Apr 29, 2016

Doctors speak out against chiropractors treating children

Ann Arnold
ABC Australia
April 22, 2016

Chiropractic treatment is claimed as a fix for everything from ear infections to tongue-tie. But some doctors want regulators to ban chiropractic treatment for children altogether, and are accusing the regulator of being unable to rein them in. Ann Arnold reports.

When you see a premature baby having its back cracked, it literally makes my eyes water. - JOHN CUNNINGHAM, SURGEON

Popular Melbourne chiropractor Ian Rossborough treats conjunctivitis and ear infection in babies and children with spinal manipulations. He shares the videos on YouTube, drawing millions of views.

In one video posted earlier this year, he is shown treating a four-day-old baby.

'I have to unfortunately extend her a little bit to get her in the right place,' he tells the parents as he moves the baby into position. Then he pushes down on her back until there's a crack.


Melbourne surgeon John Cunningham, who specialises in spines, watched that YouTube video, and says he cannot fathom why a chiropractor would adjust the spine of a newborn.

'There's not many things that make an orthopedic surgeon emotional, but when you see a premature baby having its back cracked, it literally makes my eyes water,' he says.

'There would be risks of harm. There would be risks that the child could suffer some sort of fracture. Why would you do it? This is the thing that goes through my mind when I watch that video. Why on earth would you do that to a newborn?'

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Because, says chiropractor Ian Rossborough, this baby with colic—a term generally used for young babies' unexplained bouts of crying—was helped by it.

'When you see the patients returned with these children, they always report that the child is just so much more comfortable, they sleep so much better, they eat so much better,' Rossborough says.

The gap between many chiropractors and evidence-based medicine seems ever wider. The only really strong, often-cited evidence is for lower back pain. But some chiropractors continue to push the envelope, about what they can treat, and how they can help people. Their regulator is accused of being unable to rein them in.

'The Chiropractic Board is meant to be serving and protecting the public,' Cunningham says. 'Unfortunately, it seems to want to protect its own practitioners, rather than the general public, a lot of the time.'

Formal complaint calls for board to be sacked

In February, Cunningham made a formal complaint to the Australian Health Practitioners Regulation Agency (AHPRA)—which administers the board—calling for the Chiropractic Board to be sacked.

Now the head of paediatrics at Royal Darwin Hospital, Dr Paul Bauert, says he, too, wants the Chiropractic Board and AHPRA called to account. And he wants the regulators to ban chiropractic treatment for children altogether.

'AHPRA and the Chiropractic Board, should be banning any treatment of children and adolescents under the age of 16, 17, until the evidence is available that shows that there may be some effect,' Bauert says.

'The only evidence that's available at the moment, looking at all the published chiropractic literature, the conclusions of all of those studies say that chiropractors may compete with physiotherapists in terms of treating some back problems. But all their other claims are beyond belief, and can carry a range of significant risks.'

At the same time, the number of GP referrals to chiropractors—of children—has grown by 83 per cent over the five years to June 2015.

AHPRA chief executive, Martin Fletcher, oversees the Chiropractic Board. He maintains it is doing a good job.

'I don’t believe there is a need for the board to be sacked,' he says.

'The board and AHPRA have worked very closely together to make sure that the public are protected, and that high standards of chiropractic practice are in place.'

Newsletter carries ads for courses to treat colic, tongue-tie

Last month, the Chiropractic Board issued an edict to chiropractors, that they must not promote treatment that does not have a strong evidence base. This included using spinal manipulations to treat non-muscular skeletal conditions.

The main professional body, the Chiropractors Association of Australia, does not appear to be leading by example. It accepts ads in its newsletter for chiropractic courses to treat colic and the unsettled baby, and tongue-tie.

Wayne Minter, the chair of the regulatory board, is a member of the Chiropractors Association. Background Briefing put to him that the association's newsletter appeared to contradict the board’s directions.

'I just want to reiterate that the board expects chiropractors to practice in an evidence-informed, evidence-based way, and will be held accountable to those standards,' he said.

'It’s all detailed in our code of conduct.'

Asked if the ads for courses in treating unsettled babies for colic, reflux and persistent crying sounded like an evidence-based approach, he replied that he did not know the details, and so couldn't comment. He also declined to comment on the advertisements for courses in treating babies with tongue-tie.

Health insurer adds to pressure on chiropractors

Pressure to rein in what chiropractors can promote is now coming from several directions.

Background Briefing has learnt that health insurer HCF also recently wrote to chiropractors, saying the fund would not cover treatments that don't have a strong evidence base, or that have unnecessary X-rays or open-ended preventative treatment for wellness.

But the Chiropractic Board's focus on advertising doesn't extend to what chiropractors actually do.

'The Chiropractic Board will put out these edicts, they will put out these statements, and the proof will be in the pudding,' says surgeon John Cunningham.

'I hope that over the next 12 months we see that there's results, and that the chiropractors clean up their act, especially with regarding advertising, but the proof will be in the pudding.'


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