Craniosacral therapy

name CranialSacro therapy.[9]

Craniosacral therapy (CST) is a form of bodywork or

alternative therapy using gentle touch to manipulate the
synarthrodial joints of the cranium. A practitioner of
cranial-sacral therapy may also apply light touches to a
patients spine and pelvis. Practitioners believe that this
manipulation regulates the ow of cerebrospinal uid and
aids in primary respiration.[2] Craniosacral therapy was
developed by John Upledger, D.O. in the 1970s, as an oshoot osteopathy in the cranial eld, or cranial osteopathy, which was developed in the 1930s by William Garner
Sutherland.[2][3]

From 1975 to 1983, Upledger and neurophysiologist and

histologist Ernest W. Retzla worked at Michigan State
University as clinical researchers and professors. They
assembled a research team to investigate the purported
pulse and further study Sutherlands theory of cranial
bone movement. Upledger and Retzla went on to publish their results, which they interpreted as support for
both the concept of cranial bone movement, and the concept of a cranial rhythm.[10][11][12] Later reviews of these
studies have concluded that their research did not meet
According to the American Cancer Society, although enduring standards to oer conclusive proof for the efCST may relieve the symptoms of stress or ten- fectiveness of craniosacral therapy and the existence of
sion, available scientic evidence does not support cranial bone movement.[13]
claims that craniosacral therapy helps in treating can- Practitioners of both cranial osteopathy and craniosacral
cer or any other disease.[2] CST has been character- therapy assert that there are small, rhythmic motions of
ized as pseudoscience[4] and its practice has been called the cranial bones attributed to cerebrospinal uid pressure
quackery.[5] Cranial osteopathy has received a similar as- or arterial pressure. The premise of CST is that palpasessment, with one 1990 paper nding there was no sci- tion of the cranium can be used to detect this rhythmic
entic basis for any of the practitioners claims the paper movement of the cranial bones and selective pressures
examined.[6]
may be used to manipulate the cranial bones to achieve a

therapeutic result. However, the degree of mobility and

compliance of the cranial bones is considered controversial and is a critically important concept in craniosacral
therapy.[14]

Etymology

The term craniosacral or cranial-sacral are based on

the terms cranium and sacrum, a bone of the pelvis which 2.1 Primary respiratory mechanism
connects the lowest lumbar vertebra to the two hip bones
and the tailbone.
The Primary Respiratory Mechanism (PRM), the mechanism originally proposed by Sutherland, has been summarized in ve ideas:[7]

History and conceptual basis

1. Inherent motility of the central nervous system

2. Fluctuation of the cerebrospinal uid

Cranial osteopathy, a forerunner of CST, was originated

by osteopath William Sutherland (18731954) in 1898
1900. While looking at a disarticulated skull, Sutherland was struck by the idea that the cranial sutures of the
temporal bones where they meet the parietal bones were
beveled, like the gills of a sh, indicating articular mobility for a respiratory mechanism.[7]

3. Mobility of the intracranial and intraspinal dural

membranes
4. Mobility of the cranial bones
5. Involuntary motion of the sacrum between the ilia

John Upledger devised CST. Comparing it to cranial osteopathy he wrote: Dr. Sutherlands discovery regarding
the exibility of skull sutures led to the early research behind CranioSacral Therapy and both approaches aect
the cranium, sacrum and coccyx the similarities end
there.[8] However, modern day cranial osteopaths largely
consider the two practices to be the same, but that cranial
osteopathy has been taught to non-osteopaths under the

2.2 Inherent motility of the central nervous system

The postulated intracranial uid uctuation is described
by practitioners as an interaction between four main components: arterial blood, capillary blood (brain volume),
venous blood and cerebrospinal uid (CSF).[15][16]
1

