Pediatric Chiropractic Care: The Subluxation Question And Referral Risk

Bioethics. 2016 Feb;30(2):63-8. doi: 10.1111/bioe.12225.


Chiropractors commonly treat children for a variety of ailments by manipulating the spine to correct a 'vertebral subluxation' or a 'vertebral subluxation complex' alleged to be a cause of disease. Such treatment might begin soon after a child is born. Both major American chiropractic associations - the International Chiropractic Association and the American Chiropractic Association - support chiropractic care for children, which includes subluxation correction as a treatment or preventive measure. I do not know of any credible evidence to support chiropractic subluxation theory. Any attempt to manipulate the immature, cartilaginous spine of a neonate or a small child to correct a putative chiropractic subluxation should be regarded as dangerous and unnecessary. Referral of a child to a chiropractor for such treatment should not be considered lest a bad outcome harms the child or leads to a charge of negligence or malpractice.

Keywords: children; chiropractic manipulation; epiphyseal injury; referral risk; subluxations.

MeSH terms

  • Child
  • Chiropractic* / ethics
  • Chiropractic* / standards
  • Chiropractic* / trends
  • Evidence-Based Medicine
  • Humans
  • Manipulation, Chiropractic* / adverse effects
  • Manipulation, Chiropractic* / ethics
  • Pediatrics* / ethics
  • Pediatrics* / standards
  • Pediatrics* / trends
  • Referral and Consultation*
  • Risk
  • Spinal Diseases / therapy*
  • United States