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Pediatric Chiropractic Care: Scientifically Indefensible?

In a paper published in 2008, two academic chiropractors offered this observation: “The health claims made by chiropractors with respect to the application of manipulation as a health care intervention for pediatric health conditions continue to be supported by only low levels of scientific evidence. Chiropractors continue to treat a wide variety of pediatric health conditions.”1

Despite lack of support by the medical and scientific community, chiropractic treatment of children is growing in popularity, and more chiropractors are specializing in “chiropractic pediatrics.”

The International Chiropractic Association offers a post-graduate “Diplomate in Clinical Chiropractic Pediatrics” (DICCP) and publishes a “peer reviewed” Journal of Clinical Chiropractic Pediatrics. The diplomate syllabus is a 30-module, 360+ hours classroom course during weekends over a three-year period. There is no hospital training and no contact with diseased or injured children — only a “mandatory observational/training weekend at a chiropractic center for special needs children under multi-disciplinary care.”2 A post-graduate certification in chiropractic pediatrics (CICCP) can be earned after 180 hours of classroom instruction.

In a June 2008 joint press release, the American Chiropractic Association’s (ACA) Council on Chiropractic Pediatrics and the Council on Chiropractic Pediatrics of the International Chiropractors Association (ICA) announced that the ICA’s Diplomate in Clinical Chiropractic Pediatrics (DICCP) is now recognized by the ACA and its council as the official credential for specialization in chiropractic pediatrics.3

Noting increasing public support for chiropractic treatment of children, a January 2009 press release from the American Chiropractic Association made this announcement: “Survey data indicates that the percentage of chiropractic patients under 17 years of age has increased at least 8.5 percent since 1991.…Studies are beginning to show that chiropractic can help children not only with typical back and neck pain complaints, but also with issues as varied as asthma, chronic ear infections, nursing difficulties, colic and bedwetting.”4

A trend toward greater utilization of chiropractic by children has not gone unnoticed by the medical profession. An article in the January 2007 issue of Pediatrics (the official journal of the American Academy of Pediatrics) described chiropractic as the most common complementary and alternative medicine practice used by children, who made an estimated 30 million visits to US chiropractors in 1997.5 In 1998, children and adolescents constituted 11% of patient visits to chiropractors.6

Promoting a broad scope of practice for pediatric chiropractors, the ICA Council on Chiropractic Pediatrics offers links to abstracts from chiropractic journals that support chiropractic treatment for a great variety of a childhood ailments.7 Chiropractors commonly claim to have an effective treatment for otitis media, asthma, allergies, infantile colic, and enuresis. While many of the pediatric conditions treated by chiropractors are self limiting, treatment is offered for such serious conditions as cerebral palsy, epilepsy, myasthenia gravis, ADHD, and Tourette syndrome. For the most part, treatment for all these conditions is based upon detection and correction of “vertebral subluxations.” An article titled “The Child Patient: A Matrix for Chiropractic Care” in a 2005 edition of the Journal of Clinical Chiropractic Pediatrics, for example, stated: “Any alteration in form or function in the child may signal the presence of subluxation, and the subluxation may in turn alter the physiology of the child.”8 For wellness and prevention reasons, parents are advised that children should visit a chiropractor 6 to12 times a year to be checked for subluxations.8

A 2009 survey of chiropractors and parents of chiropractic pediatric patients, conducted by the International Chiropractic Pediatric Association, revealed that “The indicated primary reason for chiropractic care of children was ‘wellness care’.”9 Such care would require manipulating the spines of healthy children for “subluxation correction.”

There is no credible evidence to support the contention that “subluxation correction” will restore or maintain health or that such subluxations even exist.10,11,12 There are hundreds of subluxation-based studies published in chiropractic journals supporting chiropractic treatment for children but only a few studies disputing such treatment. I suspect that most medical researchers feel that claims based on the chiropractic vertebral subluxation theory are too implausible to warrant investigation. But such claims should not go unchallenged, especially when they involve treatment of children.

 

Evidence Fails to Support Chiropractic Treatment of Childhood Ailments

To date, legitimate properly-controlled studies have failed to support the claims of chiropractors who treat children for organic ailments. In the case of asthma, for example, a randomized, controlled trial of chiropractic spinal manipulation for children with mild or moderate asthma, published in a 1998 issue of The New England Journal of Medicine, revealed that “the addition of chiropractic spinal manipulation to usual medical care provided no benefit.”13 A randomized, controlled trial of infantile colic treated with chiropractic spinal manipulation, published in a 2001 issue of Archives of Diseases in Childhood, concluded that “Chiropractic spinal manipulation is no more effective than placebo in the treatment of infantile colic.”14 A recent systematic review of randomized clinical trials offered this conclusion: “There is no good evidence to show that spinal manipulation is effective for infant colic.”15

It has been suggested that use of osteopathic manipulative techniques as an adjuvant therapy in routine pediatric care of recurrent acute otitis media might have potential benefit by affecting the patency of the auditory tube.16 Chiropractors who manipulate a child’s neck in a misguided attempt to correct “subluxations” might provide some symptomatic relief for secretory otitis media by inadvertently stretching the Eustachian tube, facilitating drainage of fluids from the middle ear. But the risk of such treatment outweighs any possible benefit. (Although otitis media is normally self limiting, it should be kept under observation by a pediatrician who can prescribe antibiotics, if needed, when there is acute otitis media with bacterial infection. Otitis media commonly occurs in children under 3 years of age. As the child grows older, changes in the length and angle of the Eustachian tube reduce chances of bacteria or virus traveling from the throat to the middle ear.)

Considering the implausibility of the chiropractic vertebral subluxation theory and the training chiropractors receive, there is good reason to question the ability of chiropractors to diagnose and treat childhood ailments. A correct diagnosis notwithstanding, there is no evidence to support the belief that manipulating the spine of a child to correct “vertebral subluxations” would be appropriate treatment for anything. A 1993 risk/benefit analysis of spinal manipulative therapy for relief of lumbar or cervical pain, published in Online Neurosurgery, advised neurosurgeons that “Potential complications and unknown benefits indicate that SMT [spinal manipulative therapy] should not be used in the pediatric population.”17

Because of the damage that manipulation might do to cartilaginous growth centers, there is no known justification for using spinal manipulation on an infant or a pre-adolescent child. Yet, some chiropractors recommend that the spine of a newborn baby be adjusted at birth to correct “subluxations.” According to the ICA (International Chiropractic Association) Council on Chiropractic Pediatrics, “Chiropractic care can never start too early.”18

Generally, pediatricians think of a child as being under 18 years of age — before vertebral end plate growth is completed. In a child under the age of 8 to 10 years, the cartilaginous growth centers are too immature and too vulnerable to injury to be subjected to spinal manipulation. There is some speculation that injury to growth plates might result in spinal deformity (such as scoliosis or Scheuermann’s kyphosis) as growth progresses.19 Such injury may not be detectable. “The incidence of subtle growth plate fractures following high-velocity [manipulation] techniques in children is surely under-appreciated because of the occult nature of these injuries.”19

Under normal circumstances, it seems unlikely that the cartilaginous, flexible spine of a healthy child would be as easily injured as an adult spine that has been weakened by degenerative changes. Referred pain caused by organic disease is not commonly experienced by children. When back pain in a child does occur, it is potentially more serious than back pain in an adult and should always be brought to the attention of a board-certified pediatrician.

Spinal manipulation has the potential to injure the spine of a child. A systematic review of 13 studies published up to June 2004 uncovered 14 significant manipulation-related injuries in children up to18 years of age, 9 of which were serious (e.g., subarachnoidal hemorrhage, paraplegia) and 2 of which were fatal (one child died from a brain hemorrhage and another from dislocation of the atlas following neck manipulation). Ten of the injuries were attributed to manipulation done by chiropractors, 1 to manipulation by a physiotherapist, and 1 to manipulation by a medical doctor; 2 injuries were caused by unspecified providers of manipulation. In 20 cases of harm caused by delayed diagnosis as a result of using manipulation, 7 involved a delayed diagnosis of cancer; 2 children died because of delayed treatment for meningitis.5 The incidence of spinal injuries in children is reported to be 2 to 5% of all spine injuries.21

Dubious Methods Used to “Detect and Correct” Pediatric “Subluxations”

High velocity, low amplitude thrusting, commonly used by chiropractors, is usually the type of manipulation that injures a child’s spine. Most chiropractors who manipulate an infant’s spine may simply use light thumb pressure to “adjust” an allegedly misaligned vertebra, thus reducing possibility of injury. Gentle touch may have a calming affect on an infant. But any manipulative technique applied to the neck of an infant is unnecessary and potentially dangerous. Some chiropractors may use a spring-loaded stylus or an electrically-powered mallet in an attempt to tap vertebrae into alignment. Chiropractors who adjust newborn babies to correct “subluxations” may concentrate on the upper cervical (neck) area of the spine. The upper neck is more likely to be injured by delivery during birth and is most vulnerable to injury caused by manipulation. Pediatricians have observed that “The most common traumatically injured region of the immature spine is the first and second cervical vertebrae.”19

There is no credible evidence that chiropractors are able to find “subluxations” in the spine of an infant. It seems unlikely that a chiropractor could detect vertebral misalignment by palpating the flexible, cartilaginous spine of an infant through a thick layer of baby fat. I have always suspected that chiropractors who say they can use their fingertips to feel subluxations in a baby’s spine are either deceiving themselves or misinterpreting what they are feeling.

Some chiropractors use surface electromyography, thermography, leg-length checks, or some other questionable device or approach to locate subluxations. It goes without saying that chiropractors should not expose a child to unnecessary radiation by x-raying his or her spine in a search for elusive or nonexistent “subluxations.” In Canada, the Alberta Society of Radiology has recommended that radiologists refuse requests from chiropractors who ask for diagnostic imaging of any type involving children aged 18 years or younger.21

Of all the claims made by chiropractors, I regard the claims made by those who treat children to be the most problematic. I have always advised against manipulating the spine of a small child or a newborn baby for any reason. Manipulation of the spine of an adolescent child under the age of 18, no matter who does it, should be done in concert with an evaluation and a diagnosis provided by an orthopedist, preferably a pediatric orthopedic specialist. Caring for children is very different from caring for adults and requires a special expertise. Board-certified medical and osteopathic pediatricians are best qualified to provide or recommend appropriate care based on a correct diagnosis.

