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What’s the truth about chiropractic for infants?




T
his post is the first for over a month, during which time I’ve been on the move in the UK, USA and Canada, teaching, seeing patients, and trying hard to remain focused, as the prospect of 3.5 months in Corfu (which I reached last week) loomed – just ahead – like a mirage of a cool oasis pool, to a thirsty desert traveller.
During this period a drama has been unfolding in the UK, as a major chiropractic organisation sued a journalist for libel. The BCA alleged that Simon Singh (writing in the Guardian newspaper) had alleged that chiropractic claims to successfully treat such conditions as ear infection and infant colic, were ‘bogus’.
The original article is no longer available on the Guardian site (doubtless for legal reasons), but numerous pro and con commentaries exist that contain extracts.
An example of an anti-chiropractic view can be found on the Quackometer website.
A more balanced view can be found on The Times Higher Education website.
An initial court ruling found in favour of the BCA, awarding damages, and Singh has now announced that he intends to appeal this judgement.
The whole furore has hinged on the interpretation by the judge of the word ‘bogus’, rather than on any attempt to analyse whether the claims by chiropractors have any foundation.
Prominent personalities (Stephen Fry, for example) have rallied to Singh’s defence, in the name of freedom of speech, while supporters of alternative, complementary and integrated health have been saddened by the failure of the process to allow intelligent analysis of the actual essence of the issue – can chiropractic care help conditions such as ear infection and infantile colic?

Do I have an opinion?
Well it seems to me that health enhancement involves a variety of possible influences – including biomechanical.
A brief search of available, easy to access, data, on research into chiropractic and health enhancement (outside of the obvious biomechanical, musculoskeletal arena) brought me the following articles that might be pertinent, and some of which might well have been part of the BCA defence of their position. Indeed as Singh is appealing the case, there might eventually actually be consideration of the real, underlying, in fact critical, question – can chiropractic enhance general health, and thereby encourage resolution of apparently unrelated health problems?

A brief literature search, limited to the last 3 years, using key words ‘chiropractic’ and ‘colic’ and ‘ear conditions’ yielded a selection of studies and reports, including the following:

  • Browning M Miller J 2008 Comparison of the short-term effects of chiropractic spinal manipulation and occipito-sacral decompression in the treatment of infant colic: A single-blinded, randomised, comparison trial Clinical Chiropractic 11(3:122-129.
  • Di Duro J 2006 Improvement in hearing after chiropractic care: A case series Chiropractic and Osteopathy 14:2
  • Hawk C Khorsan R Lisi A 2007 Chiropractic care for nonmusculoskeletal conditions: A systematic review with implications for whole systems research Journal of Alternative and Complementary Medicine 13(5):491-512
  • Hipperson A 2004 Chiropractic management of infantile colic Clinical Chiropractic, 7(4):180-186
  • Jamison J Davies N 2006 Chiropractic Management of Cow’s Milk Protein Intolerance in Infants With Sleep Dysfunction Syndrome: A Therapeutic Trial Journal of Manipulative and Physiological Therapeutics 29(6):469-474
  • Kingston H 2007 Effectiveness of chiropractic treatment for infantile colic. Paediatric nursing 19(8):26


The excellence or otherwise of these is not my focus, only the fact that they exist, which is enough to at least call into question Singh’s blanket use of the word ‘bogus’, with its’ connotations of fraud and deception.

The Hawk review paper (2007) contained a number of conclusions, amongst which were:
(1) The few reports of adverse effects of spinal manipulation for all ages and conditions were rare, transient, and not severe.
(2) Evidence from controlled studies and usual practice supports chiropractic care (the entire clinical encounter)
as providing benefit to patients with asthma, cervicogenic vertigo, and infantile colic. Evidence was promising for potential benefit of manual procedures for children with otitis media and elderly patients with pneumonia.

The Jamison and Davies paper (2006) was also insightful, since it makes clear that the ‘chiropractic treatment’ offered dealt with the issue of cow’s milk intolerance, with no mention of manipulation – only of a careful evaluation of possible dietary/invironmental influences that – if modified – might assist in health enhancement.
Singh seems to have failed to recognise that chiropractic is a health care profession, and that seeing a chiropractor does not necessarily mean that the patient will inevitably be manipulated.
This reminded me of a lecture I was asked to give on the subject of amino-acid nutritional supplementation, sometime in the mid-1980s, at Los Angeles College of Chiropractic, where I was a periodic visiting lecturer/tutor on soft tissue manipulation topics. Nutrition, lifestyle and general health maintenance was a major part of chiropractic training back then, and is today.

Since the judgement for the BCA has been appealed, it is to be hoped that at some stage the real issues will be evaluated in court.
Meanwhile the opportunity can be seen to exist for clarity to emerge as to just what chiropractic can offer in health terms, apart from its value in musculoskeletal care.

