Chiropractors have been banned again from manipulating babies’ spines. Here’s what the evidence actually says
10almonds is reader-supported. We may, at no cost to you, receive a portion of sales if you purchase a product through a link in this article.
Chiropractors in Australia will not be able to perform spinal manipulation on children under the age of two once more, following health concerns from doctors and politicians.
But what is the spinal treatment at the centre of the controversy? Does it work? Is there evidence of harm?
We’re a team of researchers who specialise in evidence-based musculoskeletal health. I (Matt) am a registered chiropractor, Joshua is a registered physiotherapist and Giovanni trained as a physiotherapist.
Here’s what the evidence says.
Remind me, how did this all come about?
A Melbourne-based chiropractor posted a video on social media in 2018 using a spring-loaded device (known as the Activator) to manipulate the spine of a two-week-old baby suspended upside down by the ankles.
The video sparked widespread concerns among the public, medical associations and politicians. It prompted a ban on the procedure in young children. The Victorian health minister commissioned Safer Care Victoria to conduct an independent review of spinal manipulation techniques on children.
Recently, the Chiropractic Board of Australia reinstated chiropractors’ authorisation to perform spinal manipulation on babies under two years old. But this week, it backflipped, following heavy criticism from medical associations and politicians.
What is spinal manipulation?
Spinal manipulation is a treatment used by chiropractors and other health professionals such as doctors, osteopaths and physiotherapists.
It is an umbrella term that includes popular “back cracking” techniques.
It also includes more gentle forms of treatment, such as massage or joint mobilisations. These involve applying pressure to joints without generating a “cracking” sound.
Does spinal manipulation in babies work?
Several international guidelines for health-care professionals recommend spinal manipulation to treat adults with conditions such as back pain and headache as there is an abundance of evidence on the topic. For example, spinal manipulation for back pain is supported by data from nearly 10,000 adults.
For children, it’s a different story. Safer Care Victoria’s 2019 review of spinal manipulation found very few studies testing whether this treatment was safe and effective in children.
Studies were generally small and were of poor quality. Some of those small, poor-quality studies, suggest spinal manipulation provides a very small benefit for back pain, colic and potentially bedwetting – some common reasons for parents to take their child to see a chiropractor. But overall, the review found the overall body of evidence was very poor.
However, for most other children’s conditions chiropractors treat – such as headache, asthma, otitis media (a type of ear infection), cerebral palsy, hyperactivity and torticollis (“twisted neck”) – there did not appear to be a benefit.
The number of studies investigating the effectiveness of spinal manipulation on babies under two years of age was even smaller.
There was one high-quality study and two small, poor quality studies. These did not show an appreciable benefit of spinal manipulation on colic, otitis media with effusion (known as glue ear) or twisted neck in babies.
Is spinal manipulation on babies safe?
In terms of safety, most studies in the review found serious complications were extremely rare. The review noted one baby or child dying (a report from Germany in 2001 after spinal manipulation by a physiotherapist). The most common complications were mild in nature such as increased crying and soreness.
However, because studies were very small, they cannot tell us anything about the safety of spinal manipulation in a reliable way. Studies that are designed to properly investigate if a treatment is safe typically include thousands of patients. And these studies have not yet been done.
Why do people see chiropractors?
Safer Care Victoria also conducted surveys with more than 20,000 people living in Australia who had taken their children under 12 years old to a chiropractor in the past ten years.
Nearly three-quarters said that was for treatment of a child aged two years or younger.
Nearly all people surveyed reported a positive experience when they took their child to a chiropractor and reported that their child’s condition improved with chiropractic care. Only a small number of people (0.3%) reported a negative experience, and this was mostly related to cost of treatment, lack of improvement in their child’s condition, excessive use of x-rays, and perceived pressure to avoid medications.
Many of the respondents had also consulted their GP or maternity/child health nurse.
What now for spinal manipulation in children?