Drawing the Line on Chiropractic Treatment of Children

Although spinal manipulation is often recommended as a treatment for back pain, this recommendation does not often apply to children. When the U.S. Department of Health and Human Services published a Clinical Practice Guideline suggesting that spinal manipulation can be helpful for patients with acute low-back problems without radiculopathy (sciatic pain) when used within the first month of symptoms, the report included this statement: “The recommendations included in the guideline may not apply to persons younger than 18 years since diagnostic and treatment considerations for this group are often different than for adults.”22 An adolescent child might benefit from appropriate manipulation designed to relieve symptoms caused by uncomplicated, mechanical-type back problems. But use of chiropractic “spinal adjustments” for “subluxation correction” may delay appropriate treatment based on a correct diagnosis — and the younger the child the greater the chances of misdiagnosis or injury.

Some chiropractors believe that adjusting a child’s spine will stimulate the immune system and help prevent infection. On September 8, 2009, for example, the Journal of Pediatric, Maternal and Family Health — Chiropractic issued a press release titled “Chiropractic Part of Swine Flu Prevention Program in Children.” The editor of the journal recommended that all children should be checked for vertebral subluxations before and during the flu season. “Since the nervous system has a direct effect on the immune system and because the spine houses and protects so much of the nerve system it is important to have your child’s spine checked for any interference.”23

Such alarming and unscientific views find support in the basic definition of chiropractic and in official chiropractic publications. The National Board of Chiropractic Examiners (NBCE), for example, advises that “Psychoneuroimmunology has revealed an interrelationship between the central nervous system and immunity (consistent with chiropractic philosophy)….By manually manipulating vertebrae into their normal physiological relationship, chiropractic practitioners relieve interference with the nervous system along with accompanying symptoms.” Regarding treatment of children, the NBCE advises that “Chiropractic management of childhood disorders primarily consists of adjusting concomitant spinal subluxations and providing specific nutritional advice and/or support and other palliative measures.”24

All things considered, it is an understatement to say that “Pediatric chiropractic care is often inconsistent with recommended medical guidelines.”6 Recommendation of any complementary alternative medicine therapy that has a risk/benefit ratio that is not acceptable and is not supported in medical literature may make a referring physician liable for negligence if the referral causes harm by delaying necessary conventional treatment.25

I don’t know of any reason to believe that it might be necessary to refer a child to a pediatric chiropractor or to use spinal manipulation on a child prior to onset of adolescence. “Wellness care” in the form of “subluxation correction” is unnecessary and scientifically indefensible, and it places children at risk. 

References

  1. Gotlib A, Rupert R. Chiropractic manipulation in pediatric health conditions — an updated systematic review. Chiropractic & Osteopathy. 2008;16:11 http://www.chiroandosteo.com/16/1/11 Accessed April 17, 2010.
  2. ICA Council. Diplomate in Chiropractic Pediatrics. http://www.icapediatrics.com/members-postgrad.php Accessed April 10, 2010.
  3. ACA Council on Chiropractic Pediatrics. Pediatric diplomate certification recognized by both ICA and ACA. 2007. http://www.acapedscouncil.org/pressrelease.html Accessed April 10, 2010.
  4. ACA. Increasing numbers of children receive pediatric chiropractic care. January, 2009. http://www.acatoday.org/press_css.cfm?CID=3247 Accessed April 10, 2010.
  5. Vohra S, et al. Adverse events associated with pediatric spinal manipulation: A systematic review. Pediatrics.2007; 119(1):e275-e283.
  6. Lee A, Li D, Kemper K. Chiropractic care for children. Archives of Pediatrics and Adolescent Medicine. 2000; 154:401-407.
  7. ICA Pediatrics. Journal Abstracts. http://www.icapediatrics.com/reference-journals.php Accessed April 10, 2010.
  8. Fallon J. The child patient: A matrix for chiropractic care. Journal of Clinical Chiropractic Pediatrics (Supplement). 2005; 6(3).
  9. 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: The Journal of Science and Healing.2009; 5(5):290-295.
  10. College of Physicians and Surgeons of the Province of Quebec. A scientific brief against chiropractic. New Physician.1996. http://www.chirobase.org/05RB/CPSQ/00.html Accessed April 10, 2010.
  11. Mirtz TA, Morgan L, Wyatt LH, Greene L. An epidemiological examination of the subluxation construct using Hill’s criteria of causation. Chiropractic & Osteopathy. 2009; 17:13. http://www.chiroandosteo.com/content/17/1/13 Accessed April 10, 2010.
  12. Nelson C. The subluxation question. Journal of Chiropractic Humanities. 1997; 7(1):46-55.
  13. Balon J, et al. A comparison of active and simulated chiropractic manipulation as adjunctive treatment for childhood asthma. The New England Journal of Medicine.1998; 339(15):1013-1020.
  14. Olafdottir E, et al. Randomised controlled trial of infantile colic treated with chiropractic spinal manipulation. Archives of Disease in Childhood. 2001; 84(2):138-141.
  15. Ernst E. Chiropractic spinal manipulation for infant colic: A systematic review of randomized clinical trials. International Journal of Clinical Practice. September, 2009; 63(9):1351-1353.
  16. Mills V, et al. The use of osteopathic manipulative treatment as adjuvant therapy in children with recurrent acute otitis media. Archives of Pediatrics and Adolescent Medicine.2003; 157(9):861-866.
  17. Powell FC, et al. A risk/benefit analysis of spinal manipulation therapy for relief of lumbar or cervical pain. Neurosurgery Online.1993; 33(1):73.
  18. ICA Home. Council on Chiropractic Pediatrics. http://www.icapediatrics.com Accessed April 10, 2010.
  19. O’Neal ML. The pediatric spine: Anatomical and Dynamic considerations preceding manipulation. Comprehensive Therapy.2003; 29(2):124-129.
  20. Hayes J, Arriola T. Pediatric spinal injuries. Pediatric Nursing. 2005; 31(6):464-467.
  21. Editorial. Alberta radiologists target chiropractors. Canadian Medical Association Journal. 1998; 159(10):1237.
  22. Bigos SJ, et al. Acute Low Back Problems in Adults.1994; Rockville, Maryland: U.S. Department of Health and Human Services. AHCPR Publication No. 95-0642.
  23. McCoy M. Chiropractic part of swine flu prevention program in children. McCoy Press Research Update. September 8, 2009. http://researchupdate.mccoypress.net/2009/09/08/chiropractic-part-of-swine-flu-prevention-program-in-children.aspx Accessed April 10, 2010.
  24. Christensen M, et al. Job Analysis of Chiropractic.2005. Greeley, CO; National Board of Chiropractic Examiners.
  25. Cohen MH, Kemper KJ. Complementary therapies in pediatrics: A legal perspective. Pediatrics. 2005; 115(3):774-780.

Posted in: Chiropractic, Science and Medicine

Leave a Comment (37) ↓

37 thoughts on “Pediatric Chiropractic Care: Scientifically Indefensible?

  1. moderation says:

    Bravo! Wonderful overview which I can use as reference for friends and patient’s parents.

  2. moderation says:

    Fo those of you with facebook, there is this video posted by the ICPA (International Chiropractic Pediatric Association – mentioned frequently in the posting above) …

    http://www.facebook.com/video/video.php?v=402096123581&ref=mf

    It is an interview done by Fox News 23 in Albany, NY … while the claims of the chiropracter are disturbing, more disturbing is watching the manipulations and also the equivication of the pediatrician interviewed at the end.

    On a lighter, but equally disturbing note is this site devoted to promoting chiropractic care to children using cartoon superheroes:

    http://www.chirosquad.com/

  3. Versus says:

    This post makes me both sad and furious — sad for the parents who think they are doing the best for their children and furious at the chiropractors who commit this fraud on the public. Apparently they have absolutely no shame. Thanks for speaking out. The rest in the chiropractic industry are complicit in their silence.

  4. Sir Eccles says:

    See also Simon Singh.

  5. SimonH says:

    My comment to parents is: have you ever been to a chiropractor and been told there is nothing wrong? If adults wish to go to an “alternative practitioner” well so be it, but children have no voice and are at the mercy of their parents views. In Australia chiropractic is a well-established profession & they undertake a 5-6 year course to become chiropractors. God knows what they learn!

    I have seen numerous children following assessment by chiropractors and their x-ray reports often run for a whole page, describing minor asymmetries and variations of no significance, all in need of so-called treatment.

    I shudder at the thought of an infant having manipulation of the spine. By the way the common condition that gets diagnosed by chiropractors in babies here in Melbourne is “subluxed shoulder”. As a paediatrician I have never seen or heard of a dislocated shoulder following birth or as a result of trauma – significant force usually results in either a fractured clavicle or humerus, or brachial plexus injury NEVER shoulder dislocation. Always requires multiple visits for multiple treatments at significant costs.

  6. Joe says:

    Thanks for this.

    A year ago the British Chiro. Ass. released a short list of articles they claimed supported treatment of some (visceral) childhood illnesses. It was deconstructed overnight. http://www.sciencebasedmedicine.org/?p=555

    In February of this year, they released another review concerning the benefits of “manipulative therapy” (Bronfort et al) http://www.chiroandosteo.com/content/18/1/3 It is a classic case of bait-and-switch since many of the treatments were not applied by chiros. (Right of the top, 32% involved masseurs, PTs, osteopaths,etc.; examination of specific references reveal more that do not involve chiro.) It is amusing that Chiros boast of superior abilities; yet pad their resume with anything that may be mistaken for their work.

    Moreover, it is clear that what counts for favorable evidence in Bronfort does not pass muster in scientific circles.

    For example, they claim the evidence for chiro treatment of enuresis (bed wetting) is inconclusive but favorable. That is their summary of two papers:

    Reed WR, Beavers S, Reddy SK, Kern G: “Chiropractic management of primary nocturnal enuresis.” J Manipulative Physiol Ther 1994, 17: 596-600.

    Leboeuf C, Brown P, Herman A, Leembruggen K, Walton D, Crisp TC: “Chiropractic care of children with nocturnal enuresis: a prospective outcome study.” J Manipulative Physiol Ther 1991, 14: 110-115.

    The latter (1991) study was un-blinded and uncontrolled, and concluded that chiro did not work. The former (1994) was tiny, the treatment and control groups were not closely matched; and the treatment and control groups were not statistically different after treatment. How can this be interpreted as “inconclusive” and “favorable.”

  7. DevoutCatalyst says:

    > How can this be interpreted as “inconclusive” and “favorable.”

