Chiropractic Pediatrics Vs. Reality (Part I)

No Adjustment Necessary

On May 8th, Sharon Kirkey published an article in the National Post on the dubious offerings of chiropractors who manipulate children and infants. The article was respectful of responsible chiropractors and instead focused on bogus pediatric claims outside the domain of musculoskeletal conditions. In the worst cases, I have encountered chiropractors who believe that they can use spinal manipulation to treat mental illness, infectious diseases, and even cancer in children. Despite being a regulated health profession, these claims continue nearly unabated on websites, social media, and other advertising mediums, putting the health of Canadians at great risk. I have taken it upon myself to report these practices in my spare time, but I simply do not have enough time to take on every unethical practice.

Following the publication of Kirkey’s piece, the National Post published a response from the Canadian Chiropractic Association’s (CCA) Chair, chiropractor David Peeace. The CCA is generally considered to be among the voices for progressive and evidence-based chiropractic in Canada. How progressive are they? Well, they have accepted vaccination as an effective public health measure outside the scope of chiropractic practice. You might think that is a pretty low bar for a national organization representing health professionals, but it’s a standard that even some chiropractic regulators have failed to meet.

This is why the response from the CCA was so troubling; their letter ignored the issues at hand and instead defended pediatric practices broadly. Of course, it’s worth remembering that the CCA is not a public health organization and not a regulatory body. Rather, they are an advocacy organization for chiropractors whose mission is for chiropractors to be “an integral part of every Canadian’s healthcare team by 2023.” All I will say in response to that is: won’t somebody please think of the children?

While pediatrician Dr. Clay Jones wrote a response to the CCA’s letter at Science-Based Medicine, I wrote my own response which I forwarded to the National Post editors. Since it seems evident at this point that they will not be publishing my response, I will post it here. Enjoy.

Chiropractic Pediatrics Not All It’s Cracked Up to Be

In response to criticism of pediatric practices that “border on the fraudulent,” Canada’s largest chiropractic advocacy organization responded in a fashion that one would expect from politicians rather than registered health professionals; the response ignored the pseudoscientific elephant in the room and mounted a defense of indefensible practices.

While there may be a role for chiropractors to manage musculoskeletal (MSK) conditions in adolescents and children (although not well established in the literature), this was not the issue addressed in Sharon Kirkley’s original piece, which narrowed in on “outlandish” claims that mislead the public on serious medical conditions outside of the scope and expertise of chiropractors. The piece also addressed erroneous claims that “birth trauma” to the spine is a common concern that parents should address with chiropractic care.

Despite claims of “successful outcomes,” there is no credible evidence suggesting that spinal manipulation is indicated for any infantile condition. Though the risk of serious adverse events may be low, unnecessary procedures with no demonstrated benefits and documented risks have no place in our healthcare ecosystem. An additional risk exists with young children who may present with MSK complaints that arise from serious underlying causes, requiring appropriate medical evaluation beyond the scope of chiropractic care.

Unfortunately, unsubstantiated pediatric practices and the deceptive advertising that comes with them are commonplace in Canada. Although the precise prevalence is unknown (neither chiropractic advocacy organizations nor regulators seem to keep track), their existence is no secret to anyone with a web browser.

A small proportion of these chiropractors belong to the International Chiropractic Pediatric Association (ICPA), which boasts almost 600 Canadian members. The ICPA’s mission includes the claim to “improve the health of children,” yet they have propelled anti-vaccination ideas and act as a publication venue for papers of questionable quality, highlighting additional affronts to both public health and science.

These are not just my opinions. Earlier this year, the Canadian Paediatric Society reaffirmed their position on chiropractic, raising concerns regarding lack of evidence, lack of training, misleading vaccination advice, overuse of x-rays, and potential side effects. While I have observed many members of the chiropractic profession lambast the medical profession, at least the Canadian Medical Association is forthcoming about the skeletons in their closet and is actively engaged in public health efforts, including confrontation of the opioid crisis.

To avoid instigating a #notallchiropractors movement, it’s worth acknowledging that the profession has made progress in recent years. Indeed, public health experts are increasingly willing to extend an olive branch to the chiropractic community in recognition of the responsible and knowledgeable practitioners who look after the musculoskeletal health of Canadians. The terms, however, are non-negotiable: it is time to drop the pseudoscience.

Social Media is More Harmful Than Fluoride

Driven by alternative health practitioners and people who share articles without reading them (do I repeat myself?), a recent article has been making its rounds on social media. Just like anything that would make Alex Jones say he told us so, the boldly titled article, “Fluoride Officially Classified As A Neutotoxin In World’s Top Medical Journals,” should give us pause.

Firstly, who is the source? The website is branded with the “Awareness Act” moniker, but there is no indication that this is a legitimate organization or that it is affiliated with anything other than its own pseudo-brand. There is no about page, no mission statement, no contact information other than a Gmail address offered on the DMCA page, and no single person brave enough to take personal responsibility for this monstrosity. They do, however, have some pretty dank conspiracies:

You’re better off not knowing what this video is about. Source:

If you still are not convinced that there might be more reputable sources to inform public health policy, perhaps you should check out the Awareness Act misinformation featured on Snopes, or their rating on Still want to hear what they have to say? Alright, let’s dive in.

As we know from the title, the article claims The Lancet (a medical journal) classified fluoride as a neurotoxin. That would be a strange thing for a journal to do. Why the article was written recently when they reference an issue of The Lancet Neurology from 4 years ago is another oddity, but it is clear that they were biased from the onset: “people are hoping that by bringing awareness to this that somehow we can get sodium fluoride removed from the world’s water supply.” It’s almost as if they already found their conclusion and are merely victims of confirmation bias.

Of course, it is no mystery that fluoride can be harmful in high enough doses. This is true of anything. If there is one thing alternative health and conspiracy theory communities continuously fail to grasp, it’s that the dose makes the poison. I doubt anti-fluoride activists are as careful to avoid equally harmless natural toxins found in produce.

As with all things, the benefits must be weighed against the harms. When it comes to public health, this requires careful cost-benefit analysis drawing on years of complex scientific evidence. In the case of fluoride, the evidence tells us that there are public health and financial benefits to maintaining an optimal level of fluoride. I say optimal because there are consequences from a high dose, but – despite what you might hear from dubious internet sources – overly high fluoride intake is more likely to occur from natural fluoride sources than from carefully controlled municipal systems.

Regarding the paper cited in The Lancet, it’s worth pointing out that – despite the Awareness Act article being published less than a month ago – the link in article is a dead end.

The Lancet
Must be a conspiracy, naturally. Source:

When searching for the original study, I came across this article on Snopes, which debunks the very article I set out to address in this post. Since they were so thorough, I will only conclude by pointing to a recent study examining fluoride neurotoxicity in mice. What did they find? Absolutely no evidence of neurotoxicity, strengthening the growing body of evidence indicating that fluoridated water is both safe and effective.

So what should concern you? Certainly the increasing risk of being misinformed on social media. Unfortunately – despite their best intentions – it’s likely that we all have friends and family who pose a risk by sharing misinformed health information. While it would be nice if everyone took a bit more personal responsibility ensuring they aren’t putting anyone at risk, it’s hard to blame them when even health professional endanger public health with falsehoods.