Deeply Disturbing Chiropractic Care

I hate to do a topic back to back but there was a piece of news concerning chiropractic that seemed too important to pass up. I'm speaking, of course, of the Melbourne chiropractor who was filmed giving an adjustment to a newborn infant (yes you read that right, a newborn). The article states that the child in the video is two-weeks old. In my opinion, that is far to young to be doing any such manipulation. But I'm getting ahead of myself, lets go over what was in the video. As a warning, if you watch the video yourself know that it could be distressing; I definitely found it hard to watch. But I'll try to go over the important details, and discuss them, so you don't have to watch.

The Video

The video is pretty concerning. The guy in the video, Andrew Arnold (I will not be calling him doctor as he is not deserving of the title), can be seen doing a number of manipulations on the baby. The first manipulation that grabs the attention (and the headlines by the Google search results) is Arnold grabbing the baby by the ankles and holding it upside down. Now only Arnold knows why he thought this was an appropriate thing to do. But I imagine it was an attempt to preform what is known as "Inversion Therapy." You may have heard of this through those inversion table ads. It is an area rife with pseudoscientific claims. With just a cursory search of various sites you can find claims for curing diseases and chronic pain; there is also no shortage of claims of health benefits. For example, on the Teeter® website there is a testimonial by a chiropractor stating:

In my clinical experience, inversion is best for back or neck pain, sciatica, muscle spasms, herniated and/or bulging discs. Inversion helps tremendously and many times will completely get rid of the patient’s pain. ... Inversion is beneficial to everybody, even if you have not had a back or neck injury. ... Inversion also increases the blood flow to your brain which helps people wake up when they invert in the morning, relax and sleep better when they invert at night, or helps refresh the mind during a mid-day break.

Now, to be fair, there is a sort of logic to this. The human spine is a bizarre structure. It's as if you used a suspension bridge as the main weight-bearing support for a skyscraper; it's a very unintelligent design (I'm looking at you creationists). So gravity can definitely do some damage and it would follow that changing the direction of gravity (so to speak) would relieve some of the pain caused. Furthermore, there no shortage of anecdotal evidence that inversion has helped back pain for some. In fact my sisters boyfriend has stated that it has helped him. That being said, there is no evidence that inversion will give long term relief of any condition, no evidence of preventative benefits, and no evidence that it will help brain function (though it is no secret that being upside down can cause blood to pool in the brain). It can also be dangerous for people with blood pressure issues. Getting beck to the newborn, there is no ethically sound reason for Arnold to have suspended the child as he did, there just isn't.

The second thing that jumps out is his use of a device called an "activator." According to Wikipedia it is, "a small handheld spring-loaded instrument which delivers a controlled and reproducible impulse to the spine. The aim is to produce enough force to move the vertebrae but not enough to cause injury." There is a case study where the use of an activator was linked to the death of a 75 year old woman. Now, there is certainly a lot of difference between newborns and the elderly (namely 75 years in this case). But both groups are, from a medical standpoint, fragile. There is reason to suspect that use of this instrument on a newborn might cause medical issues down the line.

That is my major takeaway from the video. A quack doctor performing untested, ethically unsound procedures on a patient who was in no need of such treatment.

The Response

In the news articles I've read, there has been much discussion on what was done about the situation. I'd like to take a moment to give my own commentary on the situation. The most used quote has come from Victorian Health Minister Jenny Mikakos where she said, “This vision is deeply disturbing. It’s appalling that young children and infants are being exposed to potential harm.” This is an appropriate response. And it seems to echo much of the outrage expressed. I do wonder, however, how much it would outrage people to learn that this is by no means a rare occurrence. In any major state in the US for example, it is not even remotely difficult to find a chiropractor willing to practice on an infant.

For me, the important response to take note of is from the The Chiropractic Board of Australia. There non-committal statement, taken from ABC AU, reads:

The board has made a strong statement about the care of children and has written to every chiropractor in Australia to warn them to comply with their professional and ethical obligations, which are clearly outlined in the board's code of conduct for chiropractors. The board has acted against chiropractors who fail to meet their obligations by limiting their registration when they fail to meet the expected standards.

What is suspiciously not in their statement is an outright condemnation of practice on infants. Even their punishment of Arnold, restriction of care to those 12 and older, seems little more than a slap on the wrist. Given the lack of evidence for treatment and the dangers presented, this should be something that they don't allow. But, as with most "regulatory" chiropractic bodies, there is a complete lack of explicit standard of care guidelines. This event is yet another example of how dangerous pediatric chiropractic can be and serves as a startling example of how little oversight chiropractors are willing to provide to maintain anything resembling a standard of care.