No evidence for ‘reckless practice’ of manipulating infant’s spine: GP

The video, originally posted to the Facebook page of Cranbourne Family Chiropractic, shows Melbourne chiropractor Andrew Arnold manipulating the infant’s spine, hips and collarbone, and has led to an investigation by authorities.
 
Mr Arnold, who cannot treat children under 12 during the investigation, also uses a spring-loaded device called an ‘activator’ on the baby, which elicits cries from the child as it is applied to his neck, tailbone and spine.
 
Victorian Health Minister Jenny Mikakos described the footage as ‘deeply disturbing’ and referred Mr Arnold to the Chiropractic Board of Australia (CBA) and the Australian Health Practitioner Regulation Agency (AHPRA).
 
‘It’s appalling that young children and infants are being exposed to potential harm,’ Ms Mikakos said.
 
‘Newborn babies are extremely fragile and it’s important to be aware that the damage done to an infant may not be obvious immediately and may not manifest until years later.
 
‘The [CBA] must condemn this practice as unprofessional and unacceptable, and AHPRA must act quickly to stop these rogue practitioners in their tracks.’
 
AHPRA prohibits the advertising of these treatments, which are not backed by peer-reviewed evidence. However, public health expert Associate Professor Ken Harvey labelled the health regulator a ‘paper tiger’ and said such ‘quackery’ should already be banned, particularly on children.
 
‘The regulator is asleep at the wheel and it is just unconscionable that it allows these guys to get away with it,’ Associate Professor Harvey told newsGP.
 
‘Repeated requests to AHPRA and the [CBA] to limit the age to protect our babies and children have fallen on deaf ears.
 
‘Standards of practice need to be laid down. If there are certain treatments that have no evidence and are dangerous – and I might add that there was a case of a child killed by this sort of craziness in the US – then the regulator and the chiropractic board should say you are not allowed to do this, this is outside your scope of practice.’


Dr James Best believes ‘it is manifestly evident that there are potentially grave risks’ in manipulating an infant’s spine.

Chair of the RACGP Specific Interests Child and Young Person’s Health network, Dr James Best, told newsGP that spinal manipulation for infants, particularly newborns, is ‘reckless practice’ and he would consider reporting the chiropractor if he discovered it was performed on one of his patients.
 
‘There are known risks of cervical manipulation in adults, and in these small children with soft and highly flexible spines it is manifestly evident that there are potentially grave risks,’ Dr Best said.
 
‘There is no evidence of any benefit of spinal manipulation in infants, and there is not even a plausible scientific rationale as to why there would be a benefit. Why on earth would you allow or undertake such a risky procedure for no benefit?’

Chair of the RACGP Expert Committee – Quality Care, Dr Mark Morgan, also emphasised the importance of GPs only referring patients for evidence-based treatment, regardless of the practitioner.
 
‘GPs should not refer to therapists if they don’t have a clue what will go on in the therapist’s rooms,’ Dr Morgan told newsGP.
 
‘The actual therapy should have evidence for the particular indication and the therapeutic intervention should be the subject of discussion, irrespective of whether it is delivered by physiotherapists, GPs themselves, chiropractors or osteopaths.
 
‘There is very limited evidence for chronic disease management by chiropractors or osteopathy. Likewise, there is very little evidence of benefits for chiropractic treatments offered to babies.’
 
In 2016 the RACGP told members not to refer patients to chiropractors following the release of a similar video showing another Melbourne chiropractor cracking the back of a four-day-old baby.
 
Then-president Dr Frank Jones called on the Federal Government and private health insurers to stop compensating policy holders for the questionable treatments, which he described as ‘cruel’.
 
A baby’s neck was also broken by a chiropractor in 2013, which again led to calls from doctors to ban the treatment of children by chiropractors.
 
AHPRA referred a complaint about the incident to the CBA, which closed the case without disclosing details to the public and allowed the chiropractor to remain practising after they undertook education in ‘the field of paediatric chiropractic’.

AHPRA Chiropractic infant