    In the alt-med world, you learn the jargon, then deploy it in novel ways. Clinically proven effective.

  8. daijiyobu says:

    Great post.

    -r.c.

  9. I shudder at the thought of an infant having manipulation of the spine.

    As do I.

    …furious at the chiropractors who commit this fraud on the public. Apparently they have absolutely no shame.

    Would that it were only chiropractors perpetrating this fraud. Look at this article (especially Figure 1) written by a medical doctor, Kathi Kemper, who at about that time was President of the Ambulatory Pediatric Association (see also refs. 6 & 25 above). (Then, FWIW, check out my response—never acknowledged or answered).

  10. SimonH says:

    That article is truly scary … and in one of the better Paediatric journals. When will people understand that we have three excellent de-toxification systems, namely the liver, the kidney and the gut… when they don’t work, then you get ill.

  11. Mojo says:

    @Joe:

    In February of this year, they released another review concerning the benefits of “manipulative therapy” (Bronfort et al)…

    That was commissioned and funded by the General Chiropractic Council (the statutory regulator for chiropractors in the UK), rather than the BCA.

  12. zeno says:

    Excellent article.

    Some chiros are claiming that “Science backs chiropractic” based on the Bronfort report and the commentaries on it:

    “Chiropractors are very fortunate in these times of evience [sic] based health care.”

    However (and as some may have expected), the Bronfort report perhaps isn’t the glowing indictment of chiropractic that some might like it to be. See my blog posts:

    The GCC’s Plethora
    Talking the talk
    Bronfort on: Ear Infections

    I will be examining other conclusions of Bronfort in the future.

  13. lkregula says:

    I can see how chiro could be helpful in the instance of bed wetting. About as effective as child abuse in preventing bed wetting.

    That video on manipulations made me squirm, and people want to have that done to their kids?

  14. MaryAnne says:

    I feel like I’m about to step in the middle of enemy waters, so here goes.

    I just don’t get it. That video from Fox News showing a baby getting adjusted looked like it FELT GOOD. The chiropractor was very gentle and the baby was in no way scared or stressed. On the contrary,

    As a chiropractor myself, I completely understand people’s fear of “spinal manipulations”, especially in the neck, which is why I don’t do spinal manipulations on kids or babies. And rarely do I do them on adults.

    Have any of you spoken to mothers who take their kids to a chiropractor? Do any of you have any idea what you’re talking about? I don’t think so. It shows. And you all think prescribing drugs and antibiotics to children is the way forward? Chiropractic, in general, especially for kids, is way out of your league.

    Dr Simon Homola’s article is full of information. He writes an intelligent piece, but unfortunately, he comes across as someone who has never adjusted a child, let alone desired to do so. He speaks about his opinion, not from experience. And how much experience, as a chiropractor in total, does he have? My advice to him is to go to med school because he really seems to be ashamed to call himself a chiropractor and now he wants to play on the medical team.

    I feel sorry for him. And I feel sad for everyone commenting here. You all have no idea how many children LOVE getting adjusted and how much better and healthy they are compared to the kids who are constantly given prescription drugs.

  15. Harriet Hall says:

    MaryAnne,

    The fact that children love getting adjusted is irrelevant to the question of efficacy or safety.

    I have never seen any evidence that children who get chiropractic adjustments are “better and healthy” compared to others. I will consider your statement false unless you can provide references.

    As for Sam Homola’s experience with chiropractic, he practiced it for a lifetime and is now retired. But experience is also irrelevant to the question of the efficacy or safety of chiropractic adjustments.

    Opinion and experience are not acceptable to science-based medicine unless they can be backed up by evidence. You haven’t provided any evidence, and I doubt if you can.

  16. Blue Wode says:

    Another great SBM blog post from Dr Homola, and very interesting to note that nearly all the comments to date have been supportive of it.

    @ MaryAnne
    Whilst you say that the chiropractor in the Fox News video was “very gentle and the baby was in no way scared or stressed”, if the following short videos of clearly distressed infants receiving chiropractic ‘adjustments’ are anything to go by, that is far from being a universal experience in ‘paediatric chiropractics’:

    http://www.youtube.com/watch?v=5QQk_Acejjw (newborn)

    http://www.youtube.com/watch?v=JrXAeWtR_8M

    http://www.youtube.com/watch?v=T5HMKrdrlAU

    http://www.youtube.com/watch?v=aZCH_-yqiDw

  17. MaryAnne says:

    @Blue Wode:

    Are you kidding me? I understand that any person unfamiliar with proper gentle chiropractic care would feel uncomfortable if they saw a baby cry while observing them getting a light gentle and specific adjustment of the upper cervical segments. So I can sympathize with your fear and any parent’s fear. But seriously, those (only 4) videos of babies getting such a quick adjustment cried for a few seconds and then were comfortable and in great hands. Babies cry. The videos showed nothing out of the ordinary. Did you happen to watch the parents in all videos? They were very happy and smiling throughout the adjustments. Everything was calm and the chiropractors all performed in a competent and professional environment.

    In contrast, I’ve heard and seen children scream bloody murder while receiving their shots at a paediatrician’s office, and then even continue to scream for hours afterwards. Yeah, that’s really comforting and reassuring.

    Look, I don’t need to prove anything: I’m 100% certain chiropractic children are many times healthier than any drugged-up medicated kids. Clearly you no nothing about good solid chiropractic care for kids. Learn a little more through experience before you continue to knock us down.

    MaryAnne

  18. Blue Wode says:

    MaryAnne wrote: “…those (only 4) videos of babies getting such a quick adjustment cried for a few seconds and then were comfortable and in great hands. Babies cry. The videos showed nothing out of the ordinary.”

    I disagree. They show distressed infants and young children being treated with a procedure for which the risks outweigh the benefits – i.e. the risks are unknown (but there are quite a few adverse events on record) and the benefits are zero.

    MaryAnne wrote: “Did you happen to watch the parents in all videos? They were very happy and smiling throughout the adjustments.”

    That is completely meaningless. The parents were simply *trusting* that their infants were safe in the hands of a figure of authority.

    MaryAnne wrote: “Everything was calm and the chiropractors all performed in a competent and professional environment.”

    Irrelevant.

    MaryAnne wrote: “In contrast, I’ve heard and seen children scream bloody murder while receiving their shots at a paediatrician’s office, and then even continue to scream for hours afterwards. Yeah, that’s really comforting and reassuring.”

    It is reassuring when you consider that the benefits of immunisation vastly outweigh any risks.

    MaryAnne wrote: “Look, I don’t need to prove anything”

    If you are a chiropractor who treats children you most certainly do.

    MaryAnne wrote: “I’m 100% certain chiropractic children are many times healthier than any drugged-up medicated kids.”

    Then would you please provide robust scientific evidence in support of your claim.

  19. Chris says:

    MaryAnne:

    I’m 100% certain chiropractic children are many times healthier than any drugged-up medicated kids. Clearly you no nothing about good solid chiropractic care for kids. Learn a little more through experience before you continue to knock us down.

    What makes you think children are “drugged-up medicated”? You seem to be including vaccines as part of being “medicated.”

    Do you think your adjustments would aid or hinder a child with pertussis or measles?

    Would chiropractic treatments be a viable substitute for treating my son’s very serious hypertrophic cardiomyopathy with obstruction? Would chiropractic adjustment have prevented his seizures caused by dehydration when he had a rotavirus infection as a toddler?

    Do you have any actual evidence that children really benefit from adjustments? Something that the British Chiropractic Association missed when they finally decided to provide their evidence (see http://www.bmj.com/cgi/content/full/339/jul08_4/b2766 )

  20. Harriet Hall says:

    MaryAnne,

    Your arguments boil down to “I believe” and “children seem to like it.” I wonder if you realize this is a science-based blog. You say “I don’t need to prove anything.” Well, no, you don’t need to prove anything to be able to believe it yourself, since you obviously don’t share our concept of evidence and are willing to accept beliefs based on personal observations (which are notoriously unreliable), but you do need to prove it if you hope to persuade others – which presumably was your intent or you would not have bothered to comment here.
    If we were to accept the kinds of arguments you offer, we would still be doing bloodletting to balance the humours and we would be at the mercy of every quack.

  21. Joe says:

    @MaryAnn eon 15 May 2010 at 5:32 pm wrote “I understand that any person unfamiliar with proper gentle chiropractic care would feel uncomfortable if they saw a baby cry while observing them getting a light gentle and specific adjustment of the upper cervical segments.”

    Actually, chiro adjustments are not “specific” at all:
    Lee RY, McGregor AH, Bull AM, Wragg P. “Dynamic response of the cervical spine to posteroanterior mobilisation.” Clin Biomech (Bristol, Avon). 2005 Feb;20(2):228-31.
    Kulig K, Landel R, Powers CM. “Assessment of lumbar spine kinematics using dynamic MRI: a proposed mechanism of sagittal plane motion induced by manual posterior-to-anterior mobilization.” J Orthop Sports Phys Ther. 2004 Feb;34(2):57-64.

    That is just another myth, like your subluxation.

    I join Dr. Hall and Blue Wode asking for evidence that chiro adjustments are in any way beneficial to children; your warm fuzzy feelings are not persuasive. George Washington’s doctors thought they were helping him when they bled him to death, chiro has no better evidence than they had (and they were clearly wrong).

  22. BillyJoe says:

    Maryanne,

    “In contrast, I’ve heard and seen children scream bloody murder while receiving their shots at a paediatrician’s office, and then even continue to scream for hours afterwards. Yeah, that’s really comforting and reassuring. ”

    May I ask you…
    Do you actively advise parents not to have their children vaccinated?
    If not, what do you tell them if they ask your opinion about vaccinations?

  23. MaryAnne says:

    Everyone:

    I’m not going to respond to every comment from Blue, Chris, Harriet, Joe, or BillyJoe. It’s too time consuming and tedious. The fundamental problem here is that we will never agree. Unless I present a competent, well-devised, double-blind, placebo-controlled, randomized study, you will, quite frankly roll your eyes and give me zero credit for anything I say. Fair enough. As Harriet H says, “…this is a science-based blog.”

    There is no doubt that our (chiropractic) profession lacks robust scientific evidence to prove that we are the leaders in wellness. That being said, modern medicine has it’s place as well – the high-tech advances in surgery/micro-surgery, emergency medicine, and medical technology saves lives and helps people.

