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Is Chiropractic safe for my child?

Recently I was asked "What are the risks of chiropractic care for my child". I conducted an extensive Medline search covering the years 1966-1997, using the terms "chiropractic" and "children", so that I may find reports of adverse events which may have occurred in children as a result of chiropractic care. In more than 31 years of medical literature, I have only found one reported case of damage to a child as a result of chiropractic care and even this case is speculative at best.

According to this report a child with a rare spinal tumor presented to a chiropractor with reports of torticollis (Wry Neck). It is alleged by the author that tissue damage (necrosis) found in the area of the tumor, discovered during autopsy, was caused by 'chiropractic manipulation'. However, there exist no scientific proof that this damage was the result of a chiropractic adjustment. Speculation by this author is irresponsible. This particular tumor (an astrocytoma) has been commonly reported to be a congenital condition in numerous medical publications. Additionally the credentials of the person performing the manipulation are not discussed. While it may seem common sense that only chiropractors would be credited with making chiropractic adjustments, such is not the case.

Terrett has done an extensive review of literature, going back to 1934, and found that of 78 cases of vertebrobasilar stroke (none of which occurred in children) following ‘chiropractic manipulation’ 36% were not performed by chiropractors. You might then ask who is performing such manipulations, which are incorrectly being attributed to chiropractors? The answer is an Indian barber, a kung-fu practitioner, a blind masseur, medical doctors, nurses, osteopaths, physiotherapists, victim’s wives’, and persons doing self neck wrenching manipulation. I find that it is sad that such irresponsible reporting by so-called responsible medical researchers is printed and is misleading the public.

Estimates of risk of chiropractic adjustment are extremely low. I will use some figures to illustrate this point:

• 30% Incidence of adverse drug event in hospitalized patients. Anderson, 1992
• 10% Incidence of psychosis due to corticosteroid therapy. Havey, 1984
• 7-10% Incidence of hepatitis due to blood transfusion. Stehling, 1986
• 6.1% Incidence of infection in postoperative orthopedic patients.
  Fernandez et al., 1992
• 3.76% Incidence of nosocomial infection in hospitalized patients in the U.S.A C.D.C., 1991
• 1-2% Incidence of paralysis due to neurosurgery of the cervical spine. Rocha vs. Harris, 1987
• 0.7% Incidence of esophageal perforation during anterior approach cervical spine surgery. Van Berge Henegouwan et al., 1991
• 0.3-0.9% Incidence of death due to cervical spine surgery. Graham, 1989
• 0.057% Incidence of seizure due to D.P.T. Vaccine. C. D. C., 1994
• 0.012% Incidence of breast cancer due to mammography.
  Bushong, 1984
• 0.005-0.015%Incidence of death from radiation-induced malignancy due to X-ray exposure of 1-RAD. Bushong, 1984
• 0.0025-0.01%Incidence of death due to radiocontrast media.
  Atkinson & Kaliner, 1992
• 0.0008-0.001%Incidence of death due to allergic reaction to anesthetic agents. Anderson, 1992
• 0.00002-0.00008%Incidence of death due to lightning in the U.S.A. Eriksson & Ornehult 1988
• 0.00001-0.00003%Incidence of serious neural complications due to cervical manipulation. Cyriax, 1978, Gutman, 1983

As you can see, the risk of injury as a result of chiropractic adjustments is extremely low for adults and even smaller for the pediatric patient. With only one questionable report of injury to a child following chiropractic care in 31 years of medical literature, potential risk is so low it can not be accurately estimated.

Originally Printed in: I.C.P.A. Newsletter September/October 1997

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