Understanding Pediatric Chiropractic Care: An Evidence-Based Look at Safety and Outcomes
As parents, making informed healthcare decisions for our children is one of our most important responsibilities. When it comes to chiropractic care for pediatric patients, concerns about safety are natural and valid. At Hershey Family Chiropractic, we believe that parents deserve access to comprehensive, evidence-based information to make the best decisions for their families.
This article examines the current research on pediatric chiropractic care, contextualizes the safety data within the broader healthcare landscape, and provides parents with the factual information they need to make informed choices.
Understanding Healthcare Risk: Context Matters
Before discussing pediatric chiropractic specifically, it’s important to understand that all healthcare interventions—from medication to surgery to manual therapy—carry some level of risk. The question is never whether risk exists, but rather how we assess, minimize, and contextualize that risk.
According to a landmark 2016 study by Johns Hopkins University, medical errors are estimated to be the third leading cause of death in the United States, with more than 250,000 deaths per year attributed to preventable medical errors. Some analyses suggest this number could be as high as 440,000 deaths annually. Common medical errors include misdiagnosis, prescription mistakes, hospital-acquired infections, and communication failures.
We share this information not to criticize the medical profession—physicians work incredibly hard to provide excellent care—but rather to provide context. Every healthcare intervention involves risk-benefit analysis, and understanding the broader landscape helps parents make informed decisions.
What Does the Research Show About Pediatric Chiropractic Safety?
Multiple systematic reviews and large-scale studies have examined the safety of chiropractic care for children. Here’s what the peer-reviewed research tells us:
The 2015 Comprehensive Literature Review
A thorough 2015 systematic review published in the Journal of Manipulative and Physiological Therapeutics examined 31 peer-reviewed articles covering adverse events in infants and children receiving manual therapy from various providers (chiropractors, physical therapists, osteopaths, and medical practitioners).
The review found that serious adverse events in infants and children receiving chiropractic, osteopathic, physiotherapy, or manual medical therapy are rare, and importantly, no deaths associated with chiropractic care were found in the academic literature PubMedScienceDirect.
Of the three deaths reported in the literature involving manual therapy for children, they occurred under the care of one physical therapist, one unknown practitioner, and one craniosacial therapist—but none were associated with chiropractic care PubMed.
Incidence of Adverse Events / Injuries
Research indicates that the risk of mild adverse events from pediatric chiropractic care is low, at approximately 0.53-1% (roughly 1 in 100-200 patients) ScienceDirect. These mild adverse events typically include temporary irritability or soreness lasting less than 24 hours and resolving without the need for additional care beyond initial recommendations.
A prospective cohort study examining 512 children receiving chiropractic care calculated an adverse event prevalence of 0.67% from chiropractor reports, with the vast majority being minor and self-limiting.
Recent Medical Literature Acknowledges Safety
According to a 2024 review published in Clinical Pediatrics, serious adverse events from chiropractic care in pediatric patients are rare, and most techniques used in pediatric patients are gentle, low-force, and appear to be safe PubMed Central. This acknowledgment from the medical literature represents an important step toward objective evaluation of pediatric chiropractic care.
How Pediatric Chiropractic Differs from Adult Care
It’s crucial to understand that chiropractic care for children is fundamentally different from adult treatment:
Gentle, Low-Force Techniques: Unlike the high-velocity, low-amplitude thrust manipulations commonly used with adults, most techniques used in pediatric patients are gentle and low-force PubMed Central. The amount of pressure used on an infant might be no more than the pressure you’d use to test the ripeness of a tomato.
Age-Appropriate Adjustments: Chiropractors trained in pediatric care understand the anatomical and physiological differences in children’s bodies and adapt their techniques accordingly. The spine of a newborn is very different from that of a teenager, and treatment approaches reflect these differences.
Comprehensive Assessment: Research emphasizes the importance of performing a thorough history and examination to exclude anatomical or neurologic anomalies before applying any manual therapy, which may further reduce adverse events ScienceDirect.
What Conditions Bring Children to Chiropractic Care?
Research shows that children visit chiropractors for a variety of reasons:
Musculoskeletal Conditions:
- Torticollis (neck muscle tightness)
- Postural issues
- Sports injuries
- Growing pains
- Scoliosis management (and early detection!) At Hershey Family Chiropractic, we are the ONLY clinic in the Central Pennsylvania region that offers the Scoliosis Activity Suit as a true, and more effective, alternative to bracing.
Common Childhood Concerns:
- Colic and excessive crying
- Breastfeeding difficulties
- Sleep disturbances
- Ear infections (recurrent)
- General wellness care
Wellness and Prevention: Many families choose chiropractic care as part of a proactive approach to their children’s health and wellness, much like regular dental check-ups or well-child visits.
