Chiropractic Care for Kids?
"Dr. P," my exasperated patient said at the end of a visit that revealed her 3-year-old's fourth ear infection. "I have a friend who took her child to a chiropractor. He manipulated her neck and poof! no more ear infections. Do you think I should go to one?"
I was horrified at the thought. Let me explain why.
On September 18, 1895, D.D. Palmer was a 50 year old "magnetic" healer, who used the body's "magnetism" to rid itself of disease. He was visited by Harvey Lillard, the janitor in his building, who was looking for relief from 17 years of hearing loss which, he related, began after he heard something pop in his back.
In the course of his examination, D.D. Palmer noted a lump in the middle of Mr. Lillard's back. What if the deafness and the lump were related? Indeed they seemed to be as, after a number of gentle thrusts to the lump, Mr. Lillard's deafness was purported to have been cured.
D.D. Palmer theorized that misplaced spinal vertebrae ("subluxations") caused pressure on the nerves, which then diminished nerve flow to the body, which then caused disease and dysfunction. Eureka! He was certain he had cracked the disease code and wrote: "A subluxated vertebrae . . . is the cause of 95 percent of all diseases. . . . The other five percent is caused by displaced joints other than those of the vertebral column." If only the spinal column were correctly positioned, the body would be healthy.
In 1897, he founded what would later be called the Palmer School of Chiropractic in Davenport, Iowa. A new way of healing was born.
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Fast forward to the present. A survey of Consumer Reports readers, published in May 2000, found that 35% of 46,860 respondents had used alternative therapies for a variety of problems, of whom 40% had chiropractic treatment for back pain. By all accounts, most were very happy with their chiropractic care (reporting higher satisfaction ratings than I'll ever get as a pediatrician!).
Chiropractors (aka "doctors of chiropractic" or "chiropractic physicians") classically treat neuro-musculo-skeletal complaints, including back pain, neck pain, pain in the joints of the arms or legs, and headaches. Most chiropractic treatments address these issues via manipulation of the spine. Chiropractors also tend to embrace a holistic health perspective, emphasizing natural, drug-free, non-surgical treatments, and healthy lifestyle changes.
Many chiropractors treat children, but not just for backaches. Here are some of the pediatric conditions which some chiropractors claim they can help: ADD/ADHD, asthma, autism, bed wetting, "birth trauma," hypertension, cerebral palsy, Crohn's disease, colitis, colic, the common cold, constipation, ear infections, epilepsy, headaches, low immunity, sinus and respiratory infections, eczema, psoriasis, sleep disturbances, stuttering, tonsillitis, Tourette's Syndrome. Impressive list! These guys must be on to something.
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Let's take stock: chiropractic is safe, effective, natural, holistic. So why did I react with horror to that mom in my office? Is there a problem here? In a word: yes. Or two words: big problems. Let me list my top 10 most serious gripes about chiropractic care:- Despite all that has been learned about disease and the human body in the past 110 years, there has been no refinement or advancement or proof of D.D. Palmer's original hypothesis. Given what we know today, it just makes no sense to believe that reduced nerve flow due to subluxations is the root of all evil (or even any evil). Rather, it's an article of faith, more of a religion than a science, since chiropractors have never bothered to try to prove it with scientific studies.
- Even if one buys the subluxation hypothesis (which you shouldn't), gentle chiropractic manipulations would not change a dislocated spine.
- I have never had a patient who went to a chiropractor and was given a clean bill of health. There is always some spinal misalignment. Pretty fishy to me.
- When chiropractic care has been put to the test of scientifically valid studies (i.e., prospective, randomized controlled trials with objective observers who are 'blind' to the treatment), its benefits are minimal (for back pain, similar to that of physical therapy) or non-existent (similar to a placebo effect - which I will discuss in my next post).
- It exposes people (and, of course kids) to needless x-ray exposure.
- Because of their "natural" bent and indifference to scientific evidence, many chiropractors do not support childhood immunizations. (You can imagine how I feel about that.)
