Craniosacral Therapy

This controversial form of hands-on therapy seeks to cure disease by manipulating the bones of the skull. Practitioners assert that certain disorders are caused by obstructions in the normal flow of the cerebrospinal fluid that bathes the brain and spinal cord. By gently nudging the head, spine, sacrum (lower spine), rib cage, and limbs, they believe they can break up these obstructions, reestablished the natural rhythm of cerebrospinal flow, and thus relieve associated illnesses.

Craniosacral Therapy
Craniosacral Therapy

Among the disorders targeted by craniosacral therapy are trigeminal neuralgia (stabbing pains in the jaw), headaches, sinusitis, visual disturbances, strabismus (an imbalance in the eye muscles), transient cerebral ischemia (temporary “mini-strokes”), traumatic brain injury, vertigo, and certain cases of mental retardation. Some proponents also suggest it for asthma, sinusitis, ear-nose-throat problems, cerebral palsy, and muscle tension headache (“to the degree that biomechanical problems cause these conditions”). Others recommend it for children with learning disabilities, attention deficit-hyperactive disorders, pervasive developmental delay, cerebral palsy, ear infections, genetic and neurological disorders, and autism. It is also proposed for certain soft tissue injuries to the head, torso and extremities.

Advocates of craniosacral therapy (also known as cranial osteopathy) cite numerous case studies as proof of its effectiveness. Nevertheless, mainstream physicians and medical organizations refuse to recommend it. They say that manipulation of the bones of the skull is impossible, since they are all fused together. They add that, whether the bones move or not, there have been no scientifically controlled clinical trials to prove the technique’s success.

How the Treatments are Done

Unlike the chiropractic adjustments that pop a joint back into proper alignment, craniosacral therapy is done with light touches to the head, spine, sacrum, ribs, and extremities. The version of the therapy propounded by Dr. John Upledger is particularly noted for its light touch–equivalent to the weight of a nickel in the palm of the hand.

Treatment Time: Sessions typically last 30 minutes to 1 hour.

Treatment Frequency: Varies with the problem and patient.

What Treatment Hopes to Accomplish

Cranial osteopathy–the initial form of this therapy–is a neglected subspecialty of general osteopathy (treatment of disease through adjustment of the bones). Developed in the 1930s by William Garner Sutherland, DO, it attempts to diagnose medical problems by evaluating the motion of the skull and sacrum, and by feeling the “cranial rhythmic impulse” throughout the body. (This impulse is said to reflect the flow of cerebrospinal fluid, as well as the motion of the brain, spinal cord, and surrounding membranes, along with movement in the skull bones and sacrum. It’s said that a trained practitioner can feel it.)

Cranial osteopaths hold that trauma to the head or body can alter or hinder the flow of fluids or change the skull’s natural configuration, thereby causing illness. Birth trauma, for example, is said to lead to colic, chronic ear infections, inability to suck or swallow, and developmental delays. Manipulations that restore the normal flow of fluids are thought to relieve such problems.

While cranial osteopathy is included in the general osteopathic curriculum and appears in the osteopathic board exams, few osteopaths include it in their practice. Out of more than 40,000 DOs in the United States, only 1,000 are members of The Cranial Academy, cranial osteopathy’s professional organization.

A more recent variation of this therapy, emphasizing a light, gentle touch, was developed in the 1970s by John Upledger, DO. Dr. Upledger’s interest in this area was ignited when, while assisting in surgery, he observed movement of the membrane that lines the skull and covers the brain and spinal cord. His work built upon that of Dr. Sutherland. Much like cranial osteopaths, his followers hold that touching the head, feet or other areas can reveal restrictions in the “craniosacral rhythm.” The same touch that finds the rhythm is also said to relieve symptoms.

Is there really a craniosacral rhythm, and can manipulating the skull really affect it? According to most mainstream doctors, the answers are clear-cut. It’s a well-known, long-established, physically evident fact, they say, that the bones of the skull fuse into a single unit around the age of two, and can’t be manipulated thereafter.

Craniosacral therapists, however, simply don’t accept this. They say that research reported in the Journal of the American Osteopathic Association as recently as 1996 has confirmed the existence of motion around the sutures of the skull bones. Using infrared markers attached to acupuncture needles or stuck to the skin, the researchers say they not only detected movement, but actually identified a cranial rhythmic impulse.

Dr. Upledger himself made intensive efforts to establish the existence of the craniosacral system, working with anatomists, physiologists, biophysicists, and bioengineers at Michigan State University’s College of Osteopathic Medicine from 1975 to 1983. He cites many published reports in support of the existence of a craniosacral system. In the end, however, he argues that “positive patient outcomes … should weigh greater than data from designed research protocols.”

Who Should Avoid This Therapy?

According to its critics, no one should try this therapy, since it can’t possibly help. And even its practitioners say its not worth trying unless the problem has a biomechanical origin (is caused by abnormal pressure or stress).

Whatever your problem, you should definitely forego craniosacral therapy if you have a known or suspected brain hemorrhage or aneurysm, or have any other condition that makes it ill-advised to alter the pressure of intracranial fluid. The treatments are also considered unwise for small children with only recently fused skull bones, although no problems have actually been reported.

What Side Effects May Occur?

Even critics of this therapy view it as physically harmless, and the chances of triggering an adverse reaction seem extremely slight. Nevertheless, problems have been reported in traumatic brain injury patients receiving craniosacral therapy as part of an outpatient rehabilitation program. The symptoms included headache, vomiting, diarrhea, cardiac palpitation, angry thoughts, paranoia, explosive behavior, and a total body spasm. Whether they were caused by the therapy or the underlying injury remains undetermined.

How to Choose a Therapist

Two organizations can give you referrals.

The Cranial Academy, a component society of the American Academy of Osteopathy, issues certificates of competency to members who have passed written, oral, and practice competency testing, and have completed 3 years of clinical practice. The Academy certifies only fully licensed professionals such as doctors, osteopaths, and, in some states, dentists. It provides names of members, but does not vouch for their competence.

The Upledger Institute offers courses in craniosacral therapy to medical doctors, doctors of osteopathy, psychologists, occupational therapists, physical therapists, massage therapists, body workers, and lay persons. However, neither the American Academy of Osteopathy nor the American Osteopathic Association grant continuing medical education credits for these courses.

When Should Treatment Stop?

If you find the treatments helpful, they can safely be continued indefinitely.

See a Conventional Doctor If…

Craniosacral therapy is not recommended for such life-threatening problems as heart disease, cancer, or medical emergencies. In addition, if your therapist is not an MD or DO, you should check with a doctor whenever a worrisome new symptom appears.