    It’s seriously delusional to claim that the medical industry performs accurate scientific studies proving that drugs and vaccines work. There are plenty of scientific studies in the medical/pharma industry that are incompetent and poorly designed, as well as blatantly deceptive. Why, for example, does the FDA still approve usage of the GlaxoSmithKline’s Rotarix and Merck’s Rotateq vaccine even after they found 2 types of pig viruses in them?
    http://www.fda.gov/NewsEvents/Newsroom/PressAnnouncements/ucm212149.htm

    How can you feel good about yourself professionally when you tell your nurses to inject your infant-patients with that crap? Don’t tell me “because it’s safe”. The FDA has no idea how safe pig viruses in humans are.

    Your industry has too much corrupt money flowing, enough to deceive the general population with your claims of being proper “health-care” (when the reality is that you are experts at keeping the human population just sick enough to keep your trillion dollar industry going without actually killing too many people [or is 100,000+ people a year not enough?]).

    I’m sure you all would love to continue battling with me, trying to knock me down along with my whole chiropractic profession with your arrogant, false sense of righteousness, but it’s better that my energy is shifted into being part of helping people by continually adjusting them. I’m a damn great chiropractor, and will continue to be for many more decades.

    And BillyJoe, to answer your question: I proudly advise parents to INFORM themselves on the risks of vaccines, to educate themselves on immunization to make a choice for themselves, not from a blind move simply trusting what their “doctor” says.

    Dr MaryAnne.

    PS – I will continue to read articles on this website, but will refrain from commenting. Good luck.

  24. BillyJoe says:

    Maryanne,

    Most of your post consists of a tu quoque fallacy.
    You cannot defend the conduct of chiropractors by pointing out the poor conduct of the pharmacuetical industry.

    “And BillyJoe, to answer your question: I proudly advise parents to INFORM themselves on the risks of vaccines, to educate themselves on immunization to make a choice for themselves… “

    That sounds like lolly language for “Yes, I’m anti-vaccine. I tell my patients not to vaccinate their children”

    The average parent doesn’t have the background knowledge to properly assess the information they find, or to distinguish between reliable and unreliable sources of information. The average parent does not have the expertise to make meaningful choices about vaccines. They need guidance from people with expertise in vaccines.

    “…not from a blind move simply trusting what their “doctor” says.”

    Just as a matter of interest, where do you send them for information and education about vaccines?

  25. Chris says:

    MaryAnne:

    Unless I present a competent, well-devised, double-blind, placebo-controlled, randomized study, you will, quite frankly roll your eyes and give me zero credit for anything I say. Fair enough. As Harriet H says, “…this is a science-based blog.”

    I pointed you to an article about the type and quality of evidence already presented by the British Chiropractic Association. You could have used that as a jumping off point.

    Though in reality, you are admitting there is no real scientific evidence.

  26. Th1Th2 says:

    MaryAnne,

    “Why, for example, does the FDA still approve usage of the GlaxoSmithKline’s Rotarix and Merck’s Rotateq vaccine even after they found 2 types of pig viruses in them?
    http://www.fda.gov/NewsEvents/Newsroom/PressAnnouncements/ucm212149.htm

    Because different craps in vaccines would make them more immunogenic. That’s why SBM loves vaccines.

    “How can you feel good about yourself professionally when you tell your nurses to inject your infant-patients with that crap? Don’t tell me “because it’s safe”. The FDA has no idea how safe pig viruses in humans are.”

    Because they are blind leading the blind. Not surprisingly, the porcine viral strain in an already rotavirus-contaminated solution is just an added bonus.

  27. jms082 says:

    There are literally thousands of studies on chiropractic care (for adults and pediatrics), widely available to anyone with any interest at all in reading them. The problem is it’s just too easy to criticize and pick on evil MaryAnne, (who likes her patients to avoid harmful pharmaceutical side effects and going under the knife when possible). I just pasted these off http://www.luxchiro.com/index.php/research-mainmenu-38.html. I can’t vouch for the site or practice, because I simply googled it and magically they appeared (it really is THAT EASY to find research on chiropractics!). They have a ton of research listed so that even the most biased scholars can find a couple solid studies to pick and choose from (if the critics are truly interested in reading—but they never really are).

    Asthma

    Studies in Peer Reviewed Journals:

    1) An impairment rating analysis of asthmatic children under chiropractic care. Graham, RL and Pistolese RA. Journal of Vertebral Subluxation Research, Vol. 1, No. 4, 1997.

    *

    Eighty one children under chiropractic care took part in this self-reported asthma related impairment study. The children were assessed before and two months after chiropractic care using an asthma impairment questionnaire. Significantly lower impairment rating scores (improvement) were reported for 90.1% of subjects 60 days after chiropractic care in comparison to their pre-chiropractic scores. In addition, 30.9% of the children voluntarily decreased their dosage of medication by an average of 66.5% while under chiropractic care. Twenty four of the patients who reported asthma attacks 30-days prior to the study had significantly decreased attacks by an average of 44.9%. Six different chiropractic techniques were used by the different chiropractors who participated in this study.

    2) Chiropractic response in the pediatric patient with asthma: a pilot study. Peet, JB. Marko SK, Piekarczyk W. Chiropractic Pediatrics Vol. 1, No. 4, May 1995, pp. 9-13.

    *

    From the abstract: This paper reviews the correlation between reducing/correcting vertebral subluxations in the asthmatic pediatric patient utilizing Chiropractic Biophysics Technique (CBP) and symptomology generally associated with this condition. A further objective will be to determine what areas of vertebral subluxation, if any, are commonly seen in this group. The children used for this study had never received any chiropractic care or manipulative care prior to participation in this study. Seven of the eight patients who completed the study were able to reduce/discontinue medication. All participants showed measurable improvement on radiographs, which correlated with an improvement in asthma symptoms in seven of the eight cases. This paper also includes an interesting discussion on the innervation of the lungs and its relationship to the vertebral subluxation complex.

    3) Treatment protocols for the chiropractic care of common pediatric conditions: otitis media and asthma. Vallone S and Fallon JM Journal of Clinical Chiropractic Pediatrics Vol 2, No.1 1997. P. 113-115

    *

    This paper’s purpose presents the results of a survey of chiropractors enrolled in the first year of a three year postgraduate course in chiropractic pediatrics. The survey sought to establish if consensus existed with respect to the modalities these doctors used to treat two of the most common childhood disorders seen by chiropractors: otitis media and asthma. Thirty-three doctors of chiropractic participated in the survey. “Of the primary therapeutic modalities employed by the chiropractor, spinal adjusting was the most commonly used for both asthma and otitis media. Certain areas of the spine were addressed most frequently for each of the two conditions.

    4) Chiropractic care in the treatment of asthma. Killinger LZ. Palmer Research Journal 1995; 2(3):74-7.

    *

    This is the case report of an 18 year old subject with a two year history of asthma and monitored for a five year period. The subject received Palmer Upper cervical Specific technique adjustments. The result was marked improvement in the subject’s health status. The greatest improvements were reported in the weeks following the chiropractic adjustments. This was an unusual case because trauma to the cervical vertebrae coincided with the occurrence of asthma and spinal care was directed to the traumatized segments.

    5) Treatment of visceral disorders by manipulative therapy. Miller WD. In: Goldstein M, Ed. The Research Status of Spinal Manipulative Therapy. Bethesda: Dept. HEW. 1975:295-301.

    *

    Patients with chronic obstructive pulmonary disease were treated with osteopathic manipulation. 92% of the patients stated they were able to walk greater distances, had fewer colds, experienced less coughing, and had less dyspnea than before treatment. 95% of patients with bronchial asthma said they benefited from chiropractic care. Peak flow rate and vital capacity increased after the third treatment.

    6) Specific upper cervical chiropractic care and lung function. Kessinger, R CRJ 1997; 27/ Mantis ID 38010

    *

    A study was conducted on 58 patients to determine whether the upper cervical knee chest adjustment, influenced pulmonary function. FEV-1 and FVC were measured before care and two weeks after care on a computerized auto-spiro spirometer. Analysis of the spirometry measurements revealed predictable statistically significant changes in FVC and FEV-1. Of the 58 patients, 57% of the subject population were considered to have “abnormal” lung function before care. The abnormal group showed the greatest increases in FVC and FEV-1 over the two-week study. Forty-two percent of the abnormal patient population actually tested within normal limits after the two-week study. The “normal” subject population also showed predictable increases in tendency to return to normal was clearly observed in just two weeks under specific chiropractic care.

    7) Chiropractic adjustment in the management of visceral conditions: a critical appraisal. Jamison JR, McEwen AP, Thomas SJ. JMPT, 1992; 15:171-180.

    *

    In this a survey of chiropractors in Australia, more than 50% of the chiropractors stated that asthma responds to chiropractic adjustments; more than 25% felt that chiropractic adjustments could benefit patients with dysmenorrhea, indigestion, constipation, migraine and sinusitis.

    9) A comparison of active and simulated chiropractic manipulation as adjunctive treatment for childhood asthma. NEJM1998; 339:1013-1020 Balon J, Aker PD, Crowther ER, et al.

    10) Asthma in a chiropractic clinic: a pilot study. Jamison J et al J Aust Chiro Assoc., 16(4):137-143, 1986.

    *

    In this study of 15 patients under chiropractic care, six patients reduced their medications and one stopped them entirely. This represents a 46.67% decrease in the need for medication while under chiropractic care.All patients reported satisfaction with their chiropractic care. However the lead author, Dr. Jamison concluded that respiratory function appeared to be unaffected by chiropractic adjustments.

    11) Prognostic factors in bronchial asthma in chiropractic practice. Nilssen N. Christiansen B. J Aust Chirop Assoc 1988;18:85-7.

    *

    In this study of 79 subjects, those most likely to report the best benefit had less severe asthma, were younger and responded within one month (and had an average of five adjustments in one month)

    12) A holistic approach to the treatment of bronchial asthma in a chiropractic practice. Lines DA. Chiropractic J of Australia 1993;23(1):4-8.

    *

    Chiropractic care of two children and one adult (two-year-old, five-year-old and thirty-year old) with asthma. Thoracic adjusting was used in two cases and lumbar adjusting was used in two cases. The patients remained asthma free six months to two years at the writing of the paper.
    *

    The author’s remarks are well stated: “With counting evidence that current medical bronchodilator and inhaled steroid intervention may be contributing to the rising mortality, the conservative, holistic, chiropractic approach presented here may well provide (a)…more effective alternative intervention to present allopathic (medical) therapy….It appears that the currently accepted allopathic (medical) management regimes still remain consensus-based rather than having been founded on actual clinical trials.”

    13) Chronic asthma and chiropractic spinal manipulation – a randomized clinical trial Nielsen NH, Bronfort G, Bendix T et al Clinical and Experimental Allergy 1995 Jan; 25 (1):80-88.

    *

    This blinded, randomized study of 31 patients aged 18-44 who were all on bronchodilators and/or inhaled steroids was conducted at the National University Hospital’s Out-patient Clinic in Copenhagen, Denmark. They received either sham or real manipulations. Interestingly, non-specific bronchial hyperreactivity (n-BR) improved by 36% and patient rated asthma severity decreased by 34% in both groups.
    *

    From the abstract: “The results do not support the hypothesis that chiropractic spinal manipulative therapy is superior to sham spinal manipulation in the management of pharmaceutically controlled chronic asthma in adults when administered twice weekly for 4 weeks.”
    *

    Dr. Koren’s comment: These conclusions appear at variance with over a hundred years of clinical observation of chiropractic’s effectiveness with asthmatics. Upon study of the paper, we notice a number of weakness: subjects were all adults on medication for years. Medication was continued during the course of spinal adjustment. A total of 8 adjustments (2x per week) were performed. So this paper shows that adult asthma sufferers, who are full of meds get as much relief as sham adjustments after 8 “manipulations.” Perhaps the sham manipulation was more manipulation than sham? Perhaps the technique used was defective or not specific enough for asthmatic sufferers? Further, many asthmatic sufferers in the real world discontinue or decrease their medications under chiropractic care. In this hospital study that was not permitted as part of the protocol. This research was poorly designed and not worthy of the term chiropractic research.

    Chiropractic Case Studies:

    There are possibly millions of asthmatic children who are destined to a life dependent upon medication; these children may never have the chance to see if chiropractic spinal adjustments can help their asthma and provide them with a better quality of life. Peter Fysh, D.C. San Jose, California. Dynamic Chiropractic. Sept. 25, 1995. p.16.

    1) Case study: eight year old female with chronic asthma. Peet JB. Chiropractic Pediatrics,1997; 3(2) 9-12.

    *

    The patient had been diagnosed with asthma three years prior to presentation. Beclovent™ and Albyterol ™ were used one to three times per day. After eight chiropractic adjustments over a period of 2 ½ weeks, the mother stated that the child had not used her inhaler for two days, her wheezing had ceased and she could run without gasping. At the time of the publication of this article, the child has been free of asthmatic attacks for four months without medication.

    2) Asthma in the Pediatric Patient. Fysh, P. Dynamic Chiropractic Sept. 25, 1995. P. 16.

    *

    Case history of Benny, 3 years old who had suffered from bronchial asthma since infancy. On increasing doses of medication, attacks occurred several times a week. Subluxation a C1 and T3-4. Anterior saucering of the spine in the mid-scapular region first described by Pottinger in 1910. After one month of care Benny’s asthma resolved. According to the author, “Benny’s case is not an unusual one.”

    3) Chronic asthma: The side-effects of the chiropractic adjustment. Arno Burnier, D.C. Chiropractic Pediatrics Vol. 1 No. 4 May 1995.

    *

    Case #1: J.P., 11-year-old male, Medical diagnosis: Chronic asthma . Medication: Theolair, Alupent Chiropractic results: Off asthma medication after first visit. Child is now a multidiscipline athlete with aspirations to become an Olympic athlete. Six years later, the child is still free of asthma and medication. Presenting Vertebral Subluxation: Occiput/C1 with an Atlas ASR. Original Adjustments: Structural manual adjustment of Atlas.
    *

    Case #2: F.H., 9 year old male. Medical diagnosis: Chronic asthma. Medication: Nasalcron Chiropractic result: Off his medication at onset of care. Clear of symptoms since first adjustment eight years prior. Presenting vertebral subluxation: CO/C1 with atlas ASRP. Original Adjustment: Atlas in lateral flexion and rotation supine.

    4) Case history of asthmatic child. Matthews, NC. Et al. A four year old female patient reported to the office . International Chiropractic Pediatric Association Newsletter. July 1996.

    *

    “Since birth she had problems with her respiratory system…clinical diagnosis of asthma. She had shortness of breath, hard and labored breathing, inability to run from shortness of breath…had become reliant on antibiotics for constant respiratory infections…had taken lots of steroidal drugs. This ‘conventional’ drug therapy had not prevented her from spending every Christmas in the hospital on a breathing machine. “A complete chiropractic examination revealed vertebral subluxation of the atlas right, sixth cervical posterior, and right posterior sacrum. Specific chiropractic adjustment were given…patient responded to the care immediately and was able to suspend using the drugs within two weeks. Within two months, she was able to play with her friends with no symtomatology. Her 5th Christmas was the first at home in her life…I wonder if her asthma should have been diagnosed as SUBLUXATION. What would have happened to her if over the last two years she had been on steroids rather than chiropractic care?”

    5) Asthma and chiropractic. Garde R. Chiropractic Pediatrics. Vol 1 No.3 Dec, 1994.

    *

    From the abstract: Case review of a 6-year-old boy who has had asthma since 1991 and his condition since chiropractic intervention. Child was prescribed aerosol inhalers (Beclovert and Vertolin) using them every day, up to three times a day. Adjustments were delivered to the cervical, thoracic and lumbar areas. Significant progress. Could run during soccer games and “almost never used his inhaler.” Slept more soundly. “Hardly ever had bouts with mucous clogged nasal passages.” Nasal inhalant use stopped.

    6) Case history: an eight year old asthmatic patient. Cohen E. Today’s Chiropractic. Jan-Feb 1988, p.81.

    *

    Improvement in care of an 8 year old asthmatic who developed the condition at age two and successful response after chiropractic care.

    7) Adjustive treatment for chronic respiratory ailment in a five year old. Case reports in chiropractic pediatrics. Esch, S. ACA J of Chiropractic December 1988.

    *

    This is the story of a 5 ½ year old girl with a four-year history of what the parents called “bronchial congestion.” She had pneumonia “several times a year” since she was 18 months old. In addition to he attacks of “bronchitis” she suffered from congestion and was wheezy after running and upon waking up in the morning. The father and mother both reported having allergies. Chiropractic Examination reveal subluxations at C-2, T-4 and L-5.At the second adjustment two days after the first the mother reported the child was not coughing as much and by the third visit a week later the mother reporting the child was breathing normally. Twelve adjustments were given over three months and the chief complain did not recur. A follow-up call four years later revealed no recurrence.

    8) Asthma and Enuresis (Case Report #1374) Zell, Paul, ICPA Newsletter, May-June 1998

    *

    History: The pre-natal history was uneventful and the birth was a Cesarean type with high APGAR scores. The inoculation history was limited to one Polio shot at age 2 and 1 Diphtheria/Tetanus shot because of a reaction to the Diphtheria/Tetanus shot. At age 2, a congenital nevus was removed from the chin. Prior to the surgery the patient was exposed to chicken pox and following the anesthesia, noted personality changes were seen along with several gastrointestinal bouts of the flu and chicken pox. There were reported treated with Homeopathy. At age 3, asthma began to occur, along with many colds and flu’s. With age her resistance to colds and flu’s were improving, however the asthma was getting worse. It was triggered by virus, bacteria or allergies. The asthma required one hospitalization for 3 days, and a series of trips to the emergency room due to the severe effects of the asthmatic attacks. Medication included Intal twice daily. Proventil at onset of an episode, and the constant company of a nebulizer for the exacerbated episodes when the breathing was labored or became a crisis. The mother reports her daughter would cough up a ball of phlegm following each episode. Also reported was the frequent amount of bloody noses she has experienced.
    *

    Examination: A thorough chiropractic examination, full spine films were taken and analyzed. Differential instrumentation, motion palpation and static palpation verified the presence of vertebral subluxation complexes (VSC) at C-2, T-5, T-12, right Ilium and second sacral tuberosity. Postural analysis showed a left high head tilt, right high shoulder and left high ilium indicating the body was adapting to the stresses of the multiple VSC’s.
    *

    Care Plan: Recommendations at 3 times per week for 12 weeks were made due to the chronicity of the subluxations and the severity of the symptoms. Progress of the VSC healing was monitored on each visit and schedule changes made accordingly.
    *

    Progress: The patient improved following the first adjustment and after the fifth adjustment, the asthma and bedwetting ceased. The stabilization of the VSC took 6 months at 3 times per week. Care was reduced to 2 times per week for 6 months and now the patient is checked once a week in the wellness phase to maintain the corrections of the VSC and wellness.
    *

    Discussion: Initially the mother was hopeful that her daughter could be helped with chiropractic care. However, due to the duration and severity of the asthma, the mother was extremely guarded in the progress of the condition. She reports having to carry all of the mediation and Nebulizer wherever they went just in case it was needed. It has taken almost a year to start feeling comfortable that her little girl did not need mediation or a machine. Today the patient is an extremely active child playing soccer and participating in all activities a young person enjoys. She continues to get adjusted on a regular basis for wellness, allowing her body to heal itself as only it knows how to do.

    Additional Articles:

    1) The asthmatic patient. Cessna R. American Chiropractor April 1989;48-50.

    *

    Discusses chiropractic success with asthmatics.

    2) Asthma in a chiropractic clinic: a pilot study. Jamison JR, Leskovec K, Lepore S, Hannan P. J Aust Chiropractic Association 1986; 16(4): 137-43.

    3) Chiropractic response in the pediatric patient with asthma: a pilot study. Peet JB, Marko SK, Piekarczyk. Chiropractic Pediatrics 1995; 1(4)9-12.

    4) Chiropractic treatment of asthma – a controlled clinical trial. Bronfort G, Nielsen N, Bendix T, Madsen F, Weeks B. Proceedings of the 1989 International Conference on Spinal Manipulation. Washington, DC. Published by FCER Arlington, VA.

    5) Management of pediatric asthma and enuresis with probable traumatic etiology. Bachman TR, Lantz CA Proceedings of the National Conference on Chiropractic and Pediatrics (ICA), 1991: 14-22.

