Chiropractic Care of Children

            Chiropractic techniques are not limited to any particular group. We see patients of all ages, sizes, genders, ethnicities, and so on. So, is the care of children “different” than chiropractic care applied to adults? If so, how?

            There are studies that review the treatment of musculoskeletal (MSK) conditions such as low back pain, non-MSK conditions such as asthma, and chiropractic care of infants, adolescents, and teenagers for a variety of conditions. The management techniques utilized by chiropractors for children vary across the profession, but typically, they are modified methods of those applied to adult patients. When one thinks of “chiropractic care,” the immediate image is that of spinal manipulation where a high velocity, low amplitude “thrust” is made and joint cavitation occurs (the release of gas creating a cracking sound similar to knuckle cracking). Chiropractic treatment can also include dietary advice, nutritional or herbal supplement recommendations, posture correction, exercise training, and the use of physiological therapeutic modalities (like electric stim, light, ice, heat, traction, ultrasound, and more). Behavioral counselling may be included, depending on the patient's condition and the individual training the chiropractor has focused on, especially on a post-graduate level. Chiropractors, like many health care providers, have post-graduate board certification options, of which pediatrics is one of many. Looking at research for children and chiropractic, here is what the current literature base supports:

1.      Pediatric care: There is evidence that chiropractic methods, when properly modified and applied, are safe. However, more research is needed to determine what the current practice model should be for this patient group.

2.      Children & adolescents: There is currently research support for treatment of this patient population for some MSK conditions, particularly low back pain. Again, additional, high-quality studies are needed to further support this category.

3.      Non-musculoskeletal care (children & adolescents): Conditions such as colic, otitis media, asthma, nocturnal enuresis (bed wetting), and attention deficit hyperactivity disorder, all require additional high-quality studies before firm conclusions can be made. At present, there is little data to support or refute the effectiveness of chiropractic care for these conditions. However, the authors do recommend that a chiropractor may play a role on the pediatric healthcare team. They suggest that it is appropriate to utilize a four to six treatment “trial” to determine effectiveness of care for a colicky infant where all other serious diagnoses have been excluded. Similarly, in cases of enuresis and asthma, chiropractic may have a role on the management team. A call for more research is a common recurring theme for the management of non-MSK conditions.

4.      ADHD in children and adolescents: One focused systematic review reported the need for more high-quality research in this area before conclusions can be made either for or against the utilization of chiropractic care for ADHD.

5.       Possible adverse effects: In review of (again) limited studies in this area, chiropractic care appears to have little negative issues associated with it. Serious side effects are reported as “rare.”

           

            Bottom line: Though more research is needed, in the absence of underlying pathology, chiropractic care may be considered as part of the pediatric management team for a four to six visit trial to determine treatment effectiveness.