At the request of state and federal ministers, the Chiropractic Board of Australia confirmed that spinal manipulation on babies under two years old will continue to be banned until it discusses the issue further with health ministers.
Many chiropractors believe this is unfair, especially considering the strong consumer support for chiropractic care outlined in the Safer Care Victoria report, and the rarity of serious reported harms in children.
Others believe that in the absence of evidence of benefit and uncertainty around whether spinal manipulation is safe in children and babies, the precautionary principle should apply and children and babies should not receive spinal manipulation.
Ultimately, high quality research is urgently needed to better understand whether spinal manipulation is beneficial for the range of conditions chiropractors provide it for, and whether the benefit outweighs the extremely small chance of a serious complication.
This will help parents make an informed choice about health care for their child.
Matt Fernandez, Senior lecturer and researcher in chiropractic, CQUniversity Australia; Giovanni E. Ferreira, NHMRC Emerging Leader Research Fellow, Institute of Musculoskeletal Health, University of Sydney, and Joshua Zadro, NHMRC Emerging Leader Research Fellow, Sydney Musculoskeletal Health, University of Sydney
This article is republished from The Conversation under a Creative Commons license. Read the original article.
Don’t Forget…
Did you arrive here from our newsletter? Don’t forget to return to the email to continue learning!
Recommended
Learn to Age Gracefully
Join the 98k+ American women taking control of their health & aging with our 100% free (and fun!) daily emails:
-
The Kitchen Prescription – by Saliha Mahmood Ahmed
10almonds is reader-supported. We may, at no cost to you, receive a portion of sales if you purchase a product through a link in this article.
One of the biggest challenges facing anyone learning to cook more healthily, is keeping it tasty. What to cook when your biggest comfort foods all contain things you “should” avoid?
Happily for us, Dr. Ahmed is here with a focus on comfort food that’s good for your gut health. It’s incidentally equally good for the heart and good against diabetes… but Dr. Ahmed is a gastroenterologist, so that’s where she’s coming from with these.
There’s a wide range of 101 recipes here, including many tagged vegetarian, vegan, and/or gluten-free, as appropriate.
While this is not a vegetarian cookbook, Dr. Ahmed does consider the key components of a good diet to be, in order of quantity that should be consumed:
- Fruits and vegetables
- Whole grains
- Legumes
- Pulses
- Nuts and seeds
…and as such, the recipes are mostly plant-based.
The recipes are from all around the world, and/but the ingredients are mostly things that are almost universal. In the event that something might be hard-to-get, she suggests an appropriate substitution.
The recipes are straightforward and clear, as well as being beautifully illustrated.
All in all, a fine addition to anyone’s kitchen!
Get your copy of The Kitchen Prescription from Amazon today!
Share This Post
-
Water Water Everywhere, But Which Is Best To Drink?
10almonds is reader-supported. We may, at no cost to you, receive a portion of sales if you purchase a product through a link in this article.
Well Well Well…
In Tuesday’s newsletter, we asked you for your (health-related) opinion on drinking water—with the understanding that this may vary from place to place. We got the above-depicted, below-described, set of responses:
- About 65% said “Filtered is best”
- About 20% said “From the mains is best”
- About 8% said “Bottled is best”
- About 3% said “Distilled is best”
- About 3% said “Some other source is best”
Of those who said “some other source is best”, one clarified that their preferred source was well water.
So what does the science say?
Fluoridated water is bad for you: True or False?
False, assuming a normal level of consumption. Rather than take up more space today though, we’ll link to what we previously wrote on this topic:
You may be wondering: but what if my level of consumption is higher than normal?
Let’s quickly look at some stats:
- The maximum permitted safety level varies from place to place, but is (for example) 2mg/l in the US, 1.5mg/l in Canada & the UK.
- The minimum recommended amount also varies from place to place, but is (for example) 0.7mg/l in Canada and the US, and 1mg/l in the UK.
It doesn’t take grabbing a calculator to realize that if you drink twice as much water as someone else, then depending on where you are, water fluoridated to the minimum may give you more than the recommended maximum.
