On 8 March 2019, the Council of Australian Governments (COAG) Health Council (CHC) noted community concerns about spinal manipulation on children performed by chiropractors and agreed that there was a need to consider whether public safety was at risk.
On behalf of the CHC, the Victorian Minister for Health, the Hon. Jenny Mikakos MP, instructed Safer Care Victoria (SCV) to undertake an independent review of the practice of chiropractic spinal manipulation on children under 12 years. The findings of this review are to be provided to the Minister for reporting to the CHC. To provide expert guidance and advice to inform the review, SCV established an independent advisory panel. The panel included expertise in chiropractic care, academic allied health, health practitioner regulation, healthcare evidence, governance, paediatrics and paediatric surgery, and musculoskeletal care, and had consumer representation.
The main conclusions were as follows:
- … spinal manipulation in children is not wholly without risk. Any risk associated
with care, no matter how uncommon or minor, must be considered in light of any potential or likely
benefits. This is particularly important in younger children, especially those under the age of 2 years in
whom minor adverse events may be more common. - … the evidence base for spinal manipulation in children is very poor. In particular, no studies have been performed in Australia … The possible, but unlikely, benefits of spinal manipulation in the management of colic or enuresis should be balanced by the possibility, albeit rare, of minor harm.
The main recommendation was straight forward: “Spinal manipulation, as defined in Section 123 of National Law, should not be provided to children under 12 years of age, by any practitioner, for general wellness or for the management of the following conditions: developmental and behavioural disorders, hyperactivity disorders, autism spectrum disorders, asthma, infantile colic, bedwetting, ear infections, digestive problems, headache, cerebral palsy and torticollis.”
The Chiropractic Board of Australia nevertheless decided they would re-start manipulationg babies. On 11/6/2024 The Sydney Morning Harald reported:
Chiropractors have given themselves the green light to resume manipulating the spines of babies following a four-year interim ban supported by the country’s health ministers. In a move slammed by doctors as irresponsible, the Chiropractic Board of Australia has quietly released new guidelines permitting the controversial treatment for children under two. The Royal Australian College of General Practitioners (RACGP) hit out at the decision, saying there was no evidence supporting the spinal manipulation of babies and children and that the practice should be outlawed. ‘‘There is no way in the world I would let anyone manipulate a child’s spine,’’ said Dr James Best, the college’s Specific Interests Child and Young Person’s Health chair. ‘‘The fact that it hasn’t been ruled out by this organisation is very disappointing and concerning. It’s irresponsible.’’ …
Subsequently, it was reported that the federal health minister has intervened in the Chiropractic Board of Australia’s controversial decision to allow practitioners to resume spinal manipulation of children under two and is seeking an urgent explanation.
As pressure mounts on chiropractors to ditch the treatment, federal Health Minister Mark Butler confirmed on Thursday that he would also raise the issue with his state and territory colleagues at a meeting of health ministers in South Australia on Friday.
“The Health Minister is writing to the Chiropractic Board seeking an urgent explanation on its decision to allow a resumption of spinal manipulation of infants under two, in spite of two reviews concluding there was no evidence to support that practice,” a spokeswoman said.
___________________________
This course of events can only be surprising to those who are not familiar with the chiropractors’ general attitude. Chiropractors have always put income before ethics and safety. This, I fear, is not a phenomenon confined to Australia or to the care of children but one that beleagues this profession worldwide from the days of DD Palmer to the present.
31 Responses to Australian chiropractors are “irresponsible” trying to put their financial interests before the health of babies
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“Chiropractors have always put income before ethics and safety.”
I didn’t see where it was calling for spinal manipulation for those under two or that this action was for financial reasons.
“…modify all care and treatment (including technique and force) to suit the age, presentation and development of the patient.”
@ DC re “I didn’t see where it was calling for spinal manipulation for those under two”
QUOTE
“in November the Chiropractic Board of Australia put out a statement to ‘clarify’ to members its expectations regarding paediatric care. It said a range of care could be provided to children, including manual therapy, soft tissue therapy and manipulation”
Ref. https://www.brisbanetimes.com.au/healthcare/health-minister-intervenes-in-chiropractors-decision-to-allow-spinal-manipulation-of-babies-20240613-p5jlfj.html
The Sydney Morning Herald carries the same comment.
With regard to financial reasons, it doesn’t take a rocket scientist to figure out that the issue is one of chiropractors’ profits being valued more highly than integrity.
@ DC More here:
“In caring for children, chiropractors provide a range of treatment modalities that may include manual therapy such as mobilisation, soft tissue therapy, manipulation…”
Ref. Revised statement on paediatric care by chiropractors launched, 29 November 2023:
https://tinyurl.com/bdfrftzy
The title is babies. Those under the age of two.
SaferCare stated in their report: “the panel agreed to a definition of spinal manipulation aligned to that defined in Section 123 of National Law. Spinal manipulation was defined as “any technique delivered by any health professional that involves a high velocity, low amplitude thrust beyond the physiological range of motion, impacting the spine, within the limits of anatomical integrity.”
