Is chiropractic an effective treatment in infantile colic?

This study provides some evidence in support of the hypothesis that chiropractic reduces the hours of crying in colicky babies.

Citation/s:
Wiberg JMM, Nordsteen J & Nilsson N. The short term effect of spinal manipulation in the treatment of infantile colic: a randomized controled clinical trial with blinded observer J Man Phys Ther (1999) 22 517-522
Lead author's name and fax: Jesper M M Wiberg

Three-part Clinical Question: In an otherwise healthy 6-week-old infant with typical colicky pain, is chiropractic effective in reducing the severity of colic, or the length of time spent crying?
Search Terms: MEDLINE "colic" AND "chiropractic" and filter "therapy"((colic AND chiropractic) AND (randomized controlled trial [PTYP] OR drug therapy [SH] OR therapeutic use [SH:NOEXP] OR random*[WORD]))Hand searching

The Study:
Single-blinded concealed randomised controlled trial without intention-to-treat.
The Study Patients: Infants with well defined colic, recruited by health visitor nurses, using a structured diagnostic interview (that included a severity assessment). Age 2-10 weeks. Parents received counselling and advice on breast feeding technique, mother's diet, air swallowing, feeding by bottle, burp technique observations of the infant's belly, stool and passing water, vomiting, eating and sleeping rhythm, and so forth as is normally given to parents by the health visitor nurse.
Control group Parents kept a diary as baseline for one week before randomisation. In addition to the standard advice, listed above, the control group received dimethicone daily for two weeks as prescribed in the Danish PDR. The diagnostic interview, including severity assessment, was repeated at the end of the first and second weeks.
Experimental group Parents kept a baseline diary for 1 week before randomisation. In addition to the standard advice given, the treatment group was referred to a local chiropracter (JMMW), who administered 3 - 5 treatments over 12 - 15 days. A routine case history was taken and examination performed. Articulations found to be restricted in movement were manipulated / mobilised with specific light pressure with the fingertips.

The Evidence:

Measure

Control Group

Experimental Group

Difference

Mean

SD

Mean

SD

Hours of colic

-1

 

-2.7

 

1.700

 

Non-Event Outcomes

Time to outcome/s

Control group 

Experimental group

P-value

Change in the number of hours of colic

8-11 days

-1

-2.7

0.04

Comments:
Dimethicone is known to be no better than placebo.
Single blinding weakens the study.
The dropouts from the control group because of worsening colic, though not included in the anaysis, further supports the study's conclusion that chiropractic is better than dimethicone.

Appraised by: Stephen Hughes; 09 April 2002
Email: doctor@silverflame.co.uk
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