"Do you adjust your own kids, doc?" I am amazed at how many times I am asked that question. I ask "Do you take your kids to the dentist?" The answer is always "Of course." I completely understand why someone would want their children to have straight, healthy teeth. What I do not understand is why there is a disconnect when it comes to parents ensuring that their children have a straight, healthy spine. So yes, I adjust my kids...when they need to be adjusted.

It is no secret that kids in America are sicker than ever. Flu outbreaks. Obesity. Headaches. Asthma. Scoliosis. Type 2 diabetes. All of these conditions are on the rise. Our kids are taking more medications and undergoing more surgeries than ever before. People don't often think twice before putting their children on an antibiotic when no effort has been made to ensure that the child's infection is bacterial or viral. For those of you who may not know the difference, a virus does not respond to antibiotics at all. Yet the vast majority of physicians do not go to the trouble of determining what type of bug the child has, whether the condition is a fever or an ear infection. Viruses are much more common than bacteria in childhood illness. However, more often than not, the physician puts the child on antibiotics and sends them home.

Lest we forget, prescription medications are considered an invasive treatment. They change the chemistry of the body. And there is absolutely no medication that doesn't have a side effect, whether it is felt or not. Yet, most parents have absolutely no qualms about subjecting their child to an invasive treatment, such as drugs and surgery (raise your hand if you had tubes put in your ears when you were a kid) yet they are mystified that someone would make a gentle adjustment to the spine of a child. Even patients of mine who have seen remarkable results through chiropractic care are often hesitant to have their children's spines checked. How could this be?

Chiropractic's Safety Record

I believe this is the number one issue in chiropractic, mostly because of a decades long slander campaign by the AMA. They literally brainwashed people into believing that chiropractic was dangerous, without offering a shred of proof to that claim. People are concerned about the safety of chiropractic care, especially when it comes to their kids. Everyone knows someone who has a story about their cousin's neighbor's babysitter's uncle who got hurt in a chiropractor's office. Rather than place all our trust in gossip and hearsay, let's check the facts.

What About the Alternatives?

In order to determine the relative safety of chiropractic care, we must first establish the safety of the most common alternative in order to create a benchmark to compare to. I am referring to over the counter medications. They are commonly used to treat all varieties of pain, including headaches, neck pain, extremity pain, lower back pain, and sciatica (all common conditions seen in a chiropractor's office.)

Many people assume that anything that can be purchased without a prescription MUST be safe. However, when you look at unbiased research, one starts to wonder. Non-steroidal anti-inflammatory drugs (or NSAIDS) are very commonly used in the treatment of pain. They include drugs such as aspirin, ibuprofen, and naproxen. Like any medication, they have an adverse effect on the kidneys and liver, since those organs must detoxify and filter the chemicals found within the drugs. However, the most troublesome side effect of NSAIDs is gastrointestinal bleeding, which can be severe enough to cause death. If you ask your doctor, he will tell you these side effects are "rare." However, whether you are talking about drug side effects or a filet mignon, the word "rare" can mean different things to different people.

According to two studies done in Spain, "The proportion of complications and deaths attributed to NSAIDs and aspirin use was 36.3%," meaning that one of out 3 people experience bleeding, whether they know it or not. However, long term use of NSAIDs poses a very considerable risk. In fact, the American Journal of Gastroenterology estimates that as many as 16,000 Americans die each year from intestinal bleeding as a direct result of NSAID use! One third of these deaths occur in those who take a daily, "low dose" aspirin in an attempt to ward off cardiovascular disease! I meet patients every day that tell me they don't take any medications, except for this so-called "baby aspirin." The Spanish study concluded that the "death rate" from NSAID use is 15.3 per 100,000, or roughly 1 out of every 6,666 people! For those who use NSAIDs on a long term basis, the risk increases. A study published in the medical journal Pain estimated that the death rate of using NSAIDs for two months is 1 in 1200! The risk of death increases more with age. To put this in perspective, if every kid in a high school with an enrollment of 1200 started taking ibuprofen, one child would die every year. I wouldn't consider that rare. I would consider that a tragedy. Prescription NSAIDs are even worse, but I already covered that in an earlier post when I mentioned the Vioxx debacle.

