Children and Adolescents Presenting to Chiropractors in Norway: National Health Insurance Data and a Detailed Survey
Anna Allen-Unhammer, (1) Francis J. H. Wilson, (2)
and Lise Hestbaek (3)
1 Markveien Fysikalske Institutt,
Markveien 25, 0554 Oslo, Norway.
2 Anglo-European College of Chiropractic,
Bournemouth, Dorset BH5 2DF UK.
3 Nordic Institute of Chiropractic and Clinical Biomechanics
and Institute of Sports Science and Biomechanics,
University of Southern Denmark,
Campusvej 55, Odense M, DK-5230 Denmark.
BACKGROUND: The idea of chiropractors treating children is controversial, yet many parents seek chiropractic care for their children. The reasons for this are not well documented. Part one of this study aimed to document the profile of all paediatric patients consulting Norwegian chiropractors in 2013 using National Health Insurance data (NHI) with regards to age, gender and primary complaints. Part two aimed to provide a more detailed description of these patients in the form of a descriptive, paper-based survey.
METHODS: Part one involved Norwegian NHI data from 2013. Part two consisted of a year-long, paper-based survey. Chiropractors registered with the Norwegian chiropractic association (NKF) were invited to participate via email. Participating chiropractors were assigned one random month to collect data. All paediatric patients (or their parents) during that were asked to complete questionnaires containing information on presenting complaint, consequences of this complaint, age, and mode of referral.
RESULTS: In general, there was good concordance between part one and two of the study in terms of age, gender and presenting complaint. The youngest children constituted the largest paediatric group in Norwegian chiropractic practice. Musculoskeletal problems were the most common reason for children visiting a chiropractor in all of the age categories, according to NHI data. Part two of the study found that one-third of young school children and adolescents reported pain lasting longer than 1-year. Eleven percent of children found that their complaint had severely affected their mood and 22 % felt their activities were very limited by their condition. Referrals from healthcare professionals were uncommon. The survey’s results were based on 161 completed questionnaires, received from 15 % of the Norwegian chiropractors.
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CONCLUSION: Musculoskeletal problems constituted the most common presenting complaint for children and adolescents presenting to Norwegian chiropractors. A sizable proportion of children seemed to be adversely affected by their complaints in terms of low mood and limitations of daily activities. Chronic presentations were not uncommon. The small sample size of the survey demands that the results be interpreted with caution.
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Every year, around 7 to 8 % of the Norwegian population consults a chiropractor, according to the Statistics Norway/Census (Statistisk Sentralbyrå’s) health survey.  The number of parents seeking chiropractic care for their children has increased substantially in recent years. [2, 3]
Yet, in the midst of this increasing trend, whether or not children should receive chiropractic care remains a contentious issue. A particular concern has been the wide range of paediatric conditions that are claimed by some chiropractors to be amenable to chiropractic treatment. While pain conditions remain the most common reason for adults seeking chiropractic and other forms of CAM, this is less clear in children.  Children have been reported to present for a variety of reasons that can be grouped into two main categories: musculoskeletal (MSK) conditions, for example torticollis, neck pain and lower back pain, and non-musculoskeletal conditions (non-MSK), such as enuresis, infantile colic (now more commonly known as excessive crying) and asthma. [5-9] The need for documentation of descriptive characteristics in paediatric patients presenting to chiropractors is warranted.
The majority of the studies documenting the descriptive characteristics of this patient group in chiropractic practice have come from English-speaking countries, but descriptive surveys have also been published in Sweden , Holland , and Denmark. [12-14]