Chiropractic care for children: controversies and issues

Question 1

What is chiropractic care?

Answer 1

Concerned with the preservation and restoration of health and focuses particular attention on the subluxation. A subluxation is a complex of functional and or pathological articular changes that compromises neural integrity and may influence organ system function and general health.

Question 2

What percentage of chiropractic practices are limited to treating only musculoskeletal conditions?

Answer 2

19%

Question 3

What percentage of Canadian chiropractic have received formal postgraduate pediatric chiropractic training?

Answer 3

46%

Question 4

What are the main reasons children go to chiropractors?

Answer 4

1. Musculoskeletal conditions 40%
2. Prevention 24%
3. Headaches 7%
4. Otitis media 5%
5. Other 23%

Question 5

What is the evidence for spinal manipulation and treatment of acute or chronic low back pain?

Answer 5

Maybe effective for acute low back pain in adults, not proven in chronic low back pain, no evidence for pediatrics.

Question 6

What is the evidence for cervical manipulation or mobilization in subacute or chronic neck pain?

Answer 6

No evidence for effectiveness

Question 7

What is the evidence for use of chiropractic therapy in children with mild to moderate asthma?

Answer 7

The addition of chiropractic spinal manipulation to usual medical care provided no benefit

Question 8

What is the evidence for the use of chiropractic therapy to treat infantile colic?

Answer 8

RCT blinded, placebo controlled trial 86 infants showed no more effective than placebo

Question 9

What is the official policy of the American Chiropractic Association on immunizations?

Answer 9

“the use of vaccines is not without risk . . .” and it supports the conscience clause in compulsory vaccination laws

Question 10

What is the official policy of the Canadian Chiropractic Association on immunizations?

Answer 10

The CCA accepts vaccination as a cost-effective and clinically effective public health preventive procedure for certain viral and microbial diseases, as demonstrated by the scientific community.

Question 11

What percentage of American chiropractors believe there was no scientific proof that immunizations prevent disease?

Answer 11

36%

Question 12

What are known complications of adult chiropractic manipulation?

Answer 12

1. Mild pain or discomfort
2. Slight headache
3. Fatigue
4. Vertebrobasilar accidents after cervical manipulation (1-4 cases per million)
5. Stroke 1 in 5.85 million cervical manipulations
6. Cervical artery dissection (25% of all traumatic dissections were associated with neck manipulation)

Question 13

What are reasons parents consult chiropractors?

Answer 13

1. Word of mouth referrals
2. Fear of SE of conventional treatments
3. Willingness to try anything to help their child
4. Presence of a chronic illness

Question 14

What should physicians ask about chiropractic care?

Answer 14

1. Were neck manipulations used?
2. Were forceful thrusts used?
3. Were herbal or homeopathic preparations given?
4. What conditions was it for
5. Frequency of visits
6. Motivation for seeking chiropractic care
7. Perceived benefit of the treatment

Question 15

Should physicians order radiographic examinations suggested by chiropractors?

Answer 15

There is a lack of substantiated evidence for the theory of subluxated vertebrae as the causality for illness in children and X-rays taken for this purpose expose the child to unnecessary radiation.