Conflict of interest note:
I am not a chiropractor, but have taught at some of the best chiropractic training colleges – and am happy to say that some of my best friends are DCs!

I once again apologise to blog readers for the lengthy gap in posts….caused by a tiring trip to the US and UK.
I am now back in blissful Corfu, where I am currently reviving!

13 Comments

  1. Thank you. My letter the Arch Dis Child was refused. I argued prescisely that to negate chiropractic was to negate similar advances in Osteopathy and Manual Medicine in Europe and Asia.
    J Ierano DC

  2. Hi Leon,

    Glad you’re back in your Meditteranean paradise! You could also list the number of books discussing specific indications and methods for treating children with many difficulties…dozens from many fields. The JMPT is coming out with a special pediatric issue this year (September I think) that will also cover the evidence behind this commonplace clinical reality that chiropractors successfully treat.

    S Cuthbert, D.C.

  3. Thanks for sharing such useful and great information, Chiropractic and exercise help restore and maintain health, function, activity levels and quality of life. Exercise training is effective in preventing back and neck pain an all types of pains.

  4. Nice article, but, its impossible to objectively define Chiropractic. When I lived in the american south, I was also a massage therapist, and still am. The Chiros are so superfluous, and are like churches. One I almost worked for only “treated” car accident patients, and this was because Florida (where I was) has liberal mandatory personal Injury Protection insurance. Everyone was either cured or booted at the 10,000 dollar mark.

  5. Hi Leon, having just come across your website (in 2016) I am interested to hear your thoughts on the outcome of the Simon Singh/ British Chiropractor Association libel case.

    The legal system ruled against the BCA and supported Simon Singh’s assertion that there is ‘not a jot of evidence’ to support the treatment of children by chiropractors. The legal action cost the BCA ‘reputationally, financially and politically’ http://www.theguardian.com/science/blog/2012/feb/22/simon-singh-british-chiropractic-association

    With the benefit of 8 years hindsight what do you think are the implication of this result for the critical question that you ask ‘ can chiropractic enhance general health’?

    • when chiropractic treatment (or any other manual approach) enhances or encourages normal function my experience is that it can enhance health … this does not mean all chiropractic treatment meets that requirement, but it certainly has that potential.

  6. If you aspire to work in an evidence based manner and the evidence (as assessed by the legal system in 2008) suggests that chiropractic is not an effective treatment for children then surely changing your opinion is a more appropriate response than continuing to endorse chiropractic?

    • My sense is that ‘evidence’ is capable of being selectively influenced (or even manipulated) if there is underlying bias – albeit possibly unconscious. In this instance (chiropractic care of children) I’m not convinced that the evidence is not selective and possibly biased. Personal experience therefore over-rides supposed evidence. This is not an ‘endorsement’ of chiropractic, more a refusal to deny what I have observed.

  7. To say at THIS STAGE of the development of natural health care science and particularly the ever-growing evidence base for chiropractic treatment of children…that there ‘is not a jot of evidence’ to support the ability of chiropractic to help children recover from a wide range of physiological dysfunctions and diseases — is to say 1) “I’ve read all the evidence and KNOW what it means”, and 2) that “I have an enormous scotoma for what the chiropractic evidence shows.”

    Take a look (with both eyes, biased anti-chiropractic styes removed):

    http://icpa4kids.org/Chiropractic-Research/

    • Dr Cuthbert makes the point clearly. The current witch-hunt against chiropractic – and osteopathy – by people such as Singh, Ernst and others, is biased and selective. They ignore contrary information. That there are ‘good and ethical ‘DCs and DOs as well as some that are less so, is just as true as the statement that ‘some’ researchers are biased, blinkered and dishonest – while others are not.

  8. You both seem to be (deliberately?) ignoring the fact that the BCA unequivocally lost their legal case. Which was the point of my original question. I understand that you have a strong belief in chiropractic and feel that sceptics are biased and engaged in a witch hunt.

    However the three senior high court judges who indepentantly assessed the strength of the evidence from both sides decided that there was no evidence to support the chiropractic treatment of children.

    The title of your article, Leon, is ‘The truth about chiropractic.’ I was interested to know if your beliefs have changed as a result of the BCA’s failed libel action. I guess the answer is no.

    • I repeat: the evidence I have seen over the past 50 years supports the value of chiropractic in appropriate situations, for children or adults.
      I have also been around long enough to have a degree of skepticism over (some) legal findings.
      I neither endorse not condemn chiropractic unequivocally – and hold the same perspective for mainstream medicine and osteopathy. The right treatment -in the right setting – produces a desirable response from the body’s self-regulating mechanisms -and it is those mechanisms that lead to healing NOT the particular brand of health promotion.
      I doubt we will make any progress in this discussion by restating our positions again and again.

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