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Infant spinal manipulation ban reinstated
The Chiropractic Board of Australia has bowed to concerns raised by medical bodies following a request from health ministers.
The Chiropractic Board of Australia quietly dropped its four-year ban on the spinal manipulation of babies last November.
In response to safety concerns, the Chiropractic Board of Australia (CBA) has again placed an interim ban on the practice of spinal manipulation for babies under two years of age, pending further discussion.
An interim ban of the practice was in place since 2019 but was lifted in November 2023 following changes to CBA guidelines. The updated guidelines were based on findings from a systematic review of the effectiveness and safety of spinal manipulation in children under 12 commissioned by Cochrane Australia, allowing chiropractors to ‘treat children according to current evidence and/or best-practice approaches’.
But last week health experts, including the RACGP, raised concerns over the procedure, with Federal Health and Aged Care Minister Mark Butler seeking ‘urgent’ clarification from the CBA on its decision to reinstate the procedure, given the lack of evidence supporting the Board’s guidelines.
The CBA said the interim decision is ‘pending further consultation with Australia’s health ministers’ and that it welcomes ‘any engagement with ministers that can further strengthen responsible practice’.
Sydney GP and Chair of RACGP Specific Interests Child and Young Person’s Health, Dr James Best, has labelled spinal manipulation for babies as ‘reckless practice’ that presents ‘potentially grave risks’.
When the four-year ban was lifted last week, Dr Best again warned there is no safety data on spinal manipulation in children.
‘There is good reason to be concerned that there may be safety issues given the anatomy and softness of children’s spines, them being more flexible and particularly more prone to damage by manipulation,’ he told newsGP.
‘Why would you be doing something that is potentially dangerous when there are current indications there is no evidence of benefit?’
In 2019 the RACGP welcomed the review into spinal manipulation of young children, which in conjunction with the Cochrane systematic review, led to the four-year ban on the practice in babies under two years. Conducted by Safer Care Victoria, the review’s findings and recommendations into a review of spinal manipulation on children performed by chiropractors showed poor evidence base for the procedure.
The latest interim ban on chiropractors is in place pending further discussion with the CBA and state, territory, and federal health ministers. The Board stated it will ‘consider its obligations under the National Law’ and any further decisions by health ministers in developing a final position.
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