I really tried hard to nail down a "chiropractic death rate," but I came up empty. Why? Because there is no such thing. One author claimed that after studying 75 years of data, he could prove that 25 people died as a result of a chiropractic adjustment. He published this report thinking that he could scare people away from utilizing chiropractic. 25 deaths per 75 years would mean that roughly .33 deaths occur each year due to chiropractic adjustments, (assuming the data can even be trusted since the source was a man with anti-chiropractic leanings). Over 250 million chiropractic adjustments are given each year in the United States. So, using the numbers given by this estimate, the chance of dying from a chiropractic adjustment is 1 out of 750 million! To put this in perspective, the chances of winning a multiple state lottery (megabucks, etc.) is 1 in 120 million. So, winning the lottery six times is MORE likely than dying from a chiropractic adjustment.

So, tell me, as a concerned parent: Would you rather treat your child's headaches with NSAIDs, which could carry a 1 out 6,666 of risk of death (using the more conservative estimate) or a treatment with a risk of 1 out of 750 million? That is not a trick question.

The Manga Report

When Canada finally decided to seriously look at adding chiropractic to the national health plan due to public demand, they hired a research team to determine not only the cost effectiveness of chiropractic for musculoskeletal conditions (low back pain, in particular), but also its safety. The results of their findings, detailed in The Manga Report are summarized below:
1. "On the evidence, particularly the most scientifically valid clinical studies, spinal manipulation applied by chiropractors is shown to be more effective than alternative treatments for LBP. Many medical therapies are of questionable validity or are clearly inadequate." (For example, there is absolutely no clinical evidence that spinal fusion surgery has any benefit at all, yet it is done routinely in the United States)
2. "There is no clinical or case-control study that demonstrates or even implies that chiropractic spinal manipulation is unsafe. Some medical treatments generate iatrogenic complications for patients. The literature suggests that chiropractic manipulation is safer than medical management of low-back pain." (Note: iatrogenic complications refers to sickness that is caused by the treatment...for example, getting a staph infection while having back surgery).
3. "Spinal manipulations are less safe and less effective when performed by non-chiropractic professionals." (I can't tell you how many times a patient has told me that their medical doctor has "cracked their neck.")
4. "Hospitals, managed health care groups and long-term care facilities should be encouraged to refer patients to chiropractors." (GASP!)

Malpractice Premiums

No one assesses risk like an insurance company. Like them or hate them, you have got to admit, they know how to calculate risk (it is how they determine how much to charge). Someone with three previous drunken driving convictions and a history of excessive speeding pays much more for car insurance than someone with a clean driving record. Why? Because the likelihood that the first insured is going to destroy property or hurt himself and/or someone else is much higher, which could cost the insurance company money. A skydiving instructor who spends his winter fishing in the Bering Sea will pay more for life insurance then, say, a life insurance salesman. The greater the potential risk, the higher the premium.

The same is true for medical malpractice insurance. If there is a greater risk for someone to be hurt/killed when receiving a certain treatment, the doctor providing that treatment would thus be charged a greater premium to account for that risk. The average MD pays over $20,000 in malpractice premiums PER YEAR. OB/GYNs pay upwards of $200,000! The average chiropractor? About $1,500. That should tell you something about the safety of chiropractic care when compared to traditional medicine.

I am not advocating that people totally abandon medical care altogether, of course. Bones will break, hearts will attack, and appendixes will become infected. When catastrophic health conditions rear their ugly head, I defer to the expertise of medical professionals. This is where they truly shine. However, when it comes to maintaining your health and dealing with chronic pain, chiropractic care is a more effective and much safer option.