Understanding Reported Adverse Events
When serious adverse events have been documented in the literature, several important patterns emerge:
Preexisting Pathology: The majority of reported serious adverse event cases involved underlying preexisting pathology ScienceDirect. This underscores the critical importance of thorough health history and examination before any manual therapy.
Technique Matters: Most serious adverse events in the literature involved high-velocity, extension, and rotational spinal manipulation—techniques that are typically not used in standard pediatric chiropractic practice, which emphasizes gentle, low-force approaches.
Context is Essential: The absolute number of reported serious adverse events must be considered in context. With an estimated 1.6 million child visits to chiropractors occurring in Australia alone each year, and millions more worldwide, the published cases of serious adverse events are statistically exceedingly rare.
What Parents Should Know and Ask
If you’re considering chiropractic care for your child, here are important questions to ask and factors to consider:
Practitioner Qualifications:
- Is the chiropractor experienced in pediatric care?
- Have they completed additional training in pediatric chiropractic techniques? (Dr. Leanne Tressler at Hershey Family Chiropractic has multiple advanced certifications within Pediatric Care specifically, and this is exceedingly important when looking for someone knowledgeable. All Chiropractors are fully licensed and qualified to treat Pediatric Patients at HFC.)
- Are they comfortable answering your questions about safety and approach?
Communication and Collaboration:
- Does the chiropractor communicate openly with your pediatrician? (Our doctors will always offer to be available to work with and communicate with your Pediatrician. Our doctors provide HIPAA-complaint, direct emails for communication with you as the patient/parent, and for any providers.)
- Are they willing to provide documentation of care?
- Do they respect your role as the parent in making healthcare decisions?
Red Flags to Watch For:
- Any practitioner who discourages vaccination without providing balanced, evidence-based information
- Promises of “cures” for serious medical conditions
- Pressure to commit to extensive, expensive treatment plans
- Unwillingness to collaborate with other healthcare providers
- Use of aggressive or forceful techniques on infants or young children
Appropriate Expectations:
- Understand what conditions are appropriately treated with chiropractic care
- Know that some conditions require medical intervention
- Recognize that chiropractic care works best as part of an integrated healthcare approach
The Importance of Evidence-Based Practice
At Hershey Family Chiropractic, we are committed to evidence-based practice. This means:
- Staying current with the latest research on pediatric chiropractic care
- Using gentle, age-appropriate techniques
- Conducting thorough health histories and examinations
- Recognizing when a condition requires medical referral
- Collaborating with pediatricians and other healthcare providers
- Being transparent about what chiropractic care can and cannot do
Making Informed Decisions
Healthcare decisions for children should always be based on:
- Current research evidence about safety and effectiveness
- Clinical expertise of qualified practitioners
- Individual patient circumstances including health history and specific needs
- Parent values and preferences regarding their child’s care
No single healthcare approach is right for every child or every condition. The goal is to make informed decisions that prioritize your child’s safety, health, and wellbeing.
A Balanced Perspective
The research is clear: when provided by appropriately trained and licensed practitioners using gentle, age-appropriate techniques, pediatric chiropractic care has a strong safety profile with serious adverse events being exceedingly rare. This doesn’t mean that risk is zero—no healthcare intervention is without risk—but it does mean that the risk profile compares favorably to many commonly accepted medical interventions.
Parents deserve to make healthcare decisions based on complete, accurate information rather than fear or misinformation. At Hershey Family Chiropractic, we welcome your questions, encourage you to review the research, and respect your role as your child’s primary healthcare decision-maker.
Our Commitment to Your Family
We believe that pediatric chiropractic care, when appropriately applied, can be a valuable part of a comprehensive approach to children’s health. We also believe that:
- Open communication with parents is essential
- Collaboration with pediatricians strengthens care
- Gentle, evidence-based techniques should always be used
- Parents’ concerns should be heard and addressed
- Medical care is essential when indicated
- Every child deserves safe, effective, compassionate care
If you have questions about pediatric chiropractic care, whether you’re considering it for your child or simply want to understand the research better, we invite you to reach out. We’re here to provide evidence-based information and support your family’s health journey.
Contact our team to learn more:
Dr. Jenifer Espetin: drjen@hersheyfamilychiropractic.com
Dr. Leanne Tressler: drleanne@hersheyfamilychiropractic.com
Dr. Jennifer Davis: drdavis@hersheyfamilychiropractic.com
Dr. Blake Tressler: drblake@hersheyfamilychiropractic.com