Kids love chiropractic care and its not hard to figure out why.

There is no one poking needles in their arms making them cry and no pills or bad tasting medicine to swallow. And chiropractic adjustments rarely hurt because the smaller the patient the more gentle they are. Mothers who bring in their children when they are sick say their children usually benefit (see inside). Still we recommend regular spinal checkups for maintaining health just like you would get regular dental checkups. Children play hard with so many tumbles and falls that it is important to check their developing spine regularly.

And unlike some negative stories you might have seen, chiropractic care for children and even infants is incredibly safe. We use no drugs or surgeries, which do have substantial risks, so the risk of harm from chiropractic care for children is negligible. Check it out inside. So the next time you stop in for a visit bring along the kids. We would love to see them and can check to make sure their spine is aligned correctly and functioning properly.

The normally respected Journal Pediatrics, the official journal of the American Academy of Pediatrics, recently published a highly controversial review that we believe erroneously suggests that chiropractic care for children might be risky. Of course there may be infinitesimal risks even with the safest health care options, like chiropractic care, but compared to the very substantial and well documented risks of drugs or surgery chiropractic care is incredibly safe. While this review correctly concluded that adverse events from chiropractic care on children are rare, they nonetheless suggested that medical doctors should caution parents that serious adverse events may be associated with “spinal manipulation” in children.1 We believe their conclusion is unsupported, that this may unnecessarily scare parents, and that the review failed to put this in perspective.
The review searched for studies in all eight major health care electronic databases from their inception as far back as 1900 to June 2004, so they covered a lot of history. They found 13,916 articles relevant to spinal manipulation on children (under 18 years old) but of all those, over all that time, they found only 13 articles that reported a total of 14 direct adverse events but only 9 were considered serious. They also found 20 indirect events, which were all considered delays in getting medical care. While some of those were serious events, it is hard to know if the patient would have sought medical care any sooner with or without the
chiropractic care.

Minimal Risks from Chiropractic

Now considering that chiropractic doctors currently see an estimated 30 million pediatric patients every year2, to find only 9 direct serious events in over 100 years is like finding a needle in a huge haystack. Even 9 in one year would be only 1 in every 3.3 million patients. That is hardly much of a risk and over 100 years the risk gets infinitesimal even if the number of children seen many decades ago was far less than current numbers.

Worse yet this review claimed that all the direct adverse events occurred from chiropractic care yet that was not the case. They may have all been spinal manipulation but chiropractic adjustments are a specific highly directed sort of movement of the spine. Other professions manipulate the spine in far different ways. Their own chart shows that one adverse event involved manipulation by a medical doctor, another by a physiotherapist, for two others the practitioner was unknown, and two more were done by chiropractic students (and those two were not serious). That only leaves 8 of the 14 direct adverse events that were attributed to licensed chiropractic doctors and only 5 of those 8 were considered serious. Now we are down to 5 events in 100 years and perhaps another 20 delayed events. At one place in the Pediatric study they even wrote, “During the decades assessed by our search strategy, adverse events resulting from spinal manipulation are either remarkably rare or underreported.”3 In spite of that their conclusion that parents should be warned did not reflect this.

Now we certainly want to avoid even one serious adverse event and chiropractic schools continue to improve training to that end. But when you put it all in perspective, your child probably has a far greater chance of being hurt in a car accident on the drive to your chiropractic doctor’s office, than from the adjustments to their spine.

Some Perspective:
Medical Risks for Children

Now lets put a little more perspective on this. In just one week recently The New York Times published two different stories on adverse drug events in children. First the Centers for Disease Control and Prevention just reported that a recent study of emergency room records from 2004 to 2005 found at least 1,519 children under age 2 had suffered serious health problems after taking common over the counter cough and cold medicines. Three of them died.4 In response a group of medical leaders petitioned the Food and Drug Administration (FDA) to stop drug makers from marketing these medicines for children under age 6, saying they don’t even work. These include medicines like Toddler’s Dimetapp, Infant Triaminic and Little Colds, all marketed to children as young as 2. While the leaders who petitioned the FDA admitted that these were generally safe in the recommended doses, they added that overdoses were common for a variety of reasons and that there is widespread consensus that there is no good evidence that they are even effective.5

Then a new study found that medication mistakes are more common when related to surgery and that young children are the most likely victims.6 The new study looked at medication errors on patients undergoing surgery, analyzed 11,000 mistakes that had been reported by hospitals since 1998, and found the rate of harm from such errors was 5%. This was higher than for medication errors as a whole, but among children it was 12%.7 That is 12 out of every 100 children having surgery. One of the authors of the study said, “There are 10,000 drugs in the marketplace and many have never been tested on children in clinical trials, so doses are often made by guesswork based on weight, involving conversion of pounds to kilograms, sometimes by nurses who are not pediatric specialists.”8
Back in 2003 Pediatrics published a report that found medical errors for children in hospitals – both surgical and nonsurgical cases – ranged from 1.81 to 2.96 per 100 discharges.9 This is not one in three million, this is one in every 55 to even one in every 33 children.

