Family First Chiropractic

Should children see a chiropractor?

Have you ever spent 10 minutes with a toddler?  It is amazing how many falls, bumps, bruises they will see  throughout their childhood.  Chiropractors can provide check-ups that can make sure all these mild traumas do not make any permanent impact as they grow older.   

When should they get checked?

Children can be checked right after birth due to the birth process.   We must remember that the child also went through labor.  Chiropractic may help if your baby has experienced symptoms of colic, ear-infections, difficulty nursing, constipation, or asthma.

Does it Hurt?

Chiropractors specializing in children use very specific, gentle techniques to care for children.  On the very young, the adjustment is as light as a finger touch.  Doctors of Chiropractic who are members of the International Chiropractic Pediatric Association have taken post-graduate classes on specific techniques for pregnant mothers, infants and children to enhance their skills in this field.

At Family First Chiropractic, complimentary consultations are offered, giving parents the opportunity to meet us, find out about chiropractic for their families and discuss their individual needs.

In regards to the safety of chiropractic care in the pediatric population, I have four research articles that I will review.  One of the primary concerns in the care of the pediatric population is its safety.  I can assure you that in my office, I take the safety and health of each child I see very seriously.  I chose the chiropractic profession based on the care I received as an adolescent.  After having two children myself, I decided to advance my training and knowledge into the field of pediatric and prenatal chiropractic through the ICPA.  I have learned valuable skills on how to safely treat and manage the pediatric chiropractic patient.  

The first study by Pistolese, addressed the safety issues associated with chiropractic care for children by assessing the risk of neurological and/or vertebrobasilar complications. The study acknowledges most complications following cervical manipulation are caused by disturbances of vertebral artery circulation, and the resultant damage to neurological components supplied by the vertebrobasilar system (7).

 The data collected calculated the number of pediatric visits, during the periods between 1966 and 1977.  It was estimated to be 502,184,156 chiropractic pediatric visits.  The risk to the pediatric chiropractic patient in this category of (N/VB) complication was estimated to be 4.0 x 10- 7% of all visits. Or approximately an incident of 1 in 250 million pediatric visits that a N/VB complication would result. “This would conclude serious complications (regardless of age) following chiropractic adjustments and/or manipulations are extremely rare (7).” 

In a follow-up to this research article the ICPA conducted an extensive search of Medline and Mantis and found only two questionable reports of adverse neurovascular events in pediatric patients following chiropractic care. While the author has heard claims from pediatricians and other health care professionals that chiropractic may cause epiphyseal plate fractures in children, no such cases were found reported in the scientific literature. Any health care professional who makes such claims should be quickly challenged to provide documentation of such claims. 

Based on information gathered in this study, the ICPA's research department has concluded the following: 

“In the prevalent scientific/clinical literature spanning the last 32+ years, there are only two reported cases of neurovascular complications related to pediatric patients receiving chiropractic care. Based on an eclectic summation of data derived from three sources, a conservative estimate of the number of pediatric visits to chiropractors in the U.S. over the same time span amount to over 1/2 billion visits. The risk of a neurovascular complication occurring as the result of chiropractic care is approximately one out of every 250 million visits (8).” 

In the Journal for the American Academy of Pediatrics “PEDIATRICS”,  a review  of thirteen studies were conducted to investigate adverse events associated with pediatric spinal manipulation (2 randomized trials, 11 observational reports). (9)  The study identified 14 cases of direct adverse events involving neurologic or musculoskeletal events. Nine cases involved serious adverse events such as, subarachnoidal hemorrhage and paraplegia, 2 involved moderately adverse events that required medical attention (eg, severe headache), and 3 involved minor adverse events (eg, midback soreness). Another 20 cases of indirect adverse events involved delayed diagnosis (eg, diabetes, neuroblastoma) and/or inappropriate provision of spinal manipulation for serious medical conditions (ie, meningitis,rhabdomyosarcoma) (9). 

The article concluded that serious adverse events may be associated with pediatric spinal manipulation; but neither causation nor incidence rates can be inferred from observational data. Conduct of a prospective population-based active surveillance study is required to properly assess the possibility of rare, yet serious, adverse events as a result of spinal manipulation on pediatric patients (9). 

In a study performed by Marchand, an Internet cross-sectional survey was conducted in 20 European countries with 4109 doctors of chiropractic invited to reply. Respondents were asked to self-report characteristics of their practices. The objective of this study was to investigate the number of reports of negative side effects (NSEs) including the age of pediatric patients.  The results concluded “Of the 956 (23.3%) participating chiropractors, 921 reported 19821 pediatric patients per month. Children represented 8.1% of chiropractors' total patient load over the last year. A total of 557 (534 mild, 23 moderate, and 0 severe) negative (adverse) side effects were reported for an estimated incidence of 0.23%. On the given treatment statements, chiropractors reported varying agreement and disagreement rates based on patient age. The 8309 answers on conditions were grouped into skeletal (57.0%), neurologic (23.7%), gastrointestinal (12.4%), infection (3.5%), genitourinary (1.5%), immune (1.4%), and miscellaneous conditions (0.5%). The number of treatment sessions delivered varied according to the condition and the patient age.”  In this survey, no severe NSEs were reported, and mild NSEs were infrequent (10).

The last published research article I would like to examine was a chiropractic practice-based research network.  Participants were chiropractors and parents of pediatric patients (aged ≤18 years) with chiropractic visits ranging from one to 12 visits. It was a cross-sectional survey used to describe the practice of pediatric chiropractic, including its safety and effectiveness.   It also assessed demographics, clinical presentations, treatment-associated aggravations, complications and improvements (11).

The results of this study were as follows: 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. Both sets of responders indicated a high rate of improvement with respect to the children's presenting complaints, in addition to salutary effects unrelated to the children's initial clinical presentations (11).

7. Pistolese, RA Risk assessment of neurological and/or vertebrobasilar complications in the pediatric chiropractic patient.  J Vertebral Sublux Res 1998;2(2):73-81

8. Anrig, C. Chiropractic -- Is It Safe for Children? Dynamic Chiropractic – September 7, 1998, Vol. 16, Issue 19 www.dynamicchiropractic.com/mpacms/dc/article.php?id=37423

9 Vohra, S, Johnston B, Cramer K, and Humphrey K. Adverse Events Associated With Pediatric Spinal Manipulation: A Systematic Review. DOI: 10.1542/peds.2006-1392

Pediatrics 2007;119;e275; originally published online December 18, 2006;

10 Marchand, AM. Chiropractic care of children from birth to adolescence and classification of reported conditions: an internet cross-sectional survey of 956 European chiropractors.  Jun;35(5):372-80. doi: 10.1016/j.jmpt.2012.04.008. Epub 2012 May 22.

11 Alcantara J, Ohm J, Kunz D. The safety and effectiveness of pediatric chiropractic: a survey of chiropractors and parents in a practice-based research network.  Explore (NY). 2009 Sep-Oct;5(5):290-5. doi: 10.1016/j.explore.2009.06.002.