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“Chiropractors have treated children in the course of their general practice since the inception of the profession. It has now emerged as a speciality discipline” – Dr Neil Davies

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Welcome To PCSA

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Paediatric Chiropractic South Africa stands for excellence in the chiropractic treatment of paediatric patients.

It is our goal, as well as the goal of our members to provide evidence based paediatric chiropractic care of the highest quality within our communities.

Our vision is to enhance the health of all infants and children through chiropractic care, and to increase integration and co-operation with other professionals involved in paediatric healthcare.

 

What is Chiropractic?

Chiropractic is a patient-centred and bio-psychosocial approach, emphasizing the mind/body relationship in health, the self-healing powers of the individual and the individual responsibility for health and encouraging patient independence.

Chiropractors are considered expertly qualified providers of spinal adjustment, manipulation and other manual treatments, exercise instruction and patient education.

Chiropractic succeeds without the use of drugs and surgery, enabling patients to avoid these procedures whenever possible”

For more information on Chiropractic in South Africa, please visit www.chiropractic.co.za

Why Chiropractic for children?

An adult’s body will function in a certain way, with certain limitations, because of how it is built, in other words your form decides your function. But in babies and children that are still growing it is the other way around. Their form is not yet set, so how well they function will ultimately lead to the type of body they will eventually develop. It is the goal of the paediatric chiropractor to maximize that potential.

As in adults, when spinal or cranial joints are not moving properly they are not able to send clear communication to the brain via the nervous system. The nervous system relies on this constant flow of communication from the joints (called proprioception) and muscles to function and develop optimally. The spinal asymmetry created by these dysfunctions can often have long reaching effects and manifest in different ways.

Some issues commonly associated with joint dysfunctions in infants and children can be:

• Nursing issues
• Poor sleep
• Fussiness in babies
• Gastrointestinal issues
• Postural asymmetries
• Behavioural problems
• Torticollis
• Positional head deformities
• Chronic pain
• Headaches

Some reasons for this asymmetry and why these joints may not be moving correctly could be:

• Birth and related injuries
• Slips and falls
• Poor posture (Desk work, iPad overuse)
• Sporting injuries

Your Chiropractor will assess if the complaint is potentially related to, or perhaps worsened by joint dysfunction and faulty neural communication. Chiropractors are trained to correct and restore proper joint function and communication allowing the body to heal and grow at its best.

It is important to correct asymmetry as soon as possible. During infancy there are optimal times at which basic skills should be learnt. If a skill is not acquired correctly or is acquired poorly out of the normal chain of events pattern, it can interfere with cognitive and motor development later on. This is a fundamental reason why even minor signs and asymmetry should be detected and treated as early as possible so as to avoid excessive treatment at a later date. Often, with children, pain is not associated with their complaints as it is in adults.

The big picture is summed up well by Behrman and Vaughan (1969) who suggest that “The goal in the…management of the child is to permit him to come into adulthood at his optimal state of development, physically, mentally and socially, so that he can compete at his most effective level”

Is Paediatric Chiropractic Effective?

Evidence

As early as 1989 Klougart showed benefit of spinal manipulation in colic. Olafsdottir (2001) showed no more effect than placebo, however the treatments in the study included mobilization only and only three treatments were given over an eight-day period. Hughes and Bolton (2002) found ambivalent evidence for effect in colicky infants but still in favour of chiropractic.
A Randomized Controlled Trial found: “Chiropractic manual therapy improved crying behaviour in infants with colic. The findings showed that knowledge of treatment by the parent did not appear to contribute to the observed treatment effects in this study. Thus, it is unlikely that observed treatment effect is due to bias on the part of the reporting parent” (Miller et al. 2012)
In a Cochrane review of manipulative therapies for infantile colic, it was noted that parents of infants receiving manipulative therapy reported fewer hours crying per day in their colicky infants than parents of babies who were not adjusted (Dobson et al. 2014)

A 2011 Systematic Review of Chiropractic care of infants with colic reported that: “chiropractic care is a viable alternative to the care of infantile colic and congruent with evidence-based practice, particularly when one considers that medical care options are no better than placebo or have associated adverse events.” (Alcantara et al. 2011)
Miller et al. 2009 concluded that: “Chiropractic treatment may be a useful adjunct to routine care given by other professionals in cases of diagnosed breastfeeding problems with a biomechanical component.”
Wiberg et al. 1999 showed that spinal manipulation was effective in relieving infantile colic
A 2016 review by Yao et al. concluded: “It can be concluded that manual chiropractic therapy is the most successful option for the management of paediatric musculo – skeletal health of infants. In addition, few adverse effects have been reported, and these are negligible in comparison to the beneficial accounts of manual therapy.”
Bronfort 2001 showed subjective ratings of asthma by patients to be significantly improved.

