Physio Network [Physio Discussed] Should spinal manipulation be used in paediatrics? With Anita Gross, Nikki Milne and Jenifer Dice
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Dec 17, 2025 In this engaging conversation, Nikki Milne, a paediatric physiotherapist, Anita Gross, a musculoskeletal researcher, and Jenifer Dice, an experienced paediatric physical therapist, dive into the complexities of spinal manipulation in children. They discuss the formation of the Paediatric Spinal Task Force, sharing their research findings and recommendations. Key takeaways include avoiding manipulation in infants, targeted approaches for children, and the significance of clear communication with parents. Their insights pave the way for safer practices in paediatric care.
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Media Events Triggered Global Action
- Media controversy over chiropractic care in Australia triggered international concern and coordination.
- That public attention accelerated government reviews and formation of the international task force.
Evidence Gaps Drove Consensus Development
- The Paediatric Spinal Task Force found insufficient high-quality evidence so they used multi-stage reviews and consensus to form guidance.
- The resulting position statement is the product of four years of systematic review, Delphi consensus and evidence-to-decision synthesis.
Avoid Manipulating Infants' Spines
- Do not perform spinal manipulation or mobilization on any infant under two years old.
- Consider mobilization or manipulation only for adolescents with musculoskeletal conditions after rigorous clinical reasoning and shared decision-making.