So show me where they are recommending or supporting HVLA on those under the age to two. Can you find any published guidelines on pediatric care by chiropractors that recommend HVLA on those under the age of two (babies)?
The reporter should have done her homework.
Regarding financial reasons, basically you’re admitting it’s not based on evidence. I could counter by stating their main motivation is based on their so-called philosophy.
@ DC
Let’s wait and see what answer the Chiroporactic Board of Australia gives to Australian Federal Health and Aged Care Minister, Mark Butler, in response to his request for an urgent explanation on the Board’s decision “to allow a resumption of spinal manipulation of infants under two, in spite of two reviews concluding there was no evidence to support that practice”. Ref. tinyurl.com/ae9khd9h
Yes, my comments on financial reasons are not based on evidence, but I reckon I am far from alone in suspecting that most chiropractors would not be able to resist (unethical) lucrative ‘cradle-to-grave’ marketing when you consider that nearly all of them are in private practice and the oversight from their regulators is highly questionable.
I didn’t see anywhere that the board suggested that HVLA be done on those under the age of two.
They did write
“…modify all care and treatment (including technique and force) to suit the age, presentation and development of the patient.”
So, it doesn’t constitute any form of regulation; it is deferred entirely to each and every chiropractor — business as usual.
Mr Thompson wrote: “So show me where they are recommending or supporting HVLA on those under the age to two.”
That isn’t how it works. You show us the age range for which they proscribe “spinal manipulation” [your term] (or HVLA).
Most of these issues are delt with in the very interesting book.
“Manual Therapy in Children”, edited by the German Orthopaedic Surgeon, Heiner Biedermann. The question should be asked of you, “Do you have a problem with conditions being treated with manual therapy, irrespective of the qualifications of the practitioner?”, or “Should a chiropractor provide this care”? Please provide a full list of the references used in your reply.
[my emphasis]
So saddened to hear that Chiropractors are still doing this to our precious children.
I also recently watched a youtube video of a Chiropractor adjusting a HORSE, a GIRAFFE and a PITBULL. I kid you not. Apparently this is a thing now.
You can’t make this stuff up.
UPDATE
Australian chiropractors have once again been banned from manipulating babies’ spines after a health board reversed its controversial decision to allow the practice.
QUOTE
The about-face by the Chiropractic Board of Australia follows revelations in this masthead that practitioners had quietly given themselves approval to resume spinal manipulation of children younger than two from November after a four-year ban.
“The board expects chiropractors to comply with the interim policy, which advises chiropractors to not use spinal manipulation to treat children under two years of age, until further consultation with health ministers can allow for developing a final position,” the board’s chair, Dr Wayne Minter, said in a statement on Monday.
The axing of the initial ban drew a fiery response from doctors’ groups and federal Health Minister Mark Butler, who put the issue on the agenda at a meeting of Australian health ministers on Friday.
On Monday, Butler said: “This is the right decision after The Age exposed the Chiropractor Board’s decision to resume spinal manipulation of infants under two.”
Health ministers vowed to write to the board “requesting it to immediately reinstate the interim ban and provide urgent advice on its recent decision to allow a resumption of this practice”, according to a statement released after Friday’s meeting.
Minter said that while there had been no evidence of serious harm to infants from chiropractic care in Australia, the board’s role was “first and foremost to protect the public”.
“We look forward to working with ministers to develop an evidence-based final policy on paediatric care that balances the paramount need to protect patients with the right for parents and other patients to have a say in the care they choose,” he said.
Neurosurgical Society of Australasia Board executive Dr Patrick Lo, who is also the Victorian chair of the Royal Australian College of Surgeons, welcomed the reintroduction of the ban.
“It’s great that they have taken heed and common sense prevails,” he said. “It is what the public demanded five years ago … this is about safety and what we leave behind for our children.”
Spinal manipulation involves moving the joints of a child’s spine beyond their normal range of motion using a high-velocity, low-amplitude thrust.
The initial ban was introduced in 2019 after footage emerged of a Melbourne chiropractor holding a two-week-old baby upside down. The chiropractor then used a spring-loaded device on the newborn’s spine and tapped him on the head, prompting then-Victorian health minister Jenny Mikakos to describe the vision as “deeply disturbing”.
A Safer Care Victoria report at the time, which involved a systematic review by Cochrane Australia, found no strong evidence that spinal manipulation helped childhood conditions such as colic, back/neck pain, headache, asthma, ear infections or torticollis (twisted neck), despite it commonly being spruiked as a solution to these issues.
While this report identified little evidence of patient harm occurring in Australia, it noted “it was clear that spinal manipulation in children is not wholly without risk”.
Ref. https://archive.ph/Avr7D#selection-3573.0-3573.154
good!
One should never do HVLA on a baby. The issue seems that the board didn’t specifically state this. They should IMO.
What the chair of the Chiropractic Board of Australia said about chiropractics on children:
https://www.abc.net.au/news/2024-06-18/chiropractor-baby-ban-reinstated/103989966
So they don’t have an evidence-based policy on chiropractic manipulation of infants and children yet?
