What alternative health

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"What do you suppose takes place in the minds of children who have monthly or even weekly treatment for 'subluxations', 'leg-length inequalities', 'energy imbalances' or other delusional concepts…?"

George Magner, 'Chiropractic: The Victim's Perspective', p.124

 

Related links

Chiropractic

Safe for children?

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"With so little training and clinical experience in treating pregnant women and their babies, and with a limited treatment method that consists primarily of spinal manipulation, I cannot imagine how chiropractors can manage pregnancies or treat newborn babies and children." Samuel Homola, D.C. (Chirobase)

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Professor Edzard Ernst challenges chiropractic organisations to either provide convincing evidence for chiropractic treatment of paediatric conditions or to change their websites' messages: "Chiropractors seem to believe that infants and children routinely require spinal adjustments. Their professional organizations' statements leave little doubt about this…..The following are 5 examples:

THE BRITISH CHIROPRACTIC ASSOCIATION — "As children grow, chiropractic can help not only the strains caused by the rough and tumble of life but also with some of the problems that children can suffer in their first years: Colic—sleeping and feeding problems—frequent ear infections—asthma—prolonged crying."; THE

CHIROPRACTIC ASSOCIATION OF IRELAND — "Even today's 'natural' childbirth methods can affect an infant's spine. Preliminary studies suggested that colic, unusual crying, poor appetite, ear infections or erratic sleeping habits can be signs of spinal distress";

THE McTIMONEY CHIROPRACTIC ASSOCIATION — Irritability, fractiousness, feeding problems, continuous crying, sleeps little, difficult to settle, colic, sickness and wind — all of these could indicate that there is a misalignment in the baby's skeletal system and that the baby is uncomfortable as a result";

THE NEW ZEALAND CHIROPRACTOR ASSOCIATION — "Parents and teachers often report children dramatically improve their attention span with Chiropractic care. Others report Chiropractic care as being the main reason for improved academic performance";

THE SCOTTISH CHIROPRACTORS ASSOCIATION — "Chiropractors are able to examine and evaluate a child's spine to determine if they can help problems such as colic, asthma, bedwetting, eczema and sleeping difficulties. Chiropractors advise that a child's spine be checked for subluxations and postural distortions before any symptoms are even present.""

Pediatrics, Vol. 122 No. 5 November 2008, pp. 1161 (doi:10.1542/peds.2008-2620)

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"Some chiropractors claim that spinal manipulation is an effective treatment for infant colic. This systematic review was aimed at evaluating the evidence for this claim. Four databases were searched and three randomised clinical trials met all the inclusion criteria. The totality of this evidence fails to demonstrate the effectiveness of this treatment. It is concluded that the above claim is not based on convincing data from rigorous clinical trials." Ernst, E. Int J Clin Pract. (September 2009) [pdf]

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"Previous research has shown that professional chiropractic organisations 'make claims for the clinical art of chiropractic that are not currently available scientific evidence…'. The claim to effectively treat otitis seems to be one of them. It is time now, I think, that chiropractors either produce the evidence or abandon the claim." Edzard Ernst in a letter to the International Journal of Clinical Practice (September 2009)

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"None of the studies showed that real manipulation was more effective than sham-manipulation in improving lung function or subjective symptoms. It is concluded that, according to the evidence of the most rigorous studies available to date, spinal manipulation is not an effective treatment for asthma." Ernst, E. Respir Med. (29th July 2009)

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"Although the content of the British Chiropractic Association's list is important, its omissions are perhaps even more so. At least three relevant randomised controlled trials and two systematic reviews are missing from it. Arguably, these are the most rigorous papers in this area, but they fail to show that chiropractic is effective. The omissions are all the more curious as the association apparently knew of these articles." Edzard Ernst, British Medical Journal (9th July 2009)

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"Medical doctors and even some chiropractors agree that chiropractic manipulation should never be done on young children. Most of a newborn's bones aren't even bone yet — they're partly cartilage. One chiropractor tried to tell me a newborn's neck is stretched up to 2 1/2 times normal length during the birth process, which is anatomically impossible. There is NO credible evidence that the birth process harms babies' spines or that chiropractic benefits children in any way." Article by Harriet Hall, MD, James Randi Educational Foundation (20th October 2008)

