The safety and effectiveness of pediatric chiropractic: A survey of chiropractors in a practice-based research network

Background and significance

Vohra and her colleagues recently performed a systematic review of the literature to document adverse events (AE) associated with pediatric spinal manipulative therapy (SMT). Over a period of 100 years and using 8 databases, they found 14 articles documenting AE with SMT. Ten of the 14 cases were associated with chiropractic SMT. Miller and Benfield performed a retrospective review of pediatric patient file at a chiropractic teaching clinic and reported an adverse event of 1 in 100 patients or 1 in 700 patient visits. To further contribute to evidence-based practice, we performed a practice-based research survey to examine the safety and effectiveness of chiropractic SMT on children.

Materials and methods

This study was approved by the IRB of Life University, Atlanta, GA, USA.

Chiropractors were asked to provide sociodemographic information, presenting complaints, and treatment-associated improvements, aggravations and complications.

Results

The children consisted of 861 females and 872 males for a total of 1733. Their average age was 6.36 years. A majority (N=629) presented for “wellness care.” The indicated primary complaints are as follows: challenged child (N=106); digestion/elimination problems (N=158); ENT/respiratory problems (N=211); immune dysfunction (N=80); musculoskeletal problems (N=384); neuromuscular problems (N=134); spinal injury (N=52) and others (N=59).

Only 16 patients reported aggravations as soreness or pain from 16,747 visits. No reported complications. Improvements were reported in 81% of the patients.

Discussion

Our practice-based research observational study reports a rate of that <1% of the patient population or 1 in 1046 patient visits resulted in minor adverse events. All reported aggravations (from chiropractor and parent survey) were minor, self-limiting and did not require hospitalization or medical attention.

Conclusion

This is the first study of its kind reporting on the safety and effectiveness of pediatric chiropractic SMT in a practice-based research setting. Prospective population-based studies are needed to further examine the safety and effectiveness of pediatric chiropractic.