I think the goal is to have a policy in which both sides accept.
Regardless, this is one “policy”
Grade 1: neonates and infants aged 0 to 2 months (low force, low speed) at 10% of estimated force for adults (equivalent to 11.2 N)
https://www.jmptonline.org/article/S0161-4754%2816%2930108-7/fulltext
I am unaware of any guidelines or policies that allow or suggest HVLA on those under the age of two.
“10% of estimated force for adults (equivalent to 11.2 N)”
Stated to three significant figures, despite the fact that:
Pseudoscience exemplified.
Do you know the definition of estimation? Apparently not.
The paper you quoted has science-y sounding terms to provide the trappings of science[𝟏]. It is sufficient to fool uneducated persons, such as yourself, but it doesn’t fool those who are formally educated in mathematics and the hard sciences.
Your sock puppets, Mr Thompson, don’t even know the structure of a sentence. Their command of English is inadequate; they are functionally illiterate — as evidenced in their comments on this blog since 2016, if not before. They are also functionally innumerate, as amply demonstrated with this doubling down on both ignorance and outright lying:
‘DC’ on Sunday 28 May 2023 at 15:29, More evidence to suggest that chiropractic is useless
Belligerent stupidity. This is apt:
Reference 𝟏
“Pseudoscience describes any belief system or methodology which tries to gain legitimacy by wearing the trappings of science but fails to abide by the rigorous methodology and standards of evidence that are the marks of true science.
Promoters of pseudoscience often adopt scientific vocabulary, describing conjectures as hypotheses, theories, or laws, providing ‘evidence’ from observation and ‘expert’ testimonies, or even developing what appear to be mathematical models of their ideas. However, in pseudoscience, there is no honest attempt to follow the scientific method, provide falsifiable predictions, or develop double-blind experiments.
Although pseudoscience is designed to appear scientific, it lacks all of the substance of science.”
https://rationalwiki.org/wiki/Pseudoscience
So rather than deal with the topic at hand you ramble on with desperate attempts to discredit the person/s? I think they have a name for that logical fallacy. Same old Pete.
Mr Thompson invokes the fallacy fallacy 😂
“It is a pity the unintelligent aren’t aware of their lack of intelligence.”
— Frank Collins
It looks like a slightly wonky conversion of 1/4 lbf to newtons. The correct conversion to that unwarranted precision is 11.1N.
So how long have they had to not yet develop such a policy?
Idk. I have heard that in the past the two sides haven’t worked together. Maybe now they will.
I do find it interesting they narrowed in on this one age group and HVLA and not the topic as a whole.
A while back I noticed a clear increase in paediatric and maternity practices by local chiropractors.
So I wanted to see how chiropractors go about treating children. What better and easier than asking Youtube. This is a collection of some links I found:
https://youtu.be/HReRIF8mK3s
https://youtu.be/TjrQVB0tG1g
https://youtu.be/4DSri5UXvCw
https://youtu.be/GcFKOZzmMOY
https://youtu.be/9wHJ7cZv8Cc
I am just not sure if I can tell what is going on there? Seems to me the different practitioners are all following different guidelines.
(If this is a double comment my first attempt vanished – somehow 🙂 )
I question if YouTube is an appropriate representation of the field.
Table 3 gives an example of what chiropractors are doing, at least in that region.
https://chiromt.biomedcentral.com/articles/10.1186/s12998-023-00514-z/tables/3
Although not specific to those under the age of two:
https://jamanetwork.com/journals/jamapediatrics/fullarticle/349085
Thank you DC.
This supports the impression I get from different sources, not least the Youtube commercials, that there is little or no consensus or clinically developed guidelines in use. The majority of methods that chiropractors apply to children seem to be make-believe acts (theatrical placebo) e.g. Cranio, LVLA, Activator, Kinesio taping etc… Or just handling and petting the child in a seemingly medical manner? All designed to impress on the parents without harm (and effect) to the subject.
I have yet to find anything that genuinely justifies chiropractic paediatric practice other than supply and demand issues for this growing industry. I invite anyone to convincingly refute this tentative conclusion.
I might add that my (tentative) conclusion is very much in line with what the Safer Care Victoria independent review found and is presented in their report from 2019.
https://www.safercare.vic.gov.au/best-practice-improvement/publications/chiropractic-spinal-manipulation-of-children-under-12
Yah, I don’t do pediatrics. Are there responders for some conditions? Maybe.
I’ve talked to enough chiropractors that see infants to think it’s mainly a “philosophical” motive, not financial.
As I’ve told them, research it or lose it.
Regardless, when discussing the topic one should be clear on the specifics. No one is calling for HVLA to be done on infants.
“No one is calling for HVLA to be done on infants.”
1. I addressed that above on Thursday 13 June 2024 at 15:42
2. No one is calling for “HVLA to be done” [sic] during maintenance care, but it has resulted in severe injury, and death.
In fact, no one is calling for any particular procedure to be “done” [sic] on any particular age group, so your point is moot.