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Craniosacral therapy, the manipulation of bones of the skull to influence muscle activies in other parts of the body, has been around for 40 years. While many claims for the method are exaggerated, there are some situations in which it clearly works.

At first glance, craniosacral therapy would seem to be one of the therapies that deserves its place on Quackwatch.

The name of the therapy refers to the manipulation of the cranium, the skull, and the sacrum, the lowest part of the spine where the backbone connects to the hip bones and tail bones. In the 1890's, an American osteopath named William Sutherland developed a treatment technique called cranial osteopathy. He had noticed that bones of the skull were beveled, like the gills of a fish. From this he concluded that the bones of the skull constituted a "respiratory mechanism" that allowed the brain to breathe.

The idea that human skull bones are analogous to fish gills is, of course, ridiculous, but 80 years later another American osteopath, John Upledger (1932-2012), working with a professor of anatomy and histology at Michigan State University named Ernest W. Retzlaff (1918-1979), were inspired by the idea of cranial osteopathy to look for "pulses" in the skull. Finding evidence of pulsating skull bones, which has not been found by anyone else, they theorized that the skull bones acted as a kind of "heart" for cerebrospinal fluid, sending waves of nourishment down the spine that made normal muscle movement possible. Applications of this theory came to be known as craniosacral therapy.

From Dubious Observation To Cure-All

Disciples of John Upledger eagerly adopted the new theories of craniosacral therapy to treating an enormous range of diseases. Upledger and the craniosacral therapists who followed him developed an idea that spinal fluid and the bloodstream interact, and manipulating skull bones could change blood flow. This principle was known as the inherent motility of the nervous system.

Because the fluids of the brain and spine tend to move around, that is, they are motile, practitioners of the new therapy began to diagnose fluctuation of the cerebrospinal fluid. Upledger had observed mobility of the intracranial and intraspinal membranes, the protective covering of the nerves, during an operation. He theorized that manipulating the fascia, the connective tissue that joins the muscles and other tissues to the skeleton, could rebalance the flow of fluids through the spinal column. Due to the theoretical mobility of the cranial bones, treatment of the head could also affect muscles and blood all over the body.

A Very Gentle Treatment

Of course, the idea of pounding on and yanking at cranial bones to try to make the skull flexible is horrific and dangerous. However, Upledger conveniently offered that pressure as slight as 5 grams (about the weight of a small coin, like an American nickel) was enough to move the sutures connecting the skull bones. Very light touch could also be applied to the back and pelvis.

The problem with craniosacral therapy came about when newly trained craniosacral therapists began to claim it could cure cancer, and also a long list of other hard-to-treat conditions, including:

  • Autism
  • Brain and Spinal Cord Injuries
  • Central Nervous System Disorders
  • Chronic Fatigue
  • Chronic Neck and Back Pain
  • Fibromyalgia
  • Infant and Childhood Disorders
  • Learning Disabilities
  • Migraines and Headaches
  • Motor-Coordination Impairments
  • Orthopedic Problems
  • Post-Traumatic Stress Disorder
  • Scoliosis
  • Stress and Tension-Related Disorders
  • TMJ Syndrome

Craniosacral therapy is typically harmless in itself, but if patients abandon other needed treatments, there can be disastrous results. However, there seems to be one application for the therapy for which it is genuinely useful.

One Time Craniosacral Therapy Really Works (Probably)

There is growing body of case reports regarding the successful use of craniosacral therapy after standard medical treatment for a kind of brain tumor called a meningioma. This is not the better know, more aggressive (and almost always deadly) kind of brain cancer glioma. A meningioma is a tumor of the meninges, or lining, of the brain. About 90 percent of meningiomas are benign. The other 10 percent are cancerous, but this kind of brain cancer progresses more slowly than most other kinds of brain cancer. 

Meningiomas can cause seizures, double vision, problems with various kinds of sensation, and severe headaches, however, and they are typically treated by the least invasive techniques available. Gamma-knife radiation is most commonly recommended in the US and Europe. In the aftermath of treatment, there can still be headaches, dizziness, and double vision, and that's where craniosacral therapy comes in. This very gentle therapy, at least in a few cases, has been associated with relief of symptoms after traditional treatment for the disease. It's just not an alternative to needed medical intervention.

If you have one of the many conditions listed earlier in this article and you are desperate for relief, there's nothing to say that you won't improve after you get craniosacral therapy. It's not inherently harmful except in a few very obvious situations (immediately after craniectomy, or sawing open the skull surgically, for example). However, before choosing craniosacral therapy, it is a good idea to go through the following considerations.

Q. What kind of training is required to do craniosacral therapy?

A. Many states in the US do not regulate craniosacral therapists, so your therapist is not required to have any other training at all. In practice, most healthcare practitioners who offer the technique are chiropractors, osteopaths, or licensed massage therapists.

Q. How many sessions are necessary?

It is highly unlikely that you will experience improvement after just one session. On the other hand, it is more common to feel better after two or three sessions a week for three or four weeks. Your therapist may be counting on your feeling better as part of the normal ups and downs of your disease.

Q. How much does craniosacral therapy cost?

In the US, sessions with a craniosacral therapist typically run $100 to $150 each. Some therapists offer a discount for treatments for children. Your initial visit is likely to cost more. Visits to the craniosacral therapist are almost never covered by insurance. 

Q. Are there any red flags that indicate that a particular therapist is someone I need to avoid?

Craniosacral therapy is complementary medicine, not alternative medicine. Anyone who tells you that you don't need to see your oncologist, or you can throw away your insulin, or you have exotic conditions that a medical doctor cannot treat and you need craniosacral therapy is a quack. Run the opposite direction! Most practitioners of craniosacral therapy, however, are sincere, and their treatments can't hurt you. They just may not be all that you need.

If you have a neurological or neuromuscular condition and nothing else has ever worked, and you have the money to spare, and you aren't foregoing any needed medical treatment, craniosacral therapy may be worth a try. It just might work for you. A placebo treatment that works is still a treatment that works.

Read full article

  • Haller H, Cramer H, Werner M, Dobos G. Treating the Sequelae of Postoperative Meningioma and Traumatic Brain Injury: A Case of Implementation of Craniosacral Therapy in Integrative Inpatient Care.J Altern Complement Med. 2015 Jan 21. [Epub ahead of print] PMID: 25607593.
  • Jäkel A, von Hauenschild P. Therapeutic effects of cranial osteopathic manipulative medicine: a systematic review. J Am Osteopath Assoc. 2011 Dec.111(12):685-93. Review. PMID: 22182954.
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