However… Those safety margins are set so much lower than the actual toxicity levels of fluoride, that it doesn’t make a difference.
For example: your writer here takes a medication that has the side effect of causing dryness of the mouth, and consequently she drinks at least 3l of water per day in a climate that could not be described as hot (except perhaps for about 2 weeks of the year). She weighs 72kg (that’s about 158 pounds), and the toxicity of fluoride (for ill symptoms, not death) is 0.2mg/kg. So, she’d need 14.4mg of fluoride, which even if the water fluoridation here were 2mg/l (it’s not; it’s lower here, but let’s go with the highest figure to make a point), would require drinking more than 7l of water faster than the body can process it.
For more about the numbers, check out:
Acute Fluoride Poisoning from a Public Water System
Bottled water is the best: True or False?
False, if we consider “best” to be “healthiest”, which in turn we consider to be “most nutrients, with highest safety”.
Bottled water generally does have higher levels of minerals than most local mains supply water does. That’s good!
But you know what else is generally has? Microplastics and nanoplastics. That’s bad!
We don’t like to be alarmist in tone; it’s not what we’re about here, but the stats on bottled water are simply not good; see:
We Are Such Stuff As Bottles Are Made Of
You may be wondering: “but what about bottled water that comes in glass bottles?”
Indeed, water that comes in glass bottles can be expected to have lower levels of plastic than water that comes in plastic bottles, for obvious reasons.
However, we invite you to consider how likely you believe it to be that the water wasn’t stored in plastic while being processed, shipped and stored, before being portioned into its final store-ready glass bottles for end-consumer use.
Distilled water is the best: True or False?
False, generally, with caveats:
Distilled water is surely the safest water anywhere, because you know that you’ve removed any nasties.
However, it’s also devoid of nutrients, because you also removed any minerals it contained. Indeed, if you use a still, you’ll be accustomed to the build-up of these minerals (generally simplified and referenced as “limescale”, but it’s a whole collection of minerals).
Furthermore, that loss of nutrients can be more than just a “something good is missing”, because having removed certain ions, that water could now potentially strip minerals from your teeth. In practice, however, you’d probably have to swill it excessively to cause this damage.
Nevertheless, if you have the misfortune of living somewhere like Flint, Michigan, then a water still may be a fair necessity of life. In other places, it can simply be useful to have in case of emergency, of course.
Here’s an example product on Amazon if you’d like to invest in a water still for such cases.
PS: distilled water is also tasteless, and is generally considered bad, tastewise, for making tea and coffee. So we really don’t recommend distilling your water unless you have a good reason to do so.
Filtered water is the best: True or False?
True for most people in most places.
Let’s put it this way: it can’t logically be worse than whatever source of water you put into it…
Provided you change the filter regularly, of course.
Otherwise, after overusing a filter, at best it won’t be working, and at worst it’ll be adding in bacteria that have multiplied in the filter over however long you left it there.
You may be wondering: can water filters remove microplastics, and can they remove minerals?
The answer in both cases is: sometimes.
- For microplastics it depends on the filter size and the microplastic size (see our previous article for details on that).
- For minerals, it depends on the filter type. Check out:
The H2O Chronicles | 5 Water Filters That Remove Minerals
One other thing to think about: while most water filtration jugs are made of PFAS-free BPA-free plastics for obvious reasons, for greater peace of mind, you might consider investing in a glass filtration jug, like this one ← this is just one example product on Amazon; by all means shop around and find one you like
Take care!
Share This Post
-
True Age – by Dr. Morgan Levine
10almonds is reader-supported. We may, at no cost to you, receive a portion of sales if you purchase a product through a link in this article.
Yesterday’s book review (Counterclockwise) was about psychological factors affecting physical aging (progression or reversal thereof); today we have a book about the physiological factors affecting physical aging (progression or reversal thereof).
Dr. Levine is first and foremost a gerontological epigeneticist, and a lot of this book touches on her research in that field and that of her colleagues.