- Some chiropractors dishonestly use the normal "popping" noise (akin to cracking a knuckle) of the manipulated spine to demonstrate spinal realignment. Not even chiropractors believe the popping sound to be of any significance, but you couldn't prove that by what they have said to my patients.
- Eschewing science, some chiropractors veer headlong into the ozone of quackery, endorsing such dubious diagnostic tests as biological terrain assessment, computerized nutrient deficiency testing, computerized range-of-motion analysis, contour analysis, cytotoxic testing, electrodermal testing, functional intracellular analysis, hair analysis, herbal crystallization analysis, inclinometry, iridology, live blood cell analysis, nutrabalance, pendulum divination, reflexology, saliva testing, thermography, a Toftness device. You can guess how much scientific evidence there is for the validity of any of these.
- Ditto to other treatment techniques beyond their usual spinal manipulations: activator methods, applied kinesiology, bioenergetic synchronization, chelation therapy, colonic irrigation, cranial or craniosacral therapy, laser acupuncture, magnetic or biomagnetic therapy, neuro-emotional technique.
- To be fair, there are many chiropractors who limit their care to musculo-skeletal aches and pains, for which at least an argument can be made (although not by me) for some efficacy. But many do not. Once you go down the road of faith rather than science when it comes to healing, this is what you get. It's a sorry state of affairs.
This has turned into a rant and has gotten kind of long. I guess what I view as quackery - even if it is relatively safe - bugs me more than I thought, especially when it is being inflicted on kids. So I'll end here and next week address the important question: if chiropractic is as ineffective as I say, why do so many love it so much?
Balon, J, et al. New England Journal of Medicine. 10/8/98 http://content.nejm.org/cgi/content/full/339/15/1013
and Provision of an Educational Booklet for the Treatment of Patients with Low Back Pain."
http://content.nejm.org/cgi/content/full/339/15/1021
Related Topics:
- WebMD Video: What Can a Chiropractor Do for You?
- Chiropractic Care and Back Pain
- Share your thoughts on our Alternative Health discussion.
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23 Comments:
You are very tough on chiropractors. I have a lot of friends who swear by them. Could you be jealously protecting your own turf?
Parents don't want proof, they want someone who will spend some time with their kids and offer optimistic outcomes. That's why they love chiropractors.
Personally, I don't understand why parents would subject their kids to treatments beyond what is offered by 21st century traditonal medicine, which gets better and better every year, unlike chiropractic which hasn't changed in 110 years.
Re #:
1. Really, who cares about what DD originally theorized? There have been fantastic scientific advancements in chiropractic.
2. What about all the research that proves otherwise? Isn't it really your word against others?
3. There are many people who have gone to chiropractors and received clean bills of health. Just because you aren't aware of it doesn't make it nonexistent.
4. Honestly, what clincal and randomized studies are you referencing? That is a biased statement. I know a high school-aged young man who avoided scoliosis surgery ONLY because of his chiropractic care. (CBP Technique, a la Don Harrison, PHD, DC, MSE)
5. And you are to determine if the X-rays are needless...when you haven't examined each of these people? I assume you make this statement as an "informed" individual- after having considered the Linear-No-Threshold Radiation Model?
6. To each professional their own opinion regarding ANYTHING- including immunizations.
7. "Some chiropractors dishonestly use the normal "popping" noise...to demonstrate spinal realignment," -- They do? I happen to know more than a few DC's, and none of them have ever suggested that. ACTUALLY, they have all explained to patients it has nothing to do with realignment. Again, your word against theirs', and it's their words you're twisting.
8. Dr. P., in all reality, there are more than a few "medical" protocols that have been questioned over the years. While I'm not taking "sides" on the procedures listed, you really can't have a valid argument about CHIROPRACTIC when you aren't arguing CHIROPRACTIC. Either stick to the point- chiropractic and the vertebral subluxation complex, or get off onto a subject you know a little more about.
