Answers to Questions about Chiropractic:
Should Chiropractors Treat Children
Who Have Skeletal Dysplasia?

Samuel Homola, D.C.

Question

Whether or not people with skeletal dysplasias should get treated by chiropractors comes up a lot in the little people forums. Lots of parents have posted about taking children with dwarfism to chiropractors, encouraging new parents to take kids with dwarfism to chiropractors for "chiropractic adjustments."

Since kids with dwarfism have real and major spine issues, serious enough to cause paralysis or death, my understanding is that they should not be touched by a chiropractor. The spine issues that go along with dwarfism are serious, and the medical treatments are pretty unpleasant. I understand the urge to seek out alternative treatments when the orthopedic surgeon says your kid needs to spend the next 6 months in a HALO for a skull-to-C7 fusion. But it terrifies me that chiropractors are treating pediatric skeletal dysplasia patients at all, much less patients with actual big-ticket congenital spine problems.

Can you write up something that I can link to when the topic comes up? Something that explains that there are hundreds of types of skeletal dysplasia, requiring even orthopedic surgeons to hit the books when dealing with patients with dwarfism. That way, when parents of a kid with dwarfism ask if they should take their kid to a chiropractor, they can be linked to a warning that chiropractic care is absolutely inappropriate for a pediatric skeletal dysplasia patient and that such treatment could result in paralysis or death.

Answer

I do not recommend pediatric chiropractic care for any child for any condition. Chiropractic manipulation should never be done on a child with skeletal dysplasia, a genetic collagen disorder affecting connective tissue in cartilage and bone. Even in a child with healthy tissue and bones, spinal manipulation or "spinal adjustments" might result in injury to cartilaginous growth centers. Such treatment would be especially dangerous for a child with skeletal dysplasia in which structural abnormality may result in narrowing (stenosis) of the spinal canal and displacement of the top two cervical vertebrae, causing compression of the spinal cord or the brain stem.

Generally, spinal manipulation is not recommended for pre-adolescent children since their bones are not fully formed. It certainly should not be done on a newborn infant or a small child, as some chiropractors are doing to correct "subluxations." I cannot imagine a more horrendous scenario than a chiropractor "adjusting" the cervical spine of a newborn infant with unrecognized skeletal dysplasia.

Chiropractors are not adequately trained in pediatric disorders to make a correct diagnosis or to recommend appropriate treatment. There are dozens of forms of skeletal dysplasia, the most common of which are achrondroplasia (dwarfism) and multiple epiphyseal dysplasia (affecting multiple cartilaginous growth centers). Less common short-limbed dwarfism in the newborn is described as lethal or potentially lethal. Special expertise and special testing are required to make a correct diagnosis and to select an appropriate treatment option in all cases of skeletal dysplasia (or osteochondrodysplasia). Not all pediatricians are capable of handling a case of skeletal dysplasia. A chiropractor is not qualified or trained to handle any pediatric condition, much less skeletal dysplasia.

While some chiropractors may be capable of treating a musculoskeletal problem in a child who has reached adolescence, I always recommend that a parent with a child suffering from any form of skeletal dysplasia seek the advice of a pediatric orthopedist.

Aso see my article Pediatric Chiropractic Care: Scientifically Indefensible?

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Dr. Homola is a second-generation chiropractor who has dedicated himself to defining the proper limits on chiropractic and to educating consumers and professionals about the field. His 1963 book Bonesetting, Chiropractic, and Cultism supported the appropriate use of spinal manipulation but renounced chiropractic dogma. His 1999 book Inside Chiropractic: A Patient's Guide provides an incisive look at chiropractic's history, benefits, and shortcomings. Now retired after 43 years of practice, he lives in Panama City, Florida.

This page was posted on June 18, 2013.