Medical Risks For All Ages

Medical errors have especially concerned medical professionals since a 2000 report by the Institute of Medicine found such mistakes cause up to 98,000 deaths a year – exceeding highway accidents and breast cancer combined.10 The FDA Center for Drug Evaluation and Research website says other studies put this figure even higher. A study in the Journal of the American Medical Association estimated that in hospitalized patients alone that serious adverse drug reactions occur in 6.7% of patients or 2,216,000 per year, with a death rate of 106,000 annually.11 This is just for drug reactions in hospitals, not for all the other sorts of mistakes that can occur in hospitals and all the drug reactions at home from prescription or over the counter drugs. This is a serious problem with huge risks. The medical community is taking many steps to reduce these numbers but even a tenth of these would still be high risks.

Now please understand that when needed, medications and surgery are often appropriate, frequently effective, can even work seeming miracles, and can save lives. And we also understand that medical care often deals with severe trauma and the most grave and serious conditions where high risks may certainly be worth taking. But the fact remains there are real risks with drugs and surgery, even with drugs so seemingly benign as over the counter cough medicine. By comparison chiropractic care for children has such dramatically low risk as to be almost negligible.

Weigh the Risks

As with nearly everything, benefits need to be weighted against risk. In one study, 73% of parents of “sick” children said that chiropractic care had been beneficial to their child.12 With extremely low risk that is a great benefit to risk ratio. Still chiropractic doctors are trained to refer you to medical specialists if chiropractic care cannot help the condition or if a child does not improve with chiropractic care. Medications are typically far riskier than chiropractic care but generally carry less risk than surgery, so it may be the next option to try. And if medications don’t help, your medical doctor may refer you to a surgeon where risks are usually even higher but if it might saves a life then even those risks are worth taking. We just want you to understand that chiropractic of the three is by far the least risky and a great first choice for maintaining childhood health.

Parents often bring their children in for specific conditions and most of the time these conditions improve following chiropractic adjustments. But keep in mind that we adjust and align the spine rather than treat specific conditions. But that allows your child’s body to function better so numerous conditions resolve. We help the body to heal itself and so we think regular spinal checkups are ideal for maintaining health both for adults and children. It is a great place to start before turning to drugs or other riskier medical treatments.

1. S. Vohra, et al., Adverse Events Associated With Pediatric Spinal Manipulation: A systematic Review,” January 2007, Pediatrics, Vol. 119, pp. 275-283
2. “WCA Responds to Pediatrics Article,” March 2007, The Chiropractic Journal, Vol. 21, No. 6, p. 6.
3. S. Vohra, Op. Cit., p. 281.
4. G. Harris, et al., “U.S. Reviewing Safety of Children’s Cough Drugs,” March 2, 2007, The New York Times.
5. Ibid.
6. D. McNeil, Jr., “Medication Errors Are Studied,” March 7, 2007, The New York Times, reporting on a study done by the United States Pharmacopeia (which sets standards for the pharmaceutical industry) and by the Uniformed Services University of the Health Sciences in Bethesda, Md., and two nurses’ associations.
7. Ibid
8. Ibid
9. A. Slonim, et al., “Hospital-reported Medical Errors in Children,” March 2003, Pediatrics, Vol. 111, No. 3, pp. 617-621.
10. D. McNeil, Jr., Op Cit.
11. J. Lazarou, et al., “Incidence of Adverse Drug Reactions in Hospitalized Patients: A Meta-analysis of Prospective Studies.” 1998 JAMA, Vol. 279, pp. 1200-1205 as reported by the FDA Center for Drug Evaluation and Research, http://www.fda.gov/cder/drug/drugReactions/default.htm#ADRs:%20
Prevalence%20and%20Incidence
12. “WCA Responds to Pediatrics Article,” Op. Cit.

Exercise Instead of Only Dieting
to Lose Weight

A recent study found that dieting alone to lose weight lowered bone density whereas exercising to lose weight did not.1 Moderately overweight middle-aged adults were assigned to three groups. The first group dieted for a year without added exercise and lost just over 18 pounds on average but paid a price for that. They also lost 2.2% of their bone mass in the lower spine and hips. The second group did not change their diet but exercised regularly for the year and lost 14.8 pounds on average. Their bone density was unchanged. The third group served as a control group and did not diet or add exercise and their weight and bone density remained the same.
Carrying extra weight around keeps bones strong by placing weight on the skeleton and so weight loss from diet decreases the load on the bones and bone mass decreases. But exercise independently creates loading on the bones and counterbalances the loss of skeletal loading from weight loss, at least that is what this study suggests.

If you want to lose weight start by adding exercise to your routine. We suspect that exercise and diet together may still preserve bone mass (although this study did not prove that). Of course exercise has so many other health benefits, from protecting your heart, keeping blood pressure low, and even preventing cancer, that it should be the foundation of your weight loss effort.

1. D. Villareal, et al., 2006, Archives of Internal Medicine, Vol. 166, pp. 2502-10 (as reported by “The Back Page,” January 2007, The Back Letter, Vol. 22, No. 1, p. 12).

Drug Overdoses Rise to No. 2 Killer

It used to be that automobile crashes were followed by falls as the second leading cause of accidental death in the nation. But unintentional drug overdoses nearly doubled from 1999 to 2004 placing it in the number two spot according to the Centers for Disease Control and Prevention. Researchers said they believed the main cause were prescription painkillers like Vicodin and OxyContin.
If you suffer with pain and take pain pills please be careful not to take more than is prescribed even if pain persists. In contrast to drugs chiropractic care can often get to the cause of your pain and relieve many painful conditions allowing you to reduce or stop taking pain pills altogether. That would certainly be a much safer and less painful solution.

1. Associated Press, February 10, 2007, The New York Times