9. See above. Then see www.idealspine.com . If you want research, you'll get more than you and your unsupported reasoning ever wanted.
10. Check the website, or better yet, ask a DC to explain to you what you apparently don't understand about the human body and chiropractic; it's ALL science, no faith and fairytales needed.
10.
I don't know about others, but my chiropractor does imply that the cracking noises in my neck and spine are a good sign. Is he misleading me?
After a horrible 9 MONTHS of chronic ear infections, my pediatrician referred us to an ENT who wanted to place tubes in my daughters ears. He wanted to schedule us for surgery the next day. I needed to think a little about the tubes and research side effects. While at my regular chiropractic visit* my chiropractor offered to adjust my daughter at no cost for 6 weeks, claiming that she could rid us of the awful ear problems that my baby girl was having. I admit, I was reluctant since my daughter was so young and I trusted that her pediatrician was making the best choices for our daughters health. I decided to go with the less invasive chiropractic, thinking that in 6 weeks we would be scheduling surgery. Well, one year and one month from the day we started chiropractic care is today and I can say that my daughter has had NO ear infections! It is a wonderful feeling. I would suggest finding a GOOD chiropractor from a friends referral before subjecting your babies to anesthesia and surgery....what will it hurt? From what I have read, maybe just your pocket books.
*(I had massive migraines and chose chiropractic care, which completely eliminated my migraine problem.)
I am a chiropractor and I am proud, although not surprised, to see all the support offered by the public in regard to your ignorant statements concerning my profession. You base your conclusions on biased opinion and not personal experience or the obvious positive experiences from thousands and thousands of satisfied patients that utilize chiropractic care each and every day. Let us focus on the needs of the patient and cooperate with each other for the benefit of the patient instead of commenting on that which you do not understand. As a side note- I personally work cooperatively with several medical doctors including a multitude of specialists and NONE of them seem to share you dishearting opinions of chiropractic.
Wow!
It is really unfortunate you feel so intimidated by something you are so ignorant of. Yes, just like there are bad doctors there are also bad Chiropractors. There are also good doctors and chiros as well. My 6 month old daughter occasionally sees my Chiropractor who is also a personal friend, What is interesting is that you think that pediatric manipulation is forceful. Nothing could be farther from the truth. She has had 4 adjustments since she was 2 months old and I am present at every one. Chiropractic care is homeopathic. There is a time and place for traditional medicine as well. You have to find the balance. My pediatrician was telling me that babies who don't poop for 3 days are fine but I knew she was miserable. My Chiro showed me some pressure points on my daughters stomach beyond the "tummy circles" to help her go...usually within 5 minutes. And when she was holding her leg funny after being in a baby carrier incorrectly it was the Chiro who showed me some gentle stretches and circles to even out her legs. What terrible experience did you have to make you so negative. Find a reputable Chiro who is trained to work on children. It's that simple.
I have recently begun a six week regimen of chiropractic treatment. I have only had two of approximately 18 adjustments. And I have to say, there is something to this whole "spinal manipulation" thing. Medical issues I have had for years have already started resolving. Maybe Dr. P should try this before criticizing it so harshly. And wouldn't the whole statement about chiro-care not changing in 110 years argue more in its favor than against it? Once you find the buried treasure you don't keep digging up the dirt.
The research articles you cited are10 years old. It's time you read some recent literature, and met some evidence based chiropractors. Would you appreciate modern medicine judged by pre-Flexner standards? Or perhaps you'd rather be benchmarked by surgeons who continue to perform procedures proven by the literature to be ineffective (but lucrative).
There are certainly chiropractors who are dishonest, more religious than scientific and dinosaurs in their thinking. However, many of us are performing an excellent non-surgical musculoskeletal service backed by good clinical information in a patient-centered approach without subscribing to the subluxation nonsense. Don't throw out the baby with the bathwater.
