May 2004

Chiropractic and children

by Timothy Feuling

Even though chiropractic is the third largest primary care system in the world (with an estimated 23-28 million people visiting chiropractors each year) many people still think it's solely for adult back pain. Sadly, this picture of chiropractic is reinforced by many chiropractors and chiropractic organizations when they fail to educate the public about the unique role of chiropractic to correct vertebral subluxations.

Because of this erroneous image, the idea of chiropractic for children seems incongruous to many ‑‑ even dangerous to some. The thought of "cracking the back" of a small child or infant is enough to make many parents shudder. Naturally, the medical establishment has been quick to exploit this fear by lashing out against chiropractic for children. In May 2001, several physicians at Toronto's Sick Kids Hospital wrote a scathing letter to the Ontario Ministry of Health demanding that chiropractors be forbidden from caring for children. "Our goal is the mandated cessation of pediatric chiropractic, period," one of the doctors stated.

A report in the Archives of Pediatric Adolescent Medicine, ("Chiropractic care for children. Lee AC, Li DH, Kemper KJ., 2000 Apr;154(4):401 7) went so far as to say that "Pediatric chiropractic care is often inconsistent with recommended medical guidelines." The report also noted that, in Boston alone, an estimated 420,000 pediatric chiropractic visits were made in 1998, costing approximately $14 million. That's $14 million that didn't go into the pockets of the medical doctors or the drug companies a strong incentive for M.D.s to use scare tactics to steer parents away from chiropractors.

These attempts to discredit chiropractic for children have caused some parents to shy away from taking their kids to chiropractors, yet chiropractic pediatrics remains one of the fastest growing segments of the profession. More and more parents are choosing safe and drug free chiropractic care rather than subjecting their children to an ever increasing barrage of drugs.

While most parents are extremely pleased with the chiropractic outcomes, some will no doubt be dissatisfied and resort to medical care. If they later tell their M.D.s of the chiropractic experience, some will be told that they shouldn't have gone to such "quacks" and that chiropractic care for children is improper or even unsafe. Such remarks may spark a lawsuit against the DC. for malpractice. Patients may accuse the DC of providing care that was either not "medically necessary" or contraindicated because of the patient's age.

It is important for the DC who cares for children to be well versed in the scientific basis supporting chiropractic pediatrics, particularly with the section on chiropractic for children in the Council on Chiropractic Practice (CCP) Clinical Practice Guideline Number 1, "Vertebral Sublxuation in Chiropractic Practice."

The CCP Guideline clearly states: "Since vertebral subluxation may affect individuals at any age, chiropractic care may be indicated at any time after birth. ... Parental education by the subluxation centered chiropractor concerning the importance of evaluating children for the presence of vertebral subluxation is encouraged."

It rates chiropractic for children as "established," and validated by both expert opinion (based on clinical experience, basic science rationale, and/or individual case studies) as well as scientific literature.

Based on these guidelines, as well as a large body of research, the World Chiropractic Alliance has also issued a position paper that "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."

To further support the scientific validity of chiropractic for children, DCs can also point to the profession's two peer reviewed journals on the topic, Chiropractic Pediatrics and the Journal of Clinical Chiropractic Pediatrics, as well as to the courses being taught at professional and postgraduate levels at accredited chiropractic colleges.

In addition, doctors should be aware of current research being conducted in the area, such as the study by Dr. R.A. Pistolese, "Risk assessment of neurological and/or vertebrobasilar complications in the pediatric chiropractic patient" (Journal of Vertebral Subluxation Research, 1998) confirming that chiropractic care presents an extremely low risk for chiropractic pediatric patients.

More research studies are available from the International Chiropractic Pediatric Association at www.4icpa.org/research.htm

Of course, to safeguard your practice against malpractice charges or complaints, be sure to properly educate patients as to the purpose and safety of chiropractic.

(Timothy J. Feuling is president of Chiropractic Benefit Services (CBS) and a member of the Board of Directors of the World Chiropractic Alliance. He assists doctors in maximizing their practices through the proper choice of insurance and related services. Doctors may contact him with questions, comments, and requests for insurance quotes at 2950 N. Dobson Rd. Ste. 1, Chandler, AZ 85224, by phone at 800-883-0412 or by e mail: feuling@cbsmalpractice.com).