The question of whether to take a child to a chiropractor often comes with intense parental concern and natural skepticism about spinal manipulation for minors. Chiropractic care is a non-invasive, drug-free approach that focuses on the musculoskeletal system and its connection to the nervous system. The practice aims to restore proper joint motion and neurological function, often using manual or instrument-assisted adjustments. This method is frequently sought for various issues in pediatric populations, ranging from infants to adolescents. This article provides information on the safety profile, techniques, common uses, and necessary qualifications for pediatric chiropractic care.
The Safety Profile of Pediatric Chiropractic Care
When performed by a trained professional, pediatric chiropractic care is generally considered safe, though serious adverse events have been reported. The overall risk of a severe complication from spinal manipulative therapy (SMT) in children appears to be extremely rare, and some reviews have found no reported deaths associated with chiropractic care in the academic literature. Reported adverse events are typically mild and temporary, such as brief local soreness, increased crying, or temporary irritability. These minor effects usually resolve within 24 hours of the adjustment.
The techniques used on children are fundamentally different from those used on adults, which significantly contributes to the low risk profile. The few documented cases of serious adverse events, like subarachnoid hemorrhage or paraplegia, often involved high-velocity, low-amplitude thrusts (HVLA), which are not appropriate for young spines. In a majority of the serious injury cases reported, an underlying, pre-existing, and often undetected pathology was present before the manual therapy was applied.
A 2023 retrospective analysis involving over 960,000 chiropractic treatment visits for patients of all ages found that none of the 39 reported adverse events occurred in children. The safety of the practice hinges on the practitioner’s use of age-appropriate, low-force, and modified techniques tailored to the child’s developmental stage. A thorough history and examination are necessary to exclude anatomical or neurological anomalies before proceeding with any manual therapy.
What Pediatric Adjustments Involve
Pediatric adjustments utilize a modified, low-force approach that is distinct from the high-velocity thrusts commonly associated with adult spinal manipulation. The force applied is significantly reduced to suit the child’s smaller size, developing anatomy, and lower tensile strength. For instance, the force used on an infant is often compared to the gentle pressure used to test the ripeness of a tomato.
The force is often adjusted based on a model that categorizes children into grades by age. For a newborn or infant up to two months old, the recommended maximum force is approximately 10% of the force used for an adult spinal manipulation. Techniques frequently involve sustained pressure, mobilization, or the use of specialized, instrument-assisted devices, like the Activator, which delivers a precise, controlled, and rapid thrust with minimal force.
Another common low-force technique is the Sacro Occipital Technique (SOT), which may use small blocks or wedges placed under the pelvis. The primary goal is to achieve the desired joint movement or alignment without the audible “cracking” sound that often accompanies adult adjustments. This gentler application minimizes the risk of injury and is generally more comfortable for the child.
Common Reasons Parents Seek Care for Children
Parents often seek chiropractic care for children to address musculoskeletal complaints, but they also frequently consult practitioners for common infant complaints. The most substantial evidence supports the use of chiropractic care for musculoskeletal conditions like back or neck pain, headaches, and postural issues in older children and adolescents. Spinal manipulation has been shown to reduce the frequency of recurrent headaches in children.
For infants, a frequent reason for consultation is torticollis, a condition involving a tight neck muscle that causes the head to tilt and turn to one side. Other common issues relate to feeding difficulties, such as poor latching during breastfeeding, which can sometimes be linked to restricted neck or jaw mobility following the birth process. The birth process itself can introduce biomechanical strain that parents hope chiropractic care can address.
Parents also seek care for non-musculoskeletal issues like infantile colic, chronic ear infections (otitis media), and bed-wetting (nocturnal enuresis). While some parents report positive results for these conditions, the scientific evidence supporting the effectiveness of chiropractic intervention for non-musculoskeletal issues is often limited or inconclusive. For example, a controlled trial on chiropractic manipulation for colic found it was no more effective than a placebo.
Selecting a Qualified Pediatric Chiropractor
The safety and efficacy of pediatric chiropractic care depend heavily on the practitioner’s competence and specialized training. Parents should look for a chiropractor who has pursued post-graduate education specifically in the care of children. Advanced certifications demonstrate a commitment to understanding the unique developmental anatomy and physiology of children, which is distinct from adult care.
Parents should seek practitioners with recognized credentials:
- The Diplomate of the Academy Council of Chiropractic Pediatrics (DACCP), which requires a rigorous 400-hour program of coursework and clinical experience.
- The 200-hour Certification in Chiropractic Pediatrics (CACCP).
These programs cover developmental anatomy, pediatric adjustment techniques, and clinical case management for pregnant women and children.
Parents should ask about the chiropractor’s experience with infants and how techniques are modified for a child’s age. It is important that chiropractic care be integrated with, and not replace, primary medical care from a pediatrician. The chiropractor should communicate with the child’s primary care physician and refer the child back to the medical doctor if the child is not improving or if a “red flag” condition is suspected.