2.3

REFERENCES

Fluctuation of the cerebrospinal uid

session, and may feel light-headed. While sometimes

thought to be caused by an increase in endorphins, reThere is research which demonstrates examiners are un- search shows the eects may actually be brought about
able to measure craniosacral motion reliably, as indicated by the endocannabinoid system.[25]
by a lack of inter-rater agreement among examiners.[17]
There are few reports of adverse events from CST treatThe authors of this research conclude this measurement
ment. In one study of craniosacral manipulation in paerror may be suciently large to render many clinical
tients with traumatic brain syndrome, the incidence of
decisions potentially erroneous. Alternative medicine
adverse eects from treatment was 5%.[26]
practitioners have interpreted this result as a product of
entrainment between patient and practitioner,[18] a principle which lacks scientic support. Whether craniosacral
motion can be reliably palpated remains a subject of de- 4 Reception
bate with studies producing mixed results.[19][20]
According to the American Cancer Society, although
CST may relieve the symptoms of stress or tension,
2.4 Mobility of the intracranial and in- available scientic evidence does not support claims that
craniosacral therapy helps in treating cancer or any other
traspinal dural membranes
disease.[2] Cranial osteopathy has received a similar asIn 1970, Upledger observed during a surgical procedure sessment, with one 1990 paper nding there was no scion the neck what he described as a slow pulsating move- entic basis for any of the practitioners claims the paper
[6]
ment within the spinal meninges. He attempted to hold examined.
the membrane still and found that he could not due to the In October 2012 Edzard Ernst conducted a systematic
strength of the action behind the movement.[21]
review of randomized clinical trials of craniosacral therapy. He concluded that the notion that CST is associated
with more than non-specic eects is not based on evi2.5 Mobility of the cranial bones
dence from rigorous randomised clinical trials.[27] Commenting specically on this conclusion Ernst commented
The extent to which cranial bones are able to move is con- on his blog that he had chosen the wording as a polite
sidered controversial and studies of the existence and de- and scientic way of saying that CST is bogus.[28] Ernst
gree of cranial motion have yielded mixed ndings.[14] also commented that the quality of ve of the six trials he
Cranial sutures are the areas in which the eight cranial had reviewed was deplorably poor, a sentiment which
bones are joined. During infancy, the cranial bones are echoed an August 2012 review that noted the moderate
not rigidly fused to each other,[22] but are instead bound methodological quality of the included studies.[7]
together by a membrane known as a fontanelle where two
sutures join. Between the rst and second year of life, the Ernst criticized a 2011 systematic review performed by
cranial bones begin to move together and fuse as a nor- Jakel and von Hauenschild for inclusion of observational
[27]
mal part of development.[14] Studies examining the age studies and including studies with healthy volunteers.
of the closure of the cranial sutures have reported mixed This review concluded that the evidence base surrounding
ndings. Closure has been reported to occur during ado- craniosacral therapy and its ecacy was sparse and comlescence while other studies indicate greater individual posed of studies with heterogeneous design. The authors
variability in the timing of this closure with fusion of the of this review stated that currently available evidence was
[29]
lambdoid suture, sagittal suture, and coronal sutures tak- insucient to draw conclusions.
ing place in the fourth decade of life, but complete fu- The evidence base for CST is sparse and lacks a demonsion of all sutures not occurring until advanced age[23] strated biologically plausible mechanism. In the ab(the eighth decade of life has been reported);[14] some sence of rigorous, well-designed randomized controlled
studies have found that the sutures never rigidly fuse.[14] trials,[30][31] it has been characterized as pseudoscience,[4]
According to Grays Anatomy, "[w]hen such sutures are and its practice called quackery.[5]
tied by sutural ligament and periosteum, almost complete
immobility results.[24]

5 See also
3

Treatment

The therapist lightly palpates the patients body, and

focuses intently on the communicated movements. A
practitioners feeling of being in tune with a patient is
described as entrainment.[18] Patients often report feelings of deep relaxation during and after the treatment

List of ineective cancer treatments

6 References
[1] Why Cranial Therapy Is Silly. www.quackwatch.com.
Retrieved 2016-10-21.

[2] Russell J, Rovere A, eds. (2009). Craniosacral Therapy. American Cancer Society Complete Guide to Complementary and Alternative Cancer Therapies (2nd ed.).
American Cancer Society. pp. 187189. ISBN
9780944235713.
[3] Craniosacral Therapy. UPMC Center for Integrative
Medicine. 2012. Retrieved 19 May 2013.
[4]