She does also discuss direct environmental factors also though, and—as you might well expect—lifestyle factors.
Regular readers of 10almonds are unlikely to gain anything new in the category of lifestyle matters, but a lot of the other material will be enlightening, especially with regard to the things that might at first glance seem set in stone, but we can in fact modify, and thus “choose our own adventure” when it comes to how the rest of our life plays out, healthwise (so: choose wisely!).
The book is mostly an overview on the (at time of writing: 2022) current state of affairs in the world of longevity research, and although it’s not a “how to” manual, there is plenty in the category of practical takeaways to be gleaned too.
The style is is mostly light pop science, but with a lot of hard science woven in—she is a good explainer, and has clearly made a notable effort to explain complex concepts in simple ways, while still delivering the complex concepts too (i.e. not overly “dumbing down”).
Bottom line: if you’d like to know about what can be done to increase your healthspan and general longevity, this book has a lot of answers!
Click here to check out True Age, and shift yours in the direction you prefer!
Share This Post
Related Posts
-
Serotonin vs Dopamine (Know The Differences)
10almonds is reader-supported. We may, at no cost to you, receive a portion of sales if you purchase a product through a link in this article.
Of the various neurotransmitters that people confuse with each other, serotonin and dopamine are the two highest on the list (with oxytocin coming third as people often attribute its effects to serotonin). But, for all they are both “happiness molecules”, serotonin and dopamine are quite different, and are even opposites in some ways:
More than just happiness
Let’s break it down:
Similarities:
- Both are neurotransmitters, neuromodulators, and monoamines.
- Both impact cognition, mood, energy, behavior, memory, and learning.
- Both influence social behavior, though in different ways.
Differences (settle in; there are many):
- Chemical structure:
- Dopamine: catecholamine (derived from phenylalanine and tyrosine)
- Serotonin: indoleamine (derived from tryptophan)
- Derivatives:
- Dopamine → noradrenaline and adrenaline (stress and alertness)
- Serotonin → melatonin (sleep and circadian rhythm)
- Effects on mental state:
- Dopamine: drives action, motivation, and impulsivity.
- Serotonin: promotes calmness, behavioral inhibition, and cooperation.
- Role in memory and learning:
- Dopamine: key in attention and working memory
- Serotonin: crucial for hippocampus activation and long-term memory
Symptoms of imbalance:
- Low dopamine:
- Loss of motivation, focus, emotion, and activity
- Linked to Parkinson’s disease and ADHD
- Low serotonin:
- Sadness, irritability, poor sleep, and digestive issues
- Linked to PTSD, anxiety, and OCD
- High dopamine:
- Excessive drive, impulsivity, addictions, psychosis
- High serotonin:
- Nervousness, nausea, and in extreme cases, serotonin syndrome (which can be fatal)
Brain networks:
- Dopamine: four pathways controlling movement, attention, executive function, and hormones.
- Serotonin: widely distributed across the cortex, partially overlapping with dopamine systems.
Speed of production:
- Dopamine: can spike and deplete quickly; fatigues faster with overuse.
- Serotonin: more stable, releasing steadily over longer periods.
Illustrative examples:
- Coffee boosts dopamine but loses its effect with repeated use.
- Sunlight helps maintain serotonin levels over time.
If you remember nothing else, remember this:
- Dopamine: action, motivation, and alertness.
- Serotonin: contentment, happiness, and calmness.
For more on all of the above, enjoy:
Click Here If The Embedded Video Doesn’t Load Automatically!
Want to learn more?
You might also like to read:
Take care!
Don’t Forget…
Did you arrive here from our newsletter? Don’t forget to return to the email to continue learning!
Learn to Age Gracefully
Join the 98k+ American women taking control of their health & aging with our 100% free (and fun!) daily emails:
-
Peanuts vs Pecans – Which is Healthier?
10almonds is reader-supported. We may, at no cost to you, receive a portion of sales if you purchase a product through a link in this article.
