The Australian Medical Association’s Victorian president, Dr Jill Tomlinson, described the practice as “manifestly unsafe”. “There is no reason that we should support a practice that carries risk with no clear benefit,” she said.
Tomlinson, who is a hand surgeon, said her members had treated patients who had suffered disc prolapses and strokes following chiropractic work. She will raise her concerns about the board’s decision with Safer Care Victoria and the Victorian health minister.
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Spinal manipulation involves moving the joints of the spine beyond a child’s normal range of motion using a high-velocity, low-amplitude thrust.
In March 2019, the Chiropractic Board of Australia announced an interim ban on the spinal manipulation of children under two, following public outrage over a video of a Melbourne chiropractor holding a two-week-old baby upside down.
The chiropractor then used a spring-loaded device on the newborn’s spine and tapped him on the head, with then Victorian health minister Jenny Mikakos describing the footage as “deeply disturbing”.
A follow-up review last year by Cochrane Australia, commissioned by the national healthcare watchdog AHPRA, reached the same conclusion about the lack of evidence supporting spinal manipulation of children.
However, in November the board released a statement to members saying that a range of care could be provided to children, including manual therapy, soft-tissue therapy and manipulation, if practitioners understand how children’s needs differ from adults and modified their care appropriately.
A spokesman for the Chiropractic Board of Australia said it “will respond to the concerns of the minister once his correspondence is received”.
The board previously told this masthead that its updated policy would ensure safe and appropriate care, based on the latest evidence and information, by chiropractors who treat children under 12.
University of Sydney health law expert Dr Christopher Rudge said the federal government had powers to potentially change the national law that governs chiropractors to ban the spinal manipulation of children.
But he said this was unlikely given the low-risk profile of the treatment and it would be more straightforward for the board to change its policy.
“Practitioners should probably do nothing if they don’t know of a clear benefit,” he said. “Beyond giving false hope to parents or patients themselves, they are taking their money … that’s another risk.”
One senior chiropractor, who spoke anonymously due to fear of industry reprisals, said chiropractors received no hands-on training when it came to treating babies and young children.
While he does not believe spinal manipulation of babies is unsafe, he said chiropractors were not trained to assess babies to determine what treatment was required and whether it was necessary.
“They might present with a parent saying they have colic but could be a bowel obstruction,” he said. “Or a headache could be brain tumour. They lack the training yet the board says they receive extensive training.”
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