George and Topaz (2013) found that: “In general, there is an increasing body of research on the use of different CAM (Complementary and Alternative Medicine) modalities among individuals with asthma”

Is Paediatric Chiropractic Safe?

In much the same way that you would not give a child an adult dose of medication so the adjustments given to children are modified accordingly. The techniques used by skilled Chiropractors are safe, gentle and effective at relieving joint dysfunction and their effects.

Evidence

A retrospective study on Chiropractic treatment of children younger than 3 years stated: “This study shows that for the population studied, chiropractic manipulation produced very few adverse effects and was a safe form of therapy in the treatment of patients in this age group. “(Miller et al. 2008)
A best evidence review by Doyle 2011. claimed: “The application of modern chiropractic paediatric care within the out- lined framework is safe. A reasonable caution to the parent/guardian is that one child per 100 to 200 attending may have mild Adverse Events , with irritability or soreness lasting less than 24 h, resolving without the need for additional care beyond initial chiropractic recommendations”
A literature review by Todd et al. 2015 concluded “Published cases of serious adverse events in infants and children receiving chiropractic, osteopathic, physiotherapy, or manual medical therapy are rare… Because underlying pre-existing pathology was associated in a majority of reported cases, performing a thorough history and examination to exclude anatomical or neurologic anomalies before applying any manual therapy may further reduce adverse events across all manual therapy professions.”

References

Alcantara, J. and Alcantara, J. D., 2011. The chiropractic care of infants with colic: a systematic review of the literature. Explore (NY), 7 (3), 168-174.
Bronfort, G., Evans, R. L., Kubic, P. and Filkin, P., 2001. Chronic pediatric asthma and chiropractic spinal manipulation: a prospective clinical series and randomized clinical pilot study. J Manipulative Physiol Ther, 24 (6), 369-377.
Dobson, D., Lucassen, P. L., Miller, J. J., Vlieger, A. M., Prescott, P. and Lewith, G., 2012. Manipulative therapies for infantile colic. Cochrane Database Syst Rev, 12, CD004796.
Gottlieb, M. S., 1993. Neglected spinal cord, brain stem and musculoskeletal injuries stemming from birth trauma. J Manipulative Physiol Ther, 16 (8), 537-543.
Hughes, S. and Bolton, J., 2002. Is chiropractic an effective treatment in infantile colic? Arch Dis Child, 86 (5), 382-384.
Klougart, N., Nilsson, N. and Jacobsen, J., 1989. Infantile colic treated by chiropractors: a prospective study of 316 cases. J Manipulative Physiol Ther, 12 (4), 281-288.
Miller, J. E. and Benfield, K., 2008. Adverse effects of spinal manipulative therapy in children younger than 3 years: a retrospective study in a chiropractic teaching clinic. J Manipulative Physiol Ther, 31 (6), 419-423.
Miller, J. E., Miller, L., Sulesund, A. K. and Yevtushenko, A., 2009. Contribution of chiropractic therapy to resolving suboptimal breastfeeding: a case series of 114 infants. J Manipulative Physiol Ther, 32 (8), 670-674.
Miller, J. E., Newell, D. and Bolton, J. E., 2012. Efficacy of chiropractic manual therapy on infant colic: a pragmatic single-blind, randomized controlled trial. J Manipulative Physiol Ther, 35 (8), 600-607.
Olafsdottir, E., Forshei, S., Fluge, G. and Markestad, T., 2001. Randomised controlled trial of infantile colic treated with chiropractic spinal manipulation. Arch Dis Child, 84 (2), 138-141.
Todd, A. J., Carroll, M. T., Robinson, A. and Mitchell, E. K., 2015. Adverse Events Due to Chiropractic and Other Manual Therapies for Infants and Children: A Review of the Literature. J Manipulative Physiol Ther, 38 (9), 699-712.
Wiberg, J. M., Nordsteen, J. and Nilsson, N., 1999. The short-term effect of spinal manipulation in the treatment of infantile colic: a randomized controlled clinical trial with a blinded observer. J Manipulative Physiol Ther, 22 (8), 517-522.
Yao, D., Deng, X. and Wang, M., 2016. Management of musculoskeletal dysfunction in infants. Exp Ther Med, 11 (6), 2079-2082.

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