    *

    A 34-month-old boy with asthma and enuresis had not responded to medical care. More than 20 emergency hospital visits had taken place for the asthma attacks during a 12 month history. Three chiropractic adjustments were administered over an 11 day period and the asthma symptoms and enuresis ceased for more than 8 weeks. The asthma and enuresis reoccurred following a minor fall from a step ladder but disappeared after adjustments. After a two year follow-up, the mother reports no reoccurrence of the asthma or the enuresis.

    6) Mechanisms and Chiropractic Management of Bronchial Asthma. Monti R. Digest of Chiropractic Economics Sep-Oct 1991;48-51.

    *

    Describes the pathophysiology of asthma and the author’s chiropractic results.

    7) Chiropractic and visceral disease: a brief survey. Wiles R, Daikow P. J Calif Chiro Assoc, 16(4): 137-143, 1986.

    *

    A survey of 17 D.C.s of whom 15 had cared for asthmatics. Areas of the spine adjusted C0- C2 47%, C3-C7 33%, T1-T6 80%, T7-T12 40%, Lumbar 7%, Sacro-iliac 13%,.

    8) A wholistic approach to the treatment of bronchial asthma in a chiropractic practice. Lines DH. Chiro J Aust 1993;23:4-8.

    *

    A comparison of the effect of chiropractic treatment on respiratory function in patients with respiratory distress symptoms and patients without. Hviid C; Bull Eur Chiro Union 1978; 26: 17-34 / Mantis ID: 3222 76.5% of patients with bronchial asthma said they benefited from chiropractic treatment. Peak flow rate and vital capacity increased after the third treatment.
    * Breathing Normal – And Then Some
    Charles Masarsky, DC
    In the 1980s, two chiropractic practitioners in Virginia published a report on breathing capacity in a series of new patients.1,2 They measured the liters of air exhaled by their patients when forcing out a full breath; this measurement is called forced vital capacity, often abbreviated to FVC. They also measured the liters of air exhaled in the first second of forcing out a full breath; this measurement is called forced expiratory volume in one second, often abbreviated to FEV-1. When repeat measurements were taken after one to three chiropractic adjustments, both FVC and FEV-1 had improved significantly.
    Bedwetting (Enuresis)
    Peer Reviewed Publications:

    1) Chiropractic management of primary nocturnal enuresis. Reed WR, Beavers S, Reddy SK, Kern G. JMPT Vol. 17, No. 9 Nov/Dec 1994.

    *

    This was a controlled clinical trial of 46 enuretic children that were placed under chiropractic care. The children were under care for a 10 week period preceded by and followed by a 2 week nontreatment period.
    *

    Participants: Forty-six nocturnal enuretic children (31 treatment and 15 control group), from a group of 57 children initially included in the study, participated in the trial.
    *

    Results:…25% of the treatment-group children had 50% or more reduction in the wet night frequency from baseline to post-treatment while none among the control group had such reduction.

    2) Nocturnal enuresis: treatment implication for the chiropractor. Kreitz, B.G. Aker, P.D., JMPT 1994:17(7): 465-473.

    *

    A review of the literature of nocturnal enuresis is presented.
    *

    The author states: “Spinal manipulative therapy has been shown to possess an efficacy comparable to the natural history.”

    3) Chiropractic care of children with nocturnal enuresis: a prospective outcome study. LeBouf C, Brown P, Herman A et al. JMPT, 1991;14(2):110-115. 171

    *

    Children with a history of persistent bed-wetting at night received eight chiropractic adjustments. Number of wet nights fell from 7/week to 4. At the end of the study, 25% of the children were classified as successes.

    4) Functional nocturnal enuresis. Blomerth PR. JMPT 1994:17:335-338.

    *

    Eight-year-old male bed wetter. Lumbar spine was manipulated once and at 1 month follow-up there was complete resolution of enuresis. “This happened in a manner that could not be attributed to time or placebo effect.”

    5) Neurogenic Bladder and spinal bifida occulta: a case report. Borregard PE. JMPT 1987; 10(3):122-3.

    *

    Examination found fixation in L3 and both SI joints, following the restoration of SI function the patient’s mother reported the patient was now aware of bladder distention approximately 30 minutes before it was necessary to void. A slight of bladder sensitivity occurred 4 months after the release from treatment and responded immediately to manipulation.

    6) Chiropractic care of children with nocturnal enuresis: A prospective outcome study. LeBoeuf, C.; Brown, P; Herman, A; Leembruggen K; Walton D; Crisp TC. JMPT, 1991, 14 (2), pp. 110-115.

    *

    In 171 children suffering from enuresis, the average number of bed-wettings per week was 7, while at the end of the study the average number of bed wettings per week was reduced to 4. Additionally 1% of patients were considered “dry” at the beginning of the study, while 15.5% were considered “dry” at the end of the study.

    7) Chiropractic management of enuresis: time series descriptive design. Gemmell HA, Jacobson, BH JMPT 1989; 12:386-389.

    *

    Case of a 14-year-old male with a long history of continuous bed-wetting that was alleviated (not completely cured) by adjustments.

    8) Characteristics of 217 children attending a chiropractic college teaching clinic. Nyiendo J. Olsen E. JMPT, 1988; 11(2):78084.

    *

    The authors found that pediatric patients at Western States Chiropractic College public clinic commonly had ordinary complaints of ear-infection, sinus problems, allergy, bedwetting, respiratory problems, and gastro-intestinal problems. Complete or substantial improvement had been noted in 61.6% of pediatric patients of their chief complaint, 60.6% received “maximum” level of improvement while only 56.7% of adult patients received “maximum” level of improvement.

    9) Epileptic seizures, Nocturnal enuresis, ADD. Langley C. Chiropractic Pediatrics Vol 1 No. 1, April, 1994.

    *

    This is an eight year old female with a history of epilepsy, heart murmur, hypoglycemia, nocturnal enuresis and attention deficit disorder. The child had been to five pediatricians, three neurologists, six psychiatrists and ten hospitalizations and had been on Depakote, Depakene, Tofranil and Tegretol. Birth was difficult including a cesarean under general anesthesia. Mother was told the baby was allergic to breast milk and formulas and stayed on prescription feeding. The doctors told the mother the girl would never ride a bike or do things like normal children do. The child was wetting the bed every night and experiencing 10-12 seizures/day, with frequent mood swings, stomach pains, diarrhea and special education classes for learning disabilities.
    *

    Chiropractic adjustments: C1 and C2 approximately three times/week. After two weeks of care the bed-wetting began to resolve and was completely resolved after six months. She was also leaving special education classes to enter regular fifth grade classes. Seizures were much milder and diminished to 8-10 per week after one year of care. Patient was also released from psychiatric care as “self managing.” Her resistance to disease in-creased and she can now ride a bike, roller skate and ice skate like a normal child. After medical examinations, she is expected to be off all medication within a month.

    Case Studies:

    1) Bed-wetting; two case studies. Marko, RB Chiropractic Pediatrics Vol. 1 No. 1 April 1994.

    *

    Case #0991: Five year old female who had been wetting her bed for six months. She was prescribed antibiotics for what MDs diagnosed as a bladder infection. After the second chiropractic adjustment, she stopped wetting her bed for three weeks. She had a bad fall and began to wet her bed again. After her next adjustment, she has remained dry.
    *

    Case #0419: Nine year old male who wet his bed almost every day of his life. After the first six months of chiropractic, he would be dry for the next day or two. A change in adjustments to the sacrum resulted in greater improvement. He is now dry for one-half to two-thirds of the nights between the adjustments.

    2) ADD, Enuresis, Toe Walking. International Chiropractic Pediatric Association Newsletter May/June 1997.

    *

    From the records of Rejeana Crystal, D.C., Hendersonville, TN. A six year old boy with nightly nocturnal enuresis (bedwetting), attention deficit disorder and toe walking. He walked with his heels 4 inches above the ground. The medical specialist recommended that both Achilles’ tendons be cut and both ankles be broken to achieve normal posture and gait. Chiropractic findings included subluxation of atlas, occiput, sacrum and pelvis…after 4 weeks of care both heels dropped 2 inches and the bedwetting frequency decreased to 2-3 times per week. His doctor could not believe how chiropractic care made such a change.

    3) Management of pediatric asthma and enuresis with probable traumatic etiology. Bachman TR, Lantz CA Proceedings of the National Conference on Chiropractic and Pediatrics (ICA), 1991: 14-22.

    *

    A 34-month-old boy with asthma and enuresis had not responded to medical care. More than 20 emergency hospital visits had taken place for the asthma attacks during a 12 month history. Three chiropractic adjustments were administered over an 11 day period and the asthma symptoms and enuresis ceased for more than 8 weeks. The asthma and enuresis reoccurred following a minor fall from a step ladder but disappeared after adjustments. After a two year follow-up, the mother reports no reoccurrence of the asthma or the enuresis.

    Additional Articles:

    Chiropractic management of primary nocturnal enuretic children. Reed WR; Beavers S; Reddy SK; Kern G; Proceedings of the National Conference on Chiropractic & Pediatrics. 1993 Oct. pp 64-82.

    *

    There were 46 primary enuretic children over a period of 14 weeks to assist in evaluating the influence of chiropractic care. Subjects were between 5 and 13 years of age. The were 31 in the treatment group, which received a spinal evaluation and/or adjustment at a minimum of every ten days. The remaining 15 subjects were control which came in with the same frequency but received a “sham” adjustment over an equal period of time. The children receiving chiropractic care averaged a 17.9% reduction in wet nights over the control group over the same period of time.

    Visit: : http://www.chiroweb.com/archives/17/04/04.html for an article on nocturnal enuresis

    References from Koren Publications’ brochure: Bed-wetting and Chiropractic:

    *

    Rosenfeld, J. & Jerkins, G.R. The bed-wetting child. Post Grad Med, 1991, 89, pp. 63-70.
    *

    Lynch, D. Nocturnal enuresis: an evaluation and management with an illustrated case. J Osteopath Med, 1991, June 10-9.
    *

    Young, D.E. & Young, R.R. Nocturnal enuresis: A review of treatment approaches. Am Fam Physician, 1985, 31, pp. 141-44.
    *

    Spitzer RL, Chairperson. Diagnostic and statistical manual of mental disorders. 3rd ed. American Psychiatric Association Task Force on Nomenclature and Statistics, Phila., 1980.
    *

    Forsythe, W.I. & Redmond, A. Enuresis and spontaneous cure rate: study of 1129 enuretics. Arch Dis Child, 1974, 49, pp. 259-63.
    *

    Bachman, T.R. & Lantz, C.A. Management of pediatric asthma and enuresis with probable traumatic etiology. Proceedings of the National Conference on Chiropractic and Pediatrics (ICA), 1991, pp. 14-22.
    *

    Blomerth, P.R. Functional nocturnal enuresis. JMPT, 1994, 17 (9), pp. 335-338.
    *

    Gemmell, H.A. & Jacobson, B.H. Chiropractic management of enuresis: Time-series descriptive design. JMPT, 1989, 12(5), pp. 386-389.
    *

    Reed, R.R., Scott, B., Reddy, S.K., & Kern, G. Chiropractic management of primary nocturnal enuresis. JMPT, 1994, 17(9), pp. 596-600.
    *

    LeBoeuf, C., Brown, P., Herman, A. et al. Chiropractic care of children with nocturnal enuresis: A prospective outcome study. JMPT, 1991, 14 (2), pp. 110-115. San Francisco Chronicles, March 5, 1992.
    *

    Moser, R. Bed-wetting: The wee hours of the night. Medical SelfCare, Jan/Feb 1990, p. 21.