By the way, chiropractic history illustrates that Palmer purposely tried to make it sound more religious than scientific since it would be easier to exist as the Christian Scientists did and stay out of jail for 'practicing medicine without a license.'
Don't knock chiropractors until you have tried them for a substantial amount of time. I used to have a sinus infection and/or cold EVERY SINGLE MONTH for three years straight, mostly related to chronic allergies. I started going to the chiropractor and I have had one cold and one infection in the last 5 years. It works. And after giving birth to my daughter, she has started chiropractic care as well. She made it through the entire fall/winter/spring without any colds or illness. Why would I opt for modern medicine that carries warnings about side effects can include death as opposed to gentle moving of the spine? No one dies from an adjustment, but they die in surgery and from drugs every day.
I agree with Dr. P on this subject, chiropractors are not real doctors, they barely go to any kind of medical school and they always want a big paycheck and always want you to come back. Once you start going you cannot stop, so they say. But the beauty of America is if you think they are miracle workers use them and if you don't you don't go, to each his own.
I will have to say that the comment on chiropractors are not doctors is just down right ridiculous and shows how ignorant you are to Doctors of Chiropractic (DC). You should take time and do a lil research to see just how similar a typical DC education is compared to an MD. You should check this website http://www.drgrisanti.com/mddc.htm if you would like.
ahhh, it's jealousy amazing. Some MDs are so worried about their piece of the pie that they forget about patient care and healthy living! Are all of the drugs that society is taking really "curing" anything when all we get is more and more sickness and disease. Why don't we go back to letting the body heal itself, from the inside out, instead of injecting, pill popping and removing organs. Advances in medicine - ha! Remember to read ALL of the fine print on all of those drug packages!
Dr P, you are a very intelligent human, and probably a good doctor, but you are ignorant when it comes to the human body. I am a chiropractor, and the chiropractic school that I went to was harder than medical school. My best friend is a MD in Texas, and we would exchange ideas while I was in school. Something that I learned was that medical school is spending more time with biochemistry than the human body. Makes sense, they write scripts to their patients and they better know what each patient is putting into their body, especially the side effects (listen to any commercial on TV that has a list that is longer than the commercial itself about side effects). Look at Center for Studies in Health Policy in Washington D.C. about the curriculum that is taught at both schools, and then make a statement.
I will have to say also that I work closely with many medical practitioners in my area, and they are happy to have a different perspective on what I see. Chiropractors see the body as a whole, and not just in parts. We try to get to the root of the problem, and not mask off the pain by covering up the symptoms.
Also in your article you talked about not having any scientific evidence backing what is done with chiropractic, that is a very ignorant statement. Chiropractic has more evidence backing what each DC does than MDs do!
For instance, it just came out last month that chiropractic adjustments reduce blood pressure! What are the side effects with it, compared to the medicine approach? With DC care, the side effects are all positive (sleeping better and less musculoskeletal pain to name a a few). In the medicine approach, the side effects are insomnia, cold hands and feet, tiredness or depression, increase blood sugar, impotence, skin rash, loss of taste, a chronic dry, hacking cough, and in some instances, kidney damage, palpitations, swollen ankles, constipation, headache or dizziness, and these are just a few of the side effects. Oh, but wait you can take other medication to help stop these symptoms, but these may have side effects as well....But don't worry we have more medication to stop those symptoms as well.
Before I talk in circles I will move to what all health care providers should be doing! Be on a health care team for each patient! To me it just seems that a patient needs to have a well rounded health care team, that is trying to get the patient the best possible health as can be. We all need to get a good MD, Dentist, Chiropractor, pediatrician, etc to work together to make our life as healthy as possible.
why not have a "health care team", instead of a "sick care team"!
THE TRUTH IS OUT THERE!!! www.youtube.com type in chiropractic and high blood pressure or chiropractic and Montel Williams or chiropractic and back pain. DCs have been around 100+ years and are just getting noticed. Make your own choice! On other thing one should think about is MD DO DC ect... study the same human body (it doesn't change) the same diseases (they don't change also) Its not only about back pain. Check it out ... "Try Chiropractic" STAY HEALTHY AND BE SAFE!
As a chiropractor, I personally do not choose to work on children under the age of 12. I refer those patients to D.C.s whom have chosen that as a specialty. My son has been vaccinated, but many chiros I know choose not to. Look into the the national association for chiropractic medicine for details on how I and many like me practice. OK, commence the stone throwing fellow chiros
The chiropractor my family and I see is far better than any MD. He has eliminated allergies and asthma in my son, removed sensitivity issues in a few of my teeth, and he removed a pain in my foot from stepping wrong off of a step. He only sees me when I have a problem and then he fixes that problem and I don't need to see him again until I have another problem. I do have to admit that there are good chiropractors and bad chiropractors just like there are good MD's and bad MD's. You just need to ask around and visit some chiropractors until you find a good one.
I was born with scoliosis and severe cervical kyphosis. The orthopedic doctor my Mum had examine me recommended taking me to a pediatric chiropractor. He wanted to see if regular chiropractic care would help my spine, preventing much of the pain until I was old enough for surgery.
He was right, and it did.I went to the same orthopedic chiropractor for the next 6 years, until I finally grew large enough to have the surgery without undue risk. During that time, I was virtually pain-free, and yes, I can remember the last two years of it.
8 years after having surgery, my neck began curving backwards again, causing me severe pain and uncontrollable migraines. So, Mum took me back to the chiropractor. I've been going ever since, and, while my neck and back will never be normal, I do not have nearly as much pain as I would. I also do not suffer from constant migraines now. They are only occasional, and usually when I've been stressed more than usual.
Chiropractors DO work. It's just a matter of finding one that is a 'true' practitioner, just like with any other doctor.
I was in a major car accident and fractured my pelvis and back at C5, C6. After years of pain, drugs and injections, my neuro wanted me to have surgery. I cried for days. My friend dragged me kicking and screaming to a chiro and he promised me relief. I told him he was nuts but would give him two weeks before I scheduled surgery. Well to my surprise 99.9% of my pain has been gone for two years. I go twice a week and now my husband and daughter go too! We have benefited in many ways!! I will never give up chiropractic care...it saved my life!
I am a practicing pediatrician and I am also sickened by the claims that chiropractors make. It ALL comes down to one thing. PROVE what you do is ANY better than placebo. Do this and you will have my confidence.
Unfortunately there is no PROOF. Hence, time alone works better than chiropractic care. And at least time is free...
As a practicing chiropractor I see the proof every day as my patients get better...without drugs...without surgery. .... I see many children who benefit from chiropractic care. Parents are upset after their baby is subjected to months and months of repeated antibiotics for ear infections with just the same result... more ear infections! We remove the pressure off the spine and nerves, which allow the muscles around the eustacian tubes to relax, which allows for proper drainage of excess fluid which means less ear inflammation (infections)! As a practicing pedatrician you should try it your way and then do a study after a couple of rounds of antibiotics don't work... Send them to a good pediatric chiropractor. You might find it to be a good relationship to have! Isn't helping our patients feel better, function better, and be less sick what we are supposed to be doing?
There were several people who responded saying that they were pediatricians and remarked that chiropractic should prove that these adjustments work. I agree, chiropractic should have more research into quality of life and its effect on the immune system. However, please show me the placebo controlled research that shows that antibiotics are effective for childhood ear infections. According to the American Academy of Pediatrics and the American Academy of Family Practice watchful waiting should be the medical choice for ear infections initially. That is not what's happening in my neck of the woods. So, how come the MD's, who purport to be the guardians of health science, practice so unscientifically. A few years ago there was a study that showed that only 15% of medical treatments were scientifically supported and it went on to say that only 1% of medical journal articles were scientifically sound. People who live in glass houses...
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