WCA statement in response
to Pediatrics journal article

The World Chiropractic Alliance strongly supports the right of parents to seek and obtain chiropractic care for all their children, regardless of age or presence or absence of symptoms. Since safeguarding the welfare of all chiropractic patients -- particularly children -- is a prime concern, we applaud all efforts to explore issues involving the safety and effectiveness of chiropractic adjustments and spinal manipulation in children.

However, a report published in Pediatrics magazine (Jan. 2007) demonstrates why it is critical for researchers to carefully distinguish between different types of interventions when investigating chiropractic and spinal manipulation. Specific chiropractic adjustments to reduce or correct vertebral subluxation in children are not the same as gross, non-specific spinal manipulations.

To determine whether reviewed studies relate to chiropractic, researchers need to ascertain whether practitioners established the presence of vertebral subluxations prior to providing care, or if non-specific manipulations were applied without objective findings of the need for intervention.

In addition, it is critical for researchers to consider the credentials of the practitioner involved in the case. Of the 14 cases of direct adverse events reviewed in the Pediatrics study, one involved manipulation performed by a physiotherapist, another by a medical doctor, and two by chiropractic students. In two others, the type of practitioner was unknown.

Only eight out of the 14 cases actually involved practitioners specifically identified as chiropractors. Researchers should avoid making conclusions about "chiropractic" care based on manipulations performed by non-chiropractors.

However, the report does highlight an important issue. Since only licensed doctors of chiropractic are extensively trained and qualified to detect and correct vertebral subluxations, they are the only ones who should be permitted to provide that care.

Because of the lack of care taken by the researchers in the Pediatrics study to distinguish between spinal manipulation and chiropractic adjustments, and between chiropractors and other providers, it is obviously premature for them to “…caution families (that) a range of adverse events or delay in appropriate treatment may be associated with the use of spinal manipulation in children.”

There is simply not enough evidence to make any association between the adverse events reviewed and chiropractic, and such warnings to already worried parents may raise unnecessary fears about chiropractic care for their children. This could lead them to consider potentially dangerous drug therapies or medical treatments rather than turn first to non-invasive, drug-free chiropractic care.

Children make more than 30 million visits to chiropractors every year. Yet, this study found just nine serious adverse events. The remaining adverse events were minor and included such things as temporary soreness. The issue of risk assessment of pediatric chiropractic care was first addressed over a decade prior to this study in a research report published in the peer-reviewed Journal of Vertebral Subluxation Research ("Risk assessment of neurological and/or vertebrobasilar complications in the pediatric chiropractic patient," www.jvsr.com). 

That article stressed the importance of recognizing that the benefits arising from chiropractic care must be weighed against any potential risk. For example, in one study, 73% of the parents of “sick” children reported that chiropractic care had been of benefit to their child.  Children under chiropractic care have also been shown to demonstrate measurable improvement in conditions ranging from respiratory dysfunction, enuresis, and other health problems.

"It is clear that specific chiropractic adjustments to correct vertebral subluxations, performed by trained doctors of chiropractic, are extremely safe, especially when compared to medical treatment involving drugs or surgery," stated Matthew McCoy, DC, editor of JVSR and vice president of the Council on Chiropractic Practice.

To ensure this excellent safety record is maintained, Dr. McCoy recommended that all chiropractic educational institutions expand their basic training in pediatric care and all doctors of chiropractic be especially sensitive to signs and symptoms in children of potentially life-threatening conditions for which a referral for co-management is indicated.

"However, parents who wish to incorporate subluxation correction in their child's health care and wellness program should not hesitate to do so," he added. "If they truly have the welfare of children at heart, the medical and pharmaceutical industries should encourage parents to seek safe, non-invasive care rather than try to frighten them into turning first to medications and medical treatments."