    Colic

    Peer Reviewed Journals:

    1) Kinematic imbalances due to suboccipital strain in newborns. Biedermann H. J. Manual Medicine 1992, 6:151-156.

    *

    More than 600 babies (to date) have been treated for suboccipital strain. One hundred thirty-five infants who were available for follow-up was reviewed in this case series report. The suboccipital strain’s main symptoms include torticollis, fever of unknown origin, loss of appetite and other symptoms of CNS disorders, swelling of one side of the facial soft tissues, asymmetric development of the skull, hips, crying when the mother tried to change the child’s position, and extreme sensitivity of the neck to palpation. Most patients in the series required one to three adjustments before returning to normal. “Removal of suboccipital strain is the fastest and most effective way to treat the symptoms…one session is sufficient in most cases. Manipulation of the occipito-cervical region leads to the disappearance of problems….”

    2) The Short-term Effect of Spinal Manipulation in the Treatment of Infantile Colic: A Randomized Controlled Clinical Trial with a Blinded Observer, Wiberg JMM, Nordsteen J, Nilsson N. Journal of Manipulative and Physiological Therapeutics. October 1999; Vol. 22, No. 8, pp. 517-522.

    *

    This is a randomized controlled trial that took place in a private chiropractic practice and the National Health Service’s health visitor nurses in a suburb of Copenhagen, Denmark. One group of infants received spinal care for 2 weeks, the other was treated with the drug dimethicone for 2 weeks. Changes in daily hours of crying were recorded in a colic diary.
    *

    From the abstract: By trial days 4 to 7, hours of crying were reduced by 1 hour in the dimethicone groups compared with 2.4 hours in the manipulation group (P = 04). On days 8 through 11, crying was reduced by 1 hour for the dimethicone group, whereas crying in the manipulation group was reduced by 2.7 hours (P=.004). From trial day 5 onward the manipulation group did significantly better that (sic) the dimethicone group. Conclusion: Spinal manipulation is effective in relieving infantile colic

    3) Infantile colic and chiropractic. Nilsson N. Eur J Chiro 1985;33 (4) :264-65.

    *

    In this study (retrospective uncontrolled questionnaire) of 132 infants with colic, 91% of the parents reported an improvement, which occurred after an average of two to three adjustments, and within one week of care.

    4) Infantile colic treated by chiropractors: a prospective study of 316 cases. Klougart N, Nilsson N and Jacobsen J (1989) JMPT, 12:281-288.

    *

    In this study, 73 chiropractors adjusted the spines of 316 infants (median age 5.7 weeks at initial examination) with moderate to severe colic (average 5.2 hours of crying per day). The infant’s mothers were provided a diary and kept track of the baby’s symptoms, intensity and length of the colicky crying as well as how comfortable the infant seemed. 94% of the children within 14 days of chiropractic care (usually three visits) showed a satisfactory response. After four weeks, the improvements were maintained. One fourth of these infants showed great improvement after the very first chiropractic adjustment. The remaining infants all showed improvement within 14 days. Note: 51% of the infants had undergone prior unsuccessful treatment, usually drug therapy.

    Case Studies:

    1) A six week old baby with colic. International Chiropractic Pediatric Association Newsletter. May/June 1997.

    *

    Six week baby with colic could not sleep for more than one hour at a time and could not hold food down. C1 subluxation was located and adjusted. After first adjustment infant fell asleep before leaving the office and slept for 8 hours straight. The baby gained two pounds in one week. The child was seen three times per week for two months thereafter once a week. The colic symptoms never returned.

    2) Chiropractic management of an infant experiencing breastfeeding difficulties and colic: a case study. Sheader, WE, Journal of Clinical Chiropractic Pediatrics, Vol. 4, No. 1, 1999.

    *

    A single case study of a 15 day old emaciated Hispanic male infant experiencing inability to breastfeed and colic since birth, crying constantly, “shaking, screaming, rash, and vomiting during and after feeding.” The baby also had “increased distress” 30 minutes after feeding and had excessive abdominal and bowel gas since birth. The mother reported the infant was given a Hepatitis B vaccination within hours after birth.
    *

    Examination: during the examination the infant continuously cried, with high-pitched screams, and full-body shaking. Child had a distended abdomen with excessive bowel gas.
    *

    Chiropractic Adjustment: Adjustment was made to the first cervical vertebra. It was followed by significant reduction of crying, screaming and shaking. The mother commented on the “quietness” of her baby. On the second visit, two days later the mother commented, “This is a completely different baby”. The vomiting before and after feeding had ceased. Another adjustment was given. By the third visit, a “significant decrease of symptoms” was reported and complete remission of abdominal findings. Baby had been successfully breastfeeding since last visit. No adjustment was given. By the fourth visit 3 days later, the baby had been symptom free for 5 days at which time he received another Hepatitis B shot with the return of all symptoms to a severe degree. Adjustment was given but there was no reduction of symptoms. The patient was adjusted three more times over the next week with minimal reduction in symptoms. By the eighth visit, eight days after receiving the vaccination the child began to show marked improvement and by the 11th visit, no symptoms were noticed and no adjustment was given.

    3) Dr. Koren comments: the high-pitched screaming the child exhibited is a neurologic cry (cri-encephalique) which is due to irritation of the central nervous system. Children with neurologic damage should not be vaccinated.

    4) Colic with projectile vomiting: a case study. Van Loon, Meghan. J of Clinical Chiropractic Pediatrics. Vol. 3 No. 1 1998. 207-210.

    *

    From the abstract: The purpose of this case study is to discuss the chiropractic care of a patient who presented to the author’s office with a medial diagnosis of colic with additional projectile vomiting. The proposed etiology, the medial approach to colic, and the chiropractic care for this infant is detailed. Also examined is the connection between birth trauma and non-spinal symptoms.
    *

    Patient: A three-month-old Caucasian male presenting with medically diagnosed colic. Symptoms had been increasing in severity over the previous two months despite medical intervention.
    *

    Results: the resolution of all preventing symptoms within a 2-week treatment period is detailed. Care consisted of chiropractic spinal adjustments and craniosacral therapy.
    *

    Conclusion: This case study details the chiropractic management of a three-month-old male with a medical diagnosis of colic who also exhibited projectile vomiting. Complete resolution of all symptoms was achieved. Proposed cranial and spinal etiologies are discussed as well as the connection between birth trauma and non-spinal symptoms.

    5) Chiropractic care of infantile colic: a case study. Killinger LZ and Azad A. J of Clinical Chiropractic Pediatrics. Vol. 3 No. 1 1998. Pp. 203-206

    *

    This is the study of an 11-month-old boy with severe, complicated, late onset infantile colic. The infant had been unable to consume solid foods for a period of four months, and suffered from severe constipation. In addition, this subject demonstrated extreme muscular weakness and lack of coordination. The baby was unable to crawl, stand or walk and was greatly unresponsive to his surroundings.
    *

    [Note: child had been under medical care at the Rochester Medical Clinic, with no improvement in his condition.] Following upper cervical specific chiropractic adjustments for a subluxation of the first cervical vertebrae (atlas) there was immediate improvements in muscle strength, coordination, responsiveness, and ability to consume solid foods without vomiting.

    6) Chiropractic management of an infant patient experiencing colic and difficult breastfeeding: a case report. Cuhel JM, Powell M, Journal of Clinical Chiropractic Pediatrics Vol. 2, No. 2 1997. P. 150-154.

    *

    A twelve-day-old male was presented for chiropractic examination and treatment by his mother. The mother related difficulty in feeding on the right breast. She also stated that he seemed “fussy” and had been producing excess bowel gas. Palpation and motion studies revealed the occiput having a limited range of motion. The atlas was found to be fixed…with infant showing visible signs of distress on palpation of the right cervical soft tissue structures. A chiropractic adjustment was performed to the atlas: right atlas transverse using infant toggle-recoil technique. The mother breastfed the infant at the office immediately following the adjustment with no problems nursing on the right breast. Over the course of this patient’s care, additional chiropractic adjustments were performed. This course of treatment was met with limited success. This prompted the mother to add that an injection of Depo-Provera (contraceptive injection) had been administered 24 hours after the delivery. The parent was advised that this injection may have been a contributor to the infant’s problem. Acting on this advice the mother did not receive the next injection as scheduled. Nutritional supplementation was utilized, and adjustments were continued. The infant’s pattern of breastfeeding and bowel function normalized.

    7) Vertebral subluxation and colic: a case study. Pluhar GR, Schobert PD. J of Chiropractic Research and Clinical Investigation, 1991;7:75-76.

    *

    From the abstract: A case study of a three-month-old female suffering from colic with resultant sleep interruption and appetite decrease is presented. Child received three adjustments with two weeks between adjustments (T-7 and upper cervical area were areas worked on.) Symptoms of colic were relieved within the above brief period.

    8) Chiropractic adjustments and infantile colic: a case study. Hyman CA in Proceedings of the fourth National Conference on Chiropractic and Pediatrics. International Chiropractors Association. Arlington, VA 1994. A case study.

    9) The side-effects of the chiropractic adjustment. Arno Burnier, D.C. Chiropractic Pediatrics Vol. 1 No. 4 May 1995.

