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Chiropractic therapy to treat newborns for specific conditions such as colic, asthma and bed wetting

General, Infant and Children | May 17, 2016 | Author: The Super Pharmacist

Children, general, infant

Chiropractic therapy to treat newborns for specific conditions such as colic, asthma and bed wetting

What is chiropractic?

Chiropractic is an alternative therapy that was invented in 1895. Its founder, DD Palmer, claimed to have adjusted the spine of a deaf man and restored his hearing in the process. Following this supposed cure, it was decided that the majority of all human disease was a result of a ‘subluxation’ (misalignment). Palmer concluded that 95% of all human illness and disease was attributable to subluxation of the spine, and the remaining 5% was due to a subluxation of other bones. The rationale for chiropractic is based on three key ideas: bones in the body of some individuals are out of place, bony displacements cause ‘nerve interference’, and the manipulation of the spine replaces the bones, removes nerve interference and results in the restoration of overall health and wellbeing. There is no credible scientific evidence to support any of the founding themes of chiropractic.

Is there any evidence to support the use of chiropractic therapy for colic, asthma and bed wetting in newborn children?

No. The aetiology of colic is unknown and therefore any treatments that offer a guaranteed cure for colic are false. As the origins of chiropractic are built on foundations that are not evidence based, and have never been evidenced to be of scientific benefit, the use of chiropractic to treat and find a remedy for other common childhood illnesses such as asthma and bed wetting is speculative. Chiropractic is often marketed as both a preventative and curative option for illnesses that have manifested or will appear if chiropractic is not undertaken, although again there is no evidence to suggest this is true. The only evidence available to support the benefit of chiropractic are a number of studies highlighting the mild benefit of its use to treat adults who suffer from persistent back pain (1). There is no evidence to support the practice of adjusting the spines of newborns in the delivery room or providing repeated lifelong adjustments to maintain health or prevent disease.

Is chiropractic dangerous?

Despite being recommended by a number of chiropractic organisations for use in children, it does carry the possibility of significant risk to a newborn child. The core treatment option of chiropractic (vertebral subluxation) is not based on rigorously tested scientific evidence. A critical evaluation of the chiropractic literature carried out by Dr Edzard Ernst, a medical doctor who is also trained in the practice of chiropractic, found the majority of studies citing its benefits to be poorly designed and funded almost exclusively by chiropractic organisations (2). The same study also highlighted that the therapeutic value of chiropractic had not been demonstrated beyond reasonable doubt, and that subluxations and ‘manipulations’ of the spine were frequently associated with both mild adverse effects and occasionally serious incidents. These findings have been reinforced by several other studies (3,4). In 2001, a systematic review of five studies revealed that roughly half of all chiropractic patients experience temporary adverse effects, such as pain, numbness, stiffness, dizziness and headaches. Although they are relatively minor effects their reported frequency is very high (5). A number of systematic reviews have shown spinal manipulations to have no medical benefit. In rare cases, spinal manipulation of the upper spine has resulted in complications that can lead to permanent disability or death in both adults and children: a systematic review carried out by Ernst in 2010 noted that the manoevure has been responsible on several occasions for a vertebral artery dissection followed by stroke (6). An additional systematic review, focusing specifically on adverse events associated with paediatric spinal manipulation, highlighted a number of neurologic and/or musculoskeletal events that had occurred in young children such as paraplegia, severe headaches and midback soreness (7). The study also noted the inappropriate use of chiropractic to treat genuine medical conditions such as meningitis and rhabdomyosarcoma. Because there is no evidence to support the use of chiropractic in children or newborn babies for any medical condition, it should be viewed as an intervention that actually introduces the possibility of harm to a newborn or young child who may otherwise be well, or be better served by receiving a medical intervention that has demonstrative clinical benefit. Attempts to manipulate or ‘subluxate’ the immature spine of a neonate or small child is therefore dangerous and unnecessary: unable to offer any medical benefit, the procedure only succeeds in introducing a degree of risk and danger that should be avoided. Even as a trained practitioner, Dr Edzard Ernst also notes that ‘chiropractors might compete with physiotherapists in terms of treating some back problems, but all their other claims are beyond belief and can carry a range of significant risks’. This followed a review of 70 studies concerning chiropractic and its use for medical conditions that had nothing to do with the spine, all of which were shown to have no evidential basis.

Is controversy over the safety and efficacy of chiropractic a relatively new development?

The validity of chiropractic as a discipline has been contested since its inception in 1895. Many of its initial proponents were jailed for practicing chiropractic as a ‘medicine’, with various chiropractic organisations attempting to reclassify themselves as religious bodies in order to continue practicing. Early chiropractors (and some modern day practitioners) were fundamentally opposed to all forms of vaccination based on a belief that all disease was linked to the spine, and were similar opposed to water fluoridisation for similar reasons. As a discipline it has consistently been accused of health misinformation by a range of medical bodies and governments: a high profile libel case in the UK in 2008, brought by a group of science writers against chiropractors, resulted in a number of chiropractic organisations being made to acknowledge no clear evidential link between the use of chiropractic and the cure of whiplash and colic (8). In conclusion, there is no evidence to support the use of chiropractic for common neonatal conditions. In the absence of any medical benefit, the use of chiropractic in neonates and young children introduces an unnecessary and avoidable degree of risk and danger.

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REFERENCES:

  1. DeVocht JW (2006) History and overview of theories and methods of chiropractic: a counterpoint Clin Orthop Relat Res 444:243–9
  2. Ernst, E (2008) Chiropractic: a critical evaluation Journal of Pain and Symptom Management 35 (5): 544–62
  3. Gouveia LO, Castanho P, Ferreira JJ (2009) Safety of chiropractic interventions: a systematic review Spine 34(11): E405–13
  4. Ernst E (2010) Deaths after chiropractic: a review of published cases Int J Clinical Practice 64 (8): 1162–1165
  5. Homola S (2011) Paediatric chiropractic care: the subluxation question and referral risk Bioethics 30(2):63-8
  6. Ernst E (2010) Deaths after chiropractic: a review of published cases Int J Clin Prac 64(8):1162-5
  7. Vohra S, Johnston BC, Cramer K, Humphreys K (2007) Adverse events associated with pediatric spine manipulation: A systematic review J Pediatrics 119(1):45-51
  8. Eden R (2008) "Doctors take Simon Singh to court" The Daily Telegraph (London). Available at http://www.telegraph.co.uk/news/newstopics/mandrake/2570744/Doctors-take-Simon-Singh-to-court.html (last accessed 7th March 2016)
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