This is a response to a recent article in the Newcastle Herald regarding chiropractic care in children.

Original article

https://www.theherald.com.au/story/5941349/spinal-health-for-all-ages-is-a-no-brainer/?fbclid=IwAR24dFeKwjk-LOiKQlW1nM-dfEbhv-JIqcjEJ5IWJA-996I-BJg4aXNyTEg

Firstly let me make some points.

1. This is not physio versus chiro – some of the people I admire the most academically are qualified chiropractors. I do not care what degree you have.
2. This chiropractor clinic is competition for my physiotherapy clinic.
3. I have also been featured in the Newcastle Herald promoting my business
4. I am a huge critic of many things in the physiotherapy profession and have written many things on these practices.
5. I do not pretend to have all the answers. Nor does the physiotherapy profession, medical profession or any other.
6. I appreciate the disenchantment with the medical/health system. I feel it too. I encourage looking for an answer, but some “answers” are not good ones. Sometimes things do not have an answer.
7. While also a physio clinic owner I am a husband and father of 3 children
8. I understand the desire to throw everything at the health of your child. This is why I feel so strongly about providing a counter point.
9. I am not speaking about congenital disorders, medical problems associated with birth and in no way mean to diminish the difficulties those families must face.

 

Ok, let’s go.

Many comments were made in the article regarding the function of the spine and nervous system, particularly with regard to the development of childhood issues such as colic, bedwetting, allergies and behavioural issues.

3 things to discuss.

First, it is impossible for a human to put enough pressure on a spine to do anything to the orientation of it. The spine is tremendous, resilient, but in children – not even close to being fully developed. An Xray of a child at different ages shows the bones in different stages of development and formation. There is no proper alignment of the spine. There is the congenital structure that each human is born with, then there is the movement that each human does. When the child moves, so does the spine. That’s it’s job.

If a spine does become dislocated, that is called a spinal cord injury and results in paralysis.

The notion that the spine can spontaneously move out of or back into structural alignment is biologically implausible.

Second, the conditions mentioned are all complex, individual presentations that can have medical and behavioural components involving multiple systems. The notion that a condition, particularly medical or psychological, can be treated by spinal pressure is again, nonsense. It is also an affront to people who have complex medical conditions, such as allergies or behavioural issues, that do not have simple solutions.

Third, subluxation theory, whereby bones are “realigned” and therefore creating therapeutic effect has been debunked for some time, to the point where modern chiropractors have distanced themselves from it as a treatment option.

 

Images and explanations, like the one shown in the article linked below (written by a chiropractor), are there to scare people into overtreating often very mild pain, or completely normal presentations

https://sciencebasedmedicine.org/the-chiropractic-technique-parade/

 

There are significant problems with treating paediatrics with this type of chiropractic care as either routine, or primary care level, outlined in this article.

 

https://sciencebasedmedicine.org/chiropractic-pediatrics-delayed-referral-misdiagnosis-adverse-events-and-ineffective-treatments/

 

So, a bunch of bad science and unnecessary treatment.

Some common counter arguments I hear

“What’s the problem if you feel better?”

• The problem is that it has identified the way the child is as a fault. That children are inherently broken and need treatment. Lots of bad things can happen to kids, which sucks. Some of those things need medical intervention, some of those things won’t change no matter what, and that is hard to take. As a parent, I get that.

But lots of things happen to kids that are completely normal. They may not be fun, but they also might not be a problem.

“I’ve seen it work, or it worked for me”

• The biggest problem with health care. This is a form of logical fallacy, a trick our brains play on us. If event A happens after event B, then event B causes event A. It’s completely logical, but unfortunately it is also incorrect.

There are lots of them – I bent over, then my back hurt. I got a flu shot, then I got sick. I treated a problem with a certain thing, then it got better.

They ignore a couple of important facts.

1. Lots of things get better with time, or on their own. Therefore the longer you treat something the more likely it is to improve anyway
2. Multiple things tend to influence a problem at any given time. The conditions given in this article are fantastic examples of things such as these. Colic, bedwetting, some allergies and behavioural issues all tend to improve with age.

The treatment applied for such problems can have zero effect, but the problem can resolve.

 

So, clinicians with treatments such as these can’t lose. If it gets better, they are heroes, if they don’t they keep treating it. Forever.

In physio it is dry needling, treatment machines and colourful taping. In medicine it is many analgesics and pharmaceuticals. All health professions have them. And we all need to do better.

 

The main point of this story is in defence of kids. They are amazing, resilient and wonderfully adaptable.

If you are anything like me, my wife, our friends, they are also the single most important thing in your life and you would do anything… ANYTHING… to protect them and keep them safe. To improve their health and give them the best possible start.

Treatments such as those mentioned are neither of those. Let them run, jump, tumble, fall, laugh, learn and have fun without hearing they are broken.

If they are sick take them to a medical doctor. If you do not like that doctor, take them to another medical doctor, a paediatric specialist, any of the millions of options in allied health that will give you good advice and not treat anything they cannot hope to be able to treat.

 

If you are worried about your child’s development, health or function please give us a call. We may not be able to help you, but we know many people who are fantastic at what they do and can help you.

 

Lastly I am fully aware that this may leave me open for criticism. I am big enough and ugly enough to take it. I welcome it. Feeling strongly about something means you have enough of a reason to do something about it and make it better. Please tear apart my practice, my advertising, everything and if you can point out something that needs to change, please do. If you think I am wrong, please let me know and I can show you a MOUNTAIN of evidence for the points I have outlined above.

I am not criticising any person, merely stating that certain treatments are useless and theories outdated.

I agree that the health system in its current form is failing many people. I know it.

I know doctors, nurses, physios, chiros, dieticians, occupational therapists, strength coaches, speech pathologists (apologies if I have forgotten anyone) that do things that help people, often in spite of the system in which they work.

The system is broken in many ways.

But people are not.

Children are not.

Science is not. It just doesn’t have all the answers yet.

Please, stop accepting and paying for treatment that at best cannot possibly help, and at worst create a vulnerable and dependent future adult, instead of a robust, confident and healthy young person.

If you hear of or are victim of another failure of the medical and health system, or a physio, or a (real) doctor, I am sorry. I really am.

Everybody makes mistakes. I have made plenty.

But there are mistakes, and there is bullshit.

 

So, if this is something you feel strongly about, either for or against, let’s start a conversation and see if we can make this pale blue dot a better place for our kids.

Dave