvement in measurements of lung function was found at the end of the study. In addition, while both the manipulation and the sham treatment groups reported significant decreases in asthma frequency and severity, there were no differences between the treatments.²⁵ A larger controlled study compared chiropractic manipulation to sham manual treatments in children whose asthma was still a problem despite usual medical management.²⁶ Both groups experienced a significant decrease in symptoms and need for medication, as well as small increases in ability to breathe. These benefits lasted for four months after the treatments were discontinued. Although there was no additional benefit of chiropractic compared to the sham treatments, it is possible that improvements in both groups were real, rather than placebo effects. The sham therapy, which consisted of “soft tissue massage and gentle palpation [touching],” may have had real effects. More research is needed to address this confusing issue.