    *

    This is a case history of R.S., male, age 15, taken from the records of Dr. Arno Burnier of Yardley, PA. 81 South Main Street, Yardley, PA 19067, 215-493-6589. Dr. Burnier has written his “miracle” cases up, please write up your own and submit them for publication in the journals. Patient: E.L. male age 4 months. Physical condition: Uncontrolled crying and screaming during all waking hours for months. Chiropractic result: Immediate resolution of behavior following the first adjustment on 5/1/ 91. To date 2/10/94 the child is a normal healthy baby. Presenting vertebral subluxation: CO/C1 with occiput posterior on the right. Original adjustment: Right occiput ridge meningeal for 20 seconds, double notch meningeal contact on sacrum for 30 seconds. Structural adjustment of occiput in extension and right rotation.

    10) Birth Trauma Results in Colic. Krauss LL, Chiropractic Pediatrics Vol. 2 No. 1, October, 1995

    *

    From the abstract: The objective of this case study is to document the effects of chiropractic on poor sleeping patterns in an infants through a difficult time in an infant’s life. Many infants do not sleep well at night or nap time, and are then irritable throughout the day. These infants are often diagnosed as colicky. The term colic is a symptom commonly seen in infants under three months of age, characterized by paroxysmal abdominal pain and frantic crying. The mother, often as a reaction, is also irritable, exhausted, and, at times, depression and self doubt set in. Physical and emotional fatigue can make this time unbearable and bonding with child difficult. This is the study of a 9 1/2 month old female child with colic. The child was adjusted C1 on the right side (using an adjusting instrument) T4-T5 was manually adjusted and the sacrum was instrument adjusted. The following day the mother reported that the infant had slept through the night, a consistent 12 hours, and woke up happy and playful.

    11) Treatment of infants in the first year of life by chiropractors. Incidents and reasons for seeking treatment. Munck LK, Hoffman H, Nielsen AA. Ugeskr Laeger 1988; 150:1841- 1844.

    *

    This was a retrospective survey of 162 children cared for by doctors of chiropractic in their first year of life. The conditions seen by DCs were:
    o

    Infantile colic 73%
    o

    Curvature 8%
    o

    Bronchitis 3%
    o

    Allergy 2.5%
    o

    Sleep disorder 1.8%
    o

    Middle ear inflammation 1.8%
    o

    Eczema 0.6%

    Additional Articles:

    1) Chiropractic and Colic. World Federation of Chiropractic – May 1999.

    *

    A pilot study presented at the World Federation of Chiropractic’s 5th Biennial Congress in Auckland, New Zealand, suggests that chiropractic care is superior to placebo for the treatment of infantile colic. A total of 30 infants, aged 0 to 8 weeks, were included in the trial. Fifteen infants received chiropractic spinal manipulation for two weeks. The remaining subjects received placebo (“sham” non-functional ultrasound). Based on parental reports at 1-month follow-up, the study’s authors found “a statistically significant difference in the response to treatment by the experimental group as opposed to the placebo group.”

    2) “Chiropractic Care Conquers Colic” December 1998 issue of Country Living’s Healthy Living, Page 53.

    *

    An inconsolable newborn finds comfort after six sessions with a chiropractor; Nicholas Roe tells the family story When I Telephoned my doctor to ask if he thought it was safe (to see a chiropractor), he was ambivalent: Chiropractic would neither harm nor help. He told me that if it was colic, it would run its course in three months.” To summarize the article: Following the first adjustment, the child was more reactive and colicky, but mom followed the instructions given her by the DC and the baby calmed right down. “We had five more sessions with Stephen. Each lasted 20 minutes and Lucy (the infant!) really seemed to enjoy them. It completely changed what was fast becoming a nightmare. I would like to recommend to everyone with a colicky infant see a chiropractor. It certainly worked for us.

    Chiropractic Care found more Effective than Drug for Colic: http://www.chiroweb.com/archives/17/26/03.html

    References from Koren Publications’ brochure: Relief from Colic

    *

    Karofsky, P.S. Infantile colic. J Fam Prac, 1984, 19, pp. 107-116.
    *

    Colon, A.R. & Dipalma, J.S. Am Fam Phy, 1989, 40(6), pp. 122-124.
    *

    Mendelsohn, R. How to raise a healthy child…in spite of your doctor. New York: Balantine Books, 1984, p. 65.
    *

    Wootan, G. & Verney, S. Take charge of your child’s health. New York: Crown Publishers Inc., 1992, p. 208. Ibid. p. 212.
    *

    Jakobsson, I. Cow’s milk as a cause of infantile colic in breastfed babies. Lancet, 1978, 2, p. 437.
    *

    Klougart, N., Nilsson, N. & Jacobsen, J. Infantile colic treated by chiropractors: A prospective study of 316 cases. JMPT, 1989, 12, pp. 281-288.
    *

    Nilsson, N. Infantile colic and chiropractic. Eur J Chiro, 1985, 33, pp. 264-265.
    *

    Pluhar, G.R. & Schobert, P.D. Vertebral subluxation and colic: A case study. J of Chiropractic Research and Clinical Investigation, 1991, 7, pp. 75-76.
    *

    Biedermann, H. Kinematic imbalances due to suboccipital strain in newborns. J Manual Medicine, 1992, 6, pp. 151-156.
    *

    Gutman, G. Blocked atlantal nerve syndrome in infants and small children. ICA Review, July 1990, pp. 37-42. (Reprinted from Manuelle Medizin, 1987, 25, pp. 5-10.)
    *

    Fryman, V. Relations of disturbances of cranio-sacral mechanisms to symptomatology of the newborn. JAOA,1966, 65, p. 1059.
    *

    Webster, L. Personal communication with author. April 20, 1995

  28. Chris says:

    I only went through a half a dozen of that Gish Gallop.

    How come many of those papers are not listed on PubMed?

  29. Chris says:

    To clarify, to evaluate the quality of the papers one need to be able to find them.

    Since PubMed indexes the medical literature from around the world (including alt med, homeopathic and others) it is easier to find copies of the papers. In other words: if it is not indexed on PubMed the paper is harder to find, and in a sense does not exist.

    Just take your list and post the PubMed Identification Numbers (PMID). An example: PMID: 20389316

    Surely you can do that. Thank you.

  30. Harriet Hall says:

    jms082 said,

    “There are literally thousands of studies on chiropractic care (for adults and pediatrics), widely available to anyone with any interest at all in reading them.”

    Of course there are thousands of studies. We knew that. There was no need to regurgitate any of them, especially this cherry-picked list that does not include studies with findings unfavorable to chiropractic. Critics of chiropractic were already well aware of the studies you cite. They were interested, looked for evidence, found these studies as well as others, and read them. They were not impressed.

    The problem is, these studies may be many in number but they are poor in quality: they are a combination of poorly designed studies, findings that do not actually support chiropractic, and case reports that amount to little more than testimonials and often are poorly documented. Systematic reviews have failed to find credible evidence that chiropractic works for conditions like asthma and colic. Edzard Ernst, the world’s first professor of complementary medicine, led a group of serious scholars that evaluated ALL the published chiropractic literature and came to the conclusion 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.”

    When Simon Singh said chiropractic claims to treat conditions like asthma and colic were “bogus,” the British Chiropractic Association published a list of studies that were their “best evidence” to support those claims and science bloggers immediately debunked those studies and showed that they were no evidence at all.

    If you are really impressed by the list of studies you cited (and not just trying to baffle us with bullshit), I hope you will continue reading this blog and its archives, because it might help you understand what is wrong with your list and what constitutes real scientific evidence.

  31. pmoran says:

    What most of this research shows is that medical practice can seem to be a doddle, so long as you can pick and choose what to treat, and in your turn be selected by patients who have the right expectations.

    Spontaneous events, placebo-related influences, and practitioner’s confirmation biases can create a powerful illusions of treatment efficacy. And some good probably IS being done, just not how the chiropractor thinks, and not without risk, depending how these childrens spines are being treated.

    It is precisely this cocktail of influences that forced the evolution of properly controlled and randomised clinical studies in order to answer certain questions. Yet even now we are having to find extra ways of preventing the leakage of certain biases into published results.

    .

  32. Chris says:

    Harriet Hall:

    If you are really impressed by the list of studies you cited (and not just trying to baffle us with bullshit)

    Considering that I could not find the first half dozen in PubMed, I can assume we was trying the “baffle with bullshit” method of discourse.

    If you look above to a previous comment of mine, you will find an Edzard Ernst BMJ paper that details the analysis of papers on pediatric care presented by the British Chiropractic Association. They were found lacking in real evidence.

    “jms082″ seems to have ignored the issues raised by Dr. Ernst, including the deliberate absence of papers that did not support their premise.

  33. Chris says:

    Sorry, a mistype (will you ever allow an edit function!)… I meant to say “I can assume he was trying the “baffle with bullshit” method of discourse.”

    Thanks (this will look weird until my comment that has no URL links and only one blockquote comes out of moderation… unless this is randomly moderated!).

  34. Chris says:

    ROFL… mod software is amusing!

  35. Holy Cow, that’s a long post! Did someone call the Guiness Book?

    I love this one. Apparently the fact that Chiropractors see children with the below conditions is supposed to be evidence for….?

    ” This was a retrospective survey of 162 children cared for by doctors of chiropractic in their first year of life. The conditions seen by DCs were:
    Infantile colic 73%
    Curvature 8%
    Bronchitis 3%
    Allergy 2.5%
    Sleep disorder 1.8%
    Middle ear inflammation 1.8%
    Eczema 0.6%”

    It’s a little like writing really big when you have a 10 page paper due.

  36. Sam Homola says:

    Posted by Sam Homola

    “It is clearly time for the advocates
    of MT [manual therapy] in children to describe and delineate their approach and provide society and the profession
    with high-quality research evidence to substantiate claims of efficacy and safety. Until that time, as a
    clinician, I will continue to educate parents based on the lack of available evidence regarding outcome
    and the potential for harm. And most importantly, as a parent I will not expose my children to such
    interventions.”

    Manual Therapy in Children: Role of the Evidence-Based Clinician

    The Journal of Manual & Manipulative Therapy
    Vol. 14 No. 1 (2006), 7-9

    Peter A. Huijbregts, PT, DPT, OCS, FAAOMPT, FCAMT

    http://jmmtonline.com/documents/editorials/EditorialV14N1.pdf

  37. BillyJoe says:

    “The conditions seen by DCs were…”

    That way they can’t be accused of claiming that chiropractic works for these conditions. The ploy is to leave the impression that chiropractic can treat these conditions without actually saying so. Unfortunately, most of the time the ploy works.

Comments are closed.