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"Parents are wasting money on unnecessary chiropractic care for young children which is not achieving any medical result, says the Australian Medical Association (AMA). Early chiropractic treatment for children under 10 is "quite inappropriate", says AMA state president Peter Ford, because there is no medical evidence to suggest it works. Dr Ford urged parents concerned about their child's spine to consult a doctor or pediatrician and, if necessary, a specialist." Adelaide Now news report (17th October 2008)

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SUMMARY: "There has been no substantive shift in this body of knowledge during the past 3 1/2 years. The health claims made by chiropractors with respect to the application of manipulation as a health care intervention for pediatric health conditions continue to be supported by only low levels of scientific evidence. Chiropractors continue to treat a wide variety of pediatric health conditions. The evidence rests primarily with clinical experience, descriptive case studies and very few observational and experimental studies. The health interests of pediatric patients would be advanced if more rigorous scientific inquiry was undertaken to examine the value of manipulative therapy in the treatment of pediatric conditions. Gotlib A, Rupert R. Chiropractic and Osteopathy (September 2008) [pdf]

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"Consumer advocates and victims of chiropractic have asked to meet with Canadian legislators and the Minister of Health to propose the following guidelines: ONE: INFANTS AND CHILDREN: Highest neck manipulation should never be done in infants and children for claims to treat such conditions as ear infections, tonsillitis, infantile colic, asthma and gastro-intestinal disorders nor as an alternative to scientific immunization against diseases such as polio, tetanus, measles, mumps, German measles or chicken pox. The Chiefs of Paediatrics of our Canadian Hospitals have all condemned such claims by chiropractors…" Article by Harriet Hall, MD, Science Based Medicine (1st July 2008)

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The Chiropractors Registration Board of Victoria has proposed chiropractic standards that attack core beliefs and practices of subluxation-based chiropractic. The draft document, which is intended to apply to children up to the age of about 13, states that "Non-indicated, unreliable and invalid diagnostic tools, instruments or methods and unnecessary diagnostic imaging procedures are to be avoided." It specifies:

(1) Routine radiographic examination and re-examination of pediatric patients is not recommended without clear clinical justification. X-ray examinations should not be performed solely for the detection of biomechanical disorders of the spine, such as vertebral subluxations, postural analysis or for the monitoring of spinal curves or posture, unless for monitoring progressive scoliosis;

(2) The use of . . . surface electromyography (SEMG) or thermography, is not considered appropriate in the diagnosis of childhood conditions;

(3) There is currently an overwhelming lack of good quality scientific evidence to support the use of spinal manipulation in the treatment of most "Type O" conditions.

"Type O" stands for organic/visceral disorders (diseases) as opposed to "type M" (musculoskeletal/biomechanical disorders). SEMG and thermography have no legitimate diagnostic value, but many subluxation-based chiropractors use them to sell patients long courses of unnecessary treatment.

(June 2008) [See the link's second news item.]

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"The ability to adequately define and, subsequently, to evaluate improvement in several paediatric illnesses is problematic for physicians and even more problematic for chiropractors who do not have equivalent training in medical diagnosis……Further, well-designed studies are needed to evaluate the chiropractic belief that musculoskeletal dysfunctions can be located and treated in children with nonmusculoskeletal conditions." Canadian Paediatric Society (February 2007)

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"The strengths of this study include being population based, the high response rate, and collection of data on partial respondents (considered to be proxies for non-respondents) that included information on the behaviours of interest…..Chiropractors who deal with immunization-related issues frequently were found to be significantly less pro-vaccination than those who do so less often. Scrutiny of the beliefs data indicates that despite a majority accepting immunization as an effective means of curbing infectious diseases, many responses are consistent with common misconceptions. The single most common behaviour was to advise on freedom of choice about immunization…..Conclusions: Similar proportions of chiropractors advise patients in favour or against immunization. A small minority deals with immunization issues frequently. Behaviours can be understood in the context of beliefs." Margaret L. Russella, H. Stephen Injeyanb, Marja J. Verhoefa, Michael Eliasziwa, Vaccine [pdf]

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Concludes that there is no convincing evidence that spinal manipulation alone can affect the duration of infantile colic symptoms. Canadian Coordinating Office for Health Technology Assessment (November 2003) [pdf]

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"The evidence suggests that chiropractic has no benefit over placebo in the treatment of infantile colic." Stephen Hughes, Northwick Park Hospital, and Jennifer Bolton, Director of Research, Anglo European College of Chiropractic (UK) Archives of Disease in Childhood (2002)