Chiropractic use in Canadian adults is strongly correlated with place of residence. For provinces in which adult chiropractic is used frequently, treatment of children younger than 18 years of age is also more common. The exception is Quebec, where chiropractic is not used as often as in the western provinces, but the treatment of children younger than age 18 years is more common than in any other region.
A cross-sectional survey of 1200 Canadian chiropractors revealed that almost all respondents treated patients younger than 18 years of age. Forty-five per cent of respondents indicated that they had received formal postgraduate paediatric chiropractic training via seminars or courses. Seventy-one per cent of chiropractors stated that they had received informal training in the care of children through reading journals, attending conferences or personal communication with colleagues. Most respondents desired more training.
A Boston study of chiropractic care used by children found that it is often inconsistent with recommended medical guidelines. Chiropractors may give advice on diet, immunizations and general health, and may also sell herbal remedies and homeopathic preparations.
Physicians may assume that patients use chiropractic mainly for musculoskeletal problems and that treatment for other conditions is rare. However, a recent survey of chiropractors in the United States, Canada and Australia found that 10% of the chief complaints presented to a chiropractor were nonmusculoskeletal in nature.
The American Chiropractic Association quotes similar figures. In children, chiropractic is also commonly used as primary or adjunctive therapy for nonmusculoskeletal conditions such as colic, enuresis, asthma, recurrent otitis media, cancer and illness prevention.
According to a study done in Alberta on chiropractors’ beliefs, most respondents believed that they should play a role – albeit a role secondary to physicians – in the treatment of nonmusculoskeletal health problems in children.
A Canada-wide survey of chiropractic care of children younger than age 18 years found that, overall, musculoskeletal conditions accounted for 40% of visits, prevention 24%, headaches 7%, otitis media 5% and various other conditions 23%. Prevention accounted for a large proportion of visits for children younger than age four years, with treatment for musculoskeletal conditions increasing with age. Chiropractors in Quebec were the most likely to provide preventive care and those in Atlantic Canada were the least likely to do so. Spinal manipulation was, by far, the most common form of therapy provided, followed by exercises, soft tissue treatment, and postural and nutritional counselling.
