What alternative health practitioners might not tell you

Should chiropractors treat young children?

"Unnecessary or inappropriate use of spinal manipulation in the case of a small child might damage the child's cartilaginous growth centers. Backache is not common in small children and might be a sign of a potentially serious illness. There is no reason to believe that chiropractic adjustments are effective for treating such ailments as ear infection, colic, bedwetting, sleeping problems, asthma, eczema, and so on. While most ailments of this type in children are self-limiting, they should be treated by pediatricians and not by chiropractors." Samuel Homola, DC (Chirobase)

Craniocervical arterial dissection in children: diagnosis and treatment

“If the history is suspicious for dissection (head and neck trauma, recent cervical
chiropractic manipulation…)” Curr Treat Options Neurol (December 2011)

Possible adverse events in children treated by manual therapy: a review

“Objective: To update the clinical research literature from the 2007 report by Vohra, Johnston, Cramer and Humphreys on possible adverse events in children treated by spinal manipulation. Conclusions: There is currently insufficient research evidence related to adverse events and manual therapy.” B. Kim Humphreys, Chiropractic & Osteopathy (2010)

The safety and effectiveness of pediatric chiropractic: a survey of chiropractors and parents in a practice-based research network

The objective of this study was to describe the practice of pediatric chiropractic, including its safety and effectiveness. The indicated primary reason for chiropractic care of children was "wellness care”…Chiropractor responders indicated three adverse events per 5,438 office visits from the treatment of 577 children. The parent responders indicated two adverse events from 1,735 office visits involving the care of 239 children. Explore (NY) (Sep-Oct 2009)

Adverse Events Associated With Pediatric Spinal Manipulation: A Systematic Review

Researchers found 14 significant injuries, 9 of which were serious, and 2 children died. In one of the fatal cases, the child died from a brain hemorrhage after receiving a neck manipulation; in the other, the child died after a suspected neck fracture. Some children suffered paralysis, while others had less serious or minor problems, such as severe headache and back pain. A chiropractor performed the adjustments in most cases. The reviewers commented that despite the fact that spinal manipulation is widely used on children, paediatric safety data are virtually non-existent. Sunita Vohra MD FRCPC MSc Bradley C. Johnston ND Kristie Cramer MSc and Kim Humphreys DC PhD Pediatrics (January 2007)

NOTE: The article did not consider harmful aspects of chiropractic care that are far more common than the reported events. These include (a) decreased use of immunisation due to misinformation given to parents, (b) psychologic harm related to unnecessary treatment, (c) psychologic harm caused by exposure to false chiropractic beliefs about "subluxations" and (d) financial harm due to unnecessary treatment.

'More Effective Reporting Needed On Spinal Manipulation In Children'

"Few serious harmful events stemming from spinal manipulation in children have been reported compared to the number of manipulations delivered", says new University of Alberta research. Study co-author Dr. Sunita Vohra, associate professor of pediatrics at the University of Alberta and director of the Complementary and Alternative Research Education Program (CARE) at the Stollery Children's Hospital said "The question we pose is, 'are these events truly rare, or are they under-reported?'" The research team identified 14 cases of direct adverse events involving neurological or musculoskeletal events. Nine cases involved serious adverse events such as hemorrhage or paraplegia, two cases reported moderate adverse events requiring medical attention such as severe headache and three involved minor adverse events such as mid-back soreness. Medical News Today (26th May 2006)

Children and chiropractic: what’s the harm?

“Once the numerator (number of adverse events) and denominator (number of treatments) are known, potential adverse events with chiropractic can be put into context, relative to risks associated with other therapies, such as adverse events due to medications or surgery. The risk:benefit ratio can only be considered if data on both efficacy and harm are collected; at present, in children, neither is substantive. Ultimately, these data are needed so that paediatric patients, their families and their healthcare providers can better evaluate ‘what’s the harm’ with respect to children and chiropractic.” Sunita Vohra MD, Focus on Alternative and Complementary Therapies [FACT] (March 2004)

The Pediatric Spine: Anatomical and Dynamic Considerations Preceding Manipulation

"The incidence of subtle growth plate fractures following high-velocity techniques in children is surely under-appreciated because of the occult nature of these injuries… Despite the seemingly 'plastic' osseous component of the child's vertebrae, the cartilaginous growth plates have been shown, in both humans and other large mammals, to be the primary sites of mechanical energy absorption during trauma. The potential for acquired growth plate injuries is very real, and for this reason, it is important that the physician trained in spinal manipulation be acquainted with the structural and functional differences between individuals of different skeletal ages. Awareness of such dissimilarities may persuade the physician to treat the pediatric spine more conservatively than the adult spine in an effort to avoid damaging the cartilaginous growth mechanisms…. Although there has not been a definite cause-and-occurence relationship established between spinal manipulation in children and growth plate injuries, the potential for growth plate fractures and other subtle injuries of the pediatric spine, including facet avulsion or dislocation, must be appreciated by the physician utilizing manipulation as a manual therapy modality. This might avoid creating irreversible injury that may not be initially recognized… The overall incidence of total injuries sustained from manipulation of the adult spine are underestimated. It is therefore likely that growth plate injuries in children following spinal manipulation are substantially underestimated." Michael L. O'Neal, DO, Assistant Professor, Department of Family Medicine, University of South Florida College of Medicine (Comprehensive Therapy 2003) [pdf]

Canadian Neurologists Warn Against Neck Manipulation

Includes a statement of concern to the Canadian public from Canadian neurologists regarding the debilitating and fatal damage manipulation of the neck may cause to the nervous system. Concern No.5 strongly recommends "the immediate banning of all spinal manipulation of infants and children". Brad Stewart, MD, Chirobase (2002)

Click here for a PDF copy of the Canadian Neurologists' statement (including the list of signatories)

Canadian Chiropractor Sued after Child is Paralyzed

Report by Stephen Barrett, MD, Chirobase (2001)

Quadriplegia after chiropractic manipulation in an infant with congenital torticollis caused by a spinal cord astrocytoma

An infant with congenital torticollis (twisted neck) underwent chiropractic manipulation, and within a few hours had respiratory insufficiency, seizures, and quadriplegia. Journal of Pediatrics (February 1992)

Traumatic vertebrobasilar occlusive disease in childhood

"Passive stretching of the cervical spine during chiropractic maneuvers may lead to vertebral artery thrombosis with subsequent embolization into the basilar artery circulation." Neurology (1978)