Norcross, John C.; Koocher, Gerald P.; Garofalo,

Ariele (2006). Discredited psychological treatments and tests: A Delphi poll. Professional Psychology: Research and Practice. 37 (5): 51522.
doi:10.1037/0735-7028.37.5.515.
Bledsoe, BE (2004). The elephant in the room:
Does OMT have proved benet?". The Journal of
the American Osteopathic Association. 104 (10):
4056; author reply 406. PMID 15537794.
Hartman, Steve E (2006). Cranial osteopathy:
Its fate seems clear. Chiropractic & Osteopathy.
14: 10. doi:10.1186/1746-1340-14-10. PMC
1564028 . PMID 16762070.
Atwood, KC (2004). Naturopathy, pseudoscience,
and medicine: Myths and fallacies vs truth. MedGenMed. 6 (1): 33. PMC 1140750 . PMID
15208545.

[5]

Arono, George R., ed. (1999). Evaluation and

Treatment of Chronic Pain (3rd ed.). Lippincott
Williams and Wilkins. p. 571. ISBN 978-0-68330149-6.
Barrett, Stephen. Why Cranial Therapy Is Silly.
Quackwatch. Retrieved December 2012. Check
date values in: |access-date= (help)

[6] Ferr, J. C.; Chevalier, C.; Lumineau, J. P.; Barbin, J.

Y. (1990-09-01). "[Cranial osteopathy, delusion or reality?]". Actualits Odonto-Stomatologiques. 44 (171):
481494. ISSN 0001-7817. PMID 2173359.
[7] Jkel, Anne; Von Hauenschild, Philip (2012). A systematic review to evaluate the clinical benets of craniosacral therapy. Complementary Therapies in Medicine.
20 (6): 45665. doi:10.1016/j.ctim.2012.07.009. PMID
23131379.
[8] Upledger, John E. (2002). CranioSacral Therapy vs.
Cranial Osteopathy: Dierences Divide. Massage Today. 2 (10).
[9] Ferguson, A.J.; Upledger, John E.; McPartland, John
M.; Collins, M.; Lever, R. Cranial osteopathy and
craniosacral therapy: current opinions. Journal of
Bodywork and Movement Therapies. 2 (1): 2837.
doi:10.1016/s1360-8592(98)80044-2.

[12] Upledger, JE; Karni, Z (1979). Mechano-electric patterns during craniosacral osteopathic diagnosis and treatment. The Journal of the American Osteopathic Association. 78 (11): 78291. PMID 582820.
[13] Green, C.; Martin, C.W.; Bassett, K.; Kazanjian, A.
(1999). A systematic review of craniosacral therapy:
Biological plausibility, assessment reliability and clinical
eectiveness. Complementary Therapies in Medicine.
7 (4): 2017. doi:10.1016/S0965-2299(99)80002-8.
PMID 10709302.
[14] Seimetz, Christina N.; Kemper, Andrew R.; Duma, Stefan
M. (2012). An investigation of cranial motion through a
review of biomechanically based skull deformation literature. International Journal of Osteopathic Medicine. 15
(4): 15265. doi:10.1016/j.ijosm.2012.05.001.
[15] Greitz, D; Franck, A; Nordell, B (1993). On the pulsatile
nature of intracranial and spinal CSF-circulation demonstrated by MR imaging. Acta radiologica. 34 (4): 3218.
doi:10.1080/02841859309173251. PMID 8318291.
[16] Greitz, D.; Wirestam, R.; Franck, A.; Nordell, B.; Thomsen, C.; Sthlberg, F. (1992). Pulsatile brain movement
and associated hydrodynamics studied by magnetic resonance phase imaging. Neuroradiology. 34 (5): 37080.
doi:10.1007/BF00596493. PMID 1407513.
[17] Wirth-Pattullo, V; Hayes, KW (1994). Interrater reliability of craniosacral rate measurements and their relationship with subjects and examiners heart and respiratory rate measurements. Physical therapy. 74 (10): 908
16; discussion 91720. PMID 8090842.
[18] McPartland, JM; Mein, EA (1997). Entrainment and the
cranial rhythmic impulse. Alternative therapies in health
and medicine. 3 (1): 405. PMID 8997803.
[19] Rogers, Joseph