Chiroaccess.com REPORTS HERE on a review that concludes that "there is currently no evidence of any adverse
effects associated with chiropractic pediatric care as well as other
professions using manual therapy."
In this review "the author drew information
from was the National Library of Medicine...[concluding] There is little
evidence derived directly from pediatric studies and most of what we
know of adverse effects is derived from adult research in this area."
One study reported "Pediatric manual therapy
is controversial within the medical community particularly with respect
to adverse events. Pediatric manual therapy (Ped MT) is commonly used by
a number of professions such as chiropractors, osteopaths and
naturopaths for a variety of treatments in children. Ped MT
interventions range from advice, light touch, massage, through to
mobilisation and high velocity spinal manipulation." The authors of this study report "only three new clinical
studies, one
systematic review
with
meta-analysis and
one evidence report were identified. Two clinical studies reported on
chiropractic care and one on osteopathic spinal
manipulation
in children. The systematic review investigated all studies of adverse
events and manual therapy and was not specific for pediatric patients.
The evidence review focused on effectiveness of spinal manipulation in a
variety of musculoskeletal conditions. No serious or catastrophic
adverse events were reported in the clinical studies or systematic
review."
The report notes that "for adults, it has been estimated that between 0.003%
and 0.13% of manual therapy treatments may result in a serious adverse
event. Although mild to moderate adverse events are common in adults, an
accurate estimate from high quality pediatric studies is currently not
available."
These authors conclude that "there is currently insufficient research evidence related to adverse
events and manual therapy. However, clinical studies and systematic
reviews from adult patients undergoing manual therapy, particularly
spinal manipulation report that mild to moderate adverse events are
common and self limiting. However serious adverse events are rare and
much less than for medication commonly prescribed for these problems."
In a second report this article notes "Spinal manipulation is a noninvasive manual procedure applied to
specific body tissues with therapeutic intent. Although spinal
manipulation is commonly used in children, there is limited
understanding of the pediatric risk estimates."
This study conducted "a comprehensive search...of 8 major electronic databases (eg, Medline, AMED, MANTIS)
from inception to June 2004...[finding] thirteen studies (2 randomized trials, 11 observational reports) were
identified for inclusion."
The authors "identified 14 cases of direct adverse
events involving neurologic or musculoskeletal events. Nine cases
involved serious adverse events (eg, subarachnoidal hemorrhage,
paraplegia), 2 involved moderately adverse events that required medical
attention (eg, severe headache), and 3 involved minor adverse events
(eg, midback soreness). Another 20 cases of indirect adverse events
involved delayed
diagnosis
(eg, diabetes, neuroblastoma) and/or inappropriate provision of spinal
manipulation for serious medical conditions (ie, meningitis,
rhabdomyosarcoma)."
These authors likewise concluded "neither causation nor
incidence rates can
be inferred from observational data" concerning pediatric manipulation.
