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Chiropractic Not Effective | |
| Chiropractic No More Effective
than Placebo for Colicky Infants Chiropractic spinal manipulation is no more effective than placebo in treating infantile colic, according to a randomized, blinded, controlled trial published in a recent issue of the journal Archives of Diseases in Childhood. An estimated 22.5 percent of newborns suffer from colic, a condition marked by prolonged, intense, high-pitch crying. Though numerous studies have explored a possible gastrointestinal etiology, the cause of infantile colic remains unknown. Olafsdotvir et al from the Department of Pediatrics at the University of Bergen, Norway, recruited 100 colicky infants from public health care clinics, pediatric outpatient clinics, general practitioners, chiropractors, and from direct referrals from parents. All participants had typical infantile colic with no signs of lactose intolerance, no previous chiropractic treatment, and no benefit from sucrose or cow's milk-free formula (there are reports that some colicky infants respond favorably to these treatments). Infants were randomized to receive spinal manipulation (using light fingertip pressure) or were held by a nurse for an equivalent period of time. The chiropractic treatment was given three times, at intervals of two to five days, for a period of eight days. At the repeated visits, the parents received counseling and support on feeding, baby care, and family interactions. Parents also described the effect of the last visit on their colicky infant with a scale of five categories that included "getting worse," "no improvement," "some improvement," "marked improvement," and "completely well." The parents were also asked to record the frequency of their infant's crying in a 24-hour diary. A total of 86 infants completed the study. According to the parents' reports, there was no significant difference in outcome between the treatment group and the control group (p=0.743). The diaries reflected a similar outcome; there was no significant difference in the number of hours that the infants in the treatment group cried compared with the infants in the control group (p=0.982). There was, however, a reduction in crying hours per day in both groups; 69.9 percent of infants in the treatment group showed some degree of improvement and 60 percent of infants in the control group improved, according to the parents' report. "Our study shows a strong placebo effect, and also an effect of counseling and support to the parents of colicky infants," suggests Olafsdotvir et al. "In conclusion, our findings indicate that there are no benefits from treating infantile colic with chiropractic spinal manipulation." "The results of this study run contrary to a 1999 Danish study on colic (Wiberg et al, 1999) which showed a significant benefit for spinal manipulation when compared to simethicone," notes Daniel Redwood, DC, a practicing chiropractor in Virginia Beach, Virginia. "The new study has two advantages over the earlier one: the parents were not told which treatment their child received, and no children were required to ingest a medication, never shown to be superior to a placebo, which proved irritating to some. Possible shortcomings of the new study, aside from the central issue of whether to use caring touch as a placebo, are that all the chiropractic treatments were administered by one practitioner and that the standardized style of manipulation he utilized might differ from other chiropractic methods in its effectiveness." "What fascinates me most about this study," Redwood adds, "is that substantial decreases in crying, which is the primary measure of colic, were seen in about 70 percent of the group of colicky infants who received spinal manipulation, and 60 percent of those who were held for 10 minutes per session by a nurse. We should never underestimate the healing power of touch, and we should therefore be wary of interpretations which conclude from these results that neither spinal manipulation nor caring touch is helpful for infantile colic. It is very difficult-perhaps impossible-to design a truly inert placebo in studies of non-pharmaceutical modalities such as chiropractic, physical therapy, acupuncture, massage, and therapeutic touch. This study, which clearly was designed with much forethought and research expertise, once again brings this great unresolved methodological challenge to the forefront." References Olafsdotvir E, Forchei S, Fluge G, Markestad T. Randomised controlled trial of infantile colic treated with chiropractic spinal manipulation. Arch Dis Child. 2001;84:138-141.Wiberg JMM, Nordsteen J, Nilsson N. 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. 1999;22(8):517-522. |
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