Chiropractic treatment for children to face 'rigorous' review in B.C.

The body that regulates chiropractors in B.C. is promising a thorough review of the scientific evidence about chiropractic treatments for children.

The move comes after the College of Chiropractors of B.C. received a complaint from a health-care professional about a chiropractor advertising therapies for kids, according to interim college registrar Richard Simpson.

"There is a significant body of evidence concerning the benefits of chiropractic treatment for patients of all ages. Still, the CCBC is committed to evidence-informed practice, best practices and standards in marketing," Simpson wrote in an email.

"As such, the board has decided to proceed with a rigorous review and evaluation of research and evidence concerning this issue and other topics."

He added that the college is interested in establishing a review of the evidence for chiropractic therapies involving patients of all ages.

"The college has received a number of documents from citizens and registrants purporting to be acceptable evidence for one form of treatment or another. It is my view, even as a layperson, that most, if not all, of the documents would not meet the test of acceptable evidence," Simpson wrote.

These reviews have not yet begun, and the college has not settled on a process for analyzing the current evidence. Simpson said it's possible the reviews will be part of a national process, which the college believes is "in the best interests of the profession."

'Zero evidence' supporting treatment of babies

The news comes as some chiropractors in other parts of the country are facing scrutiny over their treatment of babies, including newborns.

In an interview with CBC, Bernie Garrett, a UBC nursing professor who studies deception in health care, described the college's proposed review of chiropractic treatment for children as "excellent news." 

"There's practically zero evidence of any benefits, particularly in infants," Garrett said. "If you ask any pediatrician or pediatrics society as well, they'll confirm that there is no indication for chiropractic in infants or in children, unless there's obviously some [spinal] issues."

According to a position paper from the Canadian Pediatric Society, there have been no satisfactory studies of chiropractic treatments for back pain in children. Some studies have suggested that chiropractic manipulation of the neck can provide short-term relief of neck pain in children, but its efficacy hasn't been compared to other therapies, the paper says.

Garrett said he'd like to see chiropractic for infants banned in B.C., as well as strict guidelines for treatment of other children.

67 chiropractors under investigation

The college has already barred chiropractors from claiming to treat a long list of childhood conditions as part of its new efficacy claims policy. That policy, which came into effect last October, forbids chiropractors from making unscientific and unsupported claims about treating everything from Alzheimer's disease and cancer to autism, ear infections and ADHD.

All practitioners were given until Nov. 1 to bring their advertising in line with the new policy or face investigation and potential discipline.

To date, 67 chiropractors have been investigated for possible violations of the policy, and 53 have consented to reprimands, agreed to pay fines and signed undertakings promising to follow the rules from now on. Another 13 have hired lawyers, and one has yet to respond.

"Overall, I am satisfied that the vast majority of B.C.'s 1,200-plus chiropractors understand the importance of a clear, focused efficacy claims policy. For the handful of registrants who may not be in compliance, the college has been quick to identify them, communicated directly with them to discuss the issue, and forwarded concerns to the inquiry committee for consideration," Simpson said.

He said all the violations of policy were identified by the college, which has developed a scanning program that sweeps websites and social media for keywords. The college plans to continue updating the policy as it reviews scientific evidence about treatments.

Unproven claims by B.C. chiropractors became a public issue last year, after CBC reported on a Facebook video created by then-vice-chair of the college board, Avtar Jassal. In the video, he falsely claimed that smoothies are more effective than vaccination at preventing influenza.

That video violated the college's policy on immunization, which forbids chiropractors from providing any advice on vaccination issues. The video was removed from Facebook and Jassal resigned from the board following CBC's reporting.

On Monday, the college revealed that Jassal agreed to a reprimand and a fine last summer after an investigation by an independent inspector.

Is there more to this story? Reach the reporter by email at bethany.lindsay@cbc.ca