Our Verdict
When comparing peanuts to pecans, we picked the peanuts.
Why?
Peanuts are an oft-underrated nut!
In terms of macros, peanuts have more than 2.5x the protein and slightly more carbs, while pecans have very slightly more fiber and a lot more fat, of which, mostly healthy monounsaturated and polyunsaturated fats, though it’s worth noting that peanuts’ fats are equally healthy and have a similar general profile, just, less fat per 100g than pecans do. There’s a lot going for both of these very different nuts here, so we’ll call this category a tie.
In the category of vitamins, peanuts have more of vitamins B2, B3, B5, B6, B7, B9, E, and choline, while pecans have more of vitamins C and K (of which they are still not a very good source, but peanuts have none so they can technically claim it for those two vitamins); thus, a clear win for peanuts here, especially as most of its vitamins had very large margins of difference over pecans, and peanuts are a good source of all the vitamins mentioned for them.
When it comes to minerals, peanuts have more calcium, iron, magnesium, phosphorus, potassium, and selenium, while pecans have more manganese and zinc. Another win for peanuts!
Adding up the sections makes for a clear win for peanuts, but by all means enjoy either or both (diversity is good), unless you are allergic, in which case, please don’t!
Want to learn more?
You might like:
Why You Should Diversify Your Nuts
Enjoy!
Don’t Forget…
Did you arrive here from our newsletter? Don’t forget to return to the email to continue learning!
Learn to Age Gracefully
Join the 98k+ American women taking control of their health & aging with our 100% free (and fun!) daily emails:
-
Parsley vs Spinach – Which is Healthier?
10almonds is reader-supported. We may, at no cost to you, receive a portion of sales if you purchase a product through a link in this article.
Our Verdict
When comparing parsley to spinach, we picked the parsley.
Why?
First of all, writer’s anecdote: today’s choice brought to you by a real decision here in my household! You see, a certain dish I sometimes prepare (it’s just a wrap-based dish, nothing fancy) requires a greenery component, and historically I’ve used kale or spinach. Of those two, I prefer kale while my son, who lives (and dines) with me, prefers spinach. However, we both like parsley equally, so I’m going to use that today. But I was curious about how it performed nutritionally, hence today’s comparison!
Ok, now for the stats…
In terms of macros, the only difference is that parsley has more fiber and carbs, for an approximately equal glycemic index, so we’ll go with the one with the highest total fiber, which is parsley.
In the category of vitamins, parsley has more of vitamins B3, B5, B7, B9, C, and K, while spinach has more of vitamins A, B2, B6, E, and choline. So, a marginal 6:5 win for parsley (and in the margins of difference are also in parsley’s favor, for example parsley has 13x the vitamin C, and 2x or 3x the other vitamins it won with, while spinach boasts 2x for some vitamins, and only 1.2x or 1.5x the others).
When it comes to minerals, parsley has more iron, phosphorus, potassium, and zinc, while spinach has more copper, magnesium, manganese, and selenium. So, a 4:4 tie on these.
In terms of phytochemicals, parsley has a much higher polyphenol content (that’s good) while spinach has a much higher oxalate content (that’s neutral for most people, but bad if you have certain kidney problems). So, another win for parsley.
Adding up the sections makes a clear overall win for parsley, but by all means enjoy either or both, unless you are avoiding oxalates, in which case, the oxalates in spinach can be reduced by cooking, but honestly, for most dishes you might as well just pick a different greens option (like parsley, or collard greens if you want something closer to the culinary experience of eating spinach).
Want to learn more?
You might like:
Invigorating Sabzi Khordan ← another great way to enjoy parsley as main ingredient rather than just a seasoning
Enjoy!
Don’t Forget…
Did you arrive here from our newsletter? Don’t forget to return to the email to continue learning!
Learn to Age Gracefully
Join the 98k+ American women taking control of their health & aging with our 100% free (and fun!) daily emails:
