Keep Chiropractors Away From Children

May 18, 2010

Recent articles published by a variety of Canadian newspapers have promoted chiropractic treatments for children suffering from colic, ear infections, and digestive problems.  These include a Canadian Press piece " Chiropractors treat infants: Gentle touch is key when taking care of babies " as well as an editorial in the Winnipeg Free Press by a chiropractor himself: " Recent results speak for themselves "

Such articles do a great disservice to children, their parents, and the practice of medicine in Canada, as report Clifford W. Beninger and Lauren O’Driscoll of the Centre for Inquiry Committee for the Advancement of Scientific Skepticism in the following article.

There is no reliable evidence to suggest these chiropractic treatments for children are at all effective, and futhermore they are based on a pseudoscientific theory.  In particular, there have been recent publications stating that corrections of spinal "subluxations" (misalignments of the spine), especially of the upper neck vertebrae close to the base of the skull, can dramatically improve ear infections in children (Doctor of Chiropractic R.Froehle 1996).  However, these "peer-reviewed" studies have been published mainly in non-mainstream chiropractic rather than scientific journals, as they all suffer from serious methodological and analytical problems that ensure they would never be published in reputable journals. 

As claimed by Froehle (1996), children diagnosed with ear infections who had previously been treated with antibiotics needed more chiropractic "treatments" in order to improve, when compared to children who had no prior exposure to antibiotics. However, in the words of Froehle herself with regard to this study: "Because the subjects in this study constituted a sample of convenience... no inference regarding extrapolation to the target or general population may be drawn ." (emphasis ours). 

In addition, all the treatments in this study were carried out by the same chiropractor, whereas in a proper scientific study this should have been done by a randomly selected group of different chiropractors.  Other studies such as that of Doctor of Chiropractic K. Erickson and colleagues (2006) as well as L. Saunders (2004) detail chiropractic treatment of a single patient with ear infection - effectively a sample size of one - which statistically and scientifically means absolutely nothing. 

As a result, two recent articles in reputable scientific journals state: "The subcommittee made no recommendations for complementary and alternative medicine as a treatment for OME (ear infection) based on a lack of scientific evidence documenting efficacy..."  (medical doctor R. Rosenfeld and colleagues 2004) and "Only very few randomized clinical trials of chiropractic manipulation as a treatment for non-spinal conditions exist. The claim that this approach is effective for such conditions (as ear infection) is not based on data from rigorous clinical trials." (Professor of Complementary Medicine, E. Ernst 2003).

In the WFP article Dr. Chatzoglou states

Where the article falls short, however, is the author then proceeds to interview so-called experts to provide a counter-point. Now, these are people who are not chiropractors, have no training in chiropractic and minimal knowledge of chiropractic research, who are of the opinion that there is zero evidence to support these claims

However, sound science and the scientific method (which generally seem to elude the ability of chiropractors to employ), as well as the expert opinion of true medical doctors, are the real cornerstones for the treatment of disease that we have today.  Anyone who attempts to refute this is ignoring the vast body of evidence and, albeit unintentionally, misleading the public.

In the world of mainstream medicine, new treatments undergo a rigorous review process before they are allowed on the market. If a new treatment or medication is not proven to be effective in carefully controlled clinical trials, then it is not approved for general use. Unfortunately, as we can see from above, this is not the case with the few published studies on the effectiveness of chiropractic spinal manipulations for the treatment of non-spinal ailments such as ear infections.  In Britain, after considerable scrutiny was placed on the dubious claims made by chiropractors, the General Chiropractic Council, the country's regulatory body for chiropractors, recently commissioned a comprehensive report on the scientific evidence for chiropractic care. Result: for pediatric care, there was good evidence that chiropractic treatment was of no use in the treatment of infant colic, and no reliable evidence at all regarding treatment of ear infections.
 
It is hardly surprising then that there is no evidence to support treatment of conditions such as ear infections, given that the theory these treatments are based on is unsound. There is also no good evidence that such subluxations even exist, no plausible mechanism connecting such problems with the immune system (or any evidence of such a mechanism), and no plausible explanation of how spinal manipulations should affect such disparate parts of the body as the ear and the digestive system.

Since the mystic D.D. Palmer founded chiropractic in the 19th century, medical science and biology have made considerable progress in isolating the pathways of disease, and the body's response to it. No such progress has been made in chiropractic theory, which continues to cling to thoroughly outdated "vitalistic" notions.

There is a very real concern that children are being denied the best medical treatment due to the publication (and public consumption) of newspaper articles and web sites that make extraordinary claims regarding the use of alternative therapies such as chiropractic for treatment of a host of health problems.  Parents should be as informed as possible when making health decisions for their children and it does not help matters that misinformation is so prevalent in the media today.  

Author Bios

Clifford W. Beninger
Clifford W. Beninger grew up in Sudbury, Ontario and completed a H.B.Sc. and M.Sc. in biology at Carleton University and in 1990 began his Ph.D. at the University of Ottawa, but conducted the research at the Canadian Forestry Service natural products lab in Sault Ste Marie Ontario. Since completion of his Ph.D. in Biology with a specialization in Chemical Ecology, he has worked for the USDA and University of Guelph on a variety of research projects.  He has 31 publications in peer-reviewed journals such as Chemical Ecology, Biochemical Systematics and Ecology and Food Chemistry.  Dr. Beninger currently lives in Ottawa and works as a consultant.  He is a member and science adviser of the Committee for the Advancement of Scientific Skepticism at CFI Canada.

Lauren O’Driscoll
Originally from Calgary, AB., Lauren O'Driscoll recently completed a BSc degree in criminology and psychology at the University of Toronto and a BSc- Psychology Honours degree at Macquarie University (Sydney, Australia). She has a number of years of research experience in both academic and clinical settings. Though her interests are fairly broad (pertaining to psychology and science more generally), Ms. Driscoll's research background is primarily within the area of social psychology. She is a member of the Committee for the Advancement of Scientific Skepticism at CFI Canada.

The Committee for the Advancement of Scientific Skepticism (CASS) is a national team which critically examines scientific, technological and medical claims in public discourse. Working with our expert advisers we address factual inaccuracies and misinformation in public debates by promoting evidence-based science. To achieve these ends CASS works within the infrastructure of Centre for Inquiry (CFI) Canada to co-ordinate campaigns with them and other interested parties.

References

Erickson, K. 2004. Case study in integrative medicine: Jared C. A child with recurrent otitis media and upper respiratory illness.  Explore 2: 235-237.
 
Ernst, E. 2003. Chiropractic manipulation for non-spinal pain – a systematic review. The New Zealand Medical Journal. 116:

Froehle, R.M. 1996. Ear infection: a retrospective study examining improvement from chiropractic care and analyzing for influencing factors.   Journal of Manipulative and Physiological Therapies 19:168-177.

Rosenfeld, R.M. Culpepper, L., Doyle K.J., Grundfast, K.M.  Hoberman, A., Kenna, M.A., Lieberthal, A.S., Mahoney, M., Wahl, R.A., Woods, C.R. and Yawn, B. 2004. Clinical practice guideline: Otitis media with effusion. Otolaryngology–Head and Neck Surgery 130:s95-s118.

Saunders, L.  2004. Chiropractic treatment of otitis media with effusion: a case report and literature review of the epidemiological risk factors that predispose towards the condition and that influence theoutcome of chiropractic treatment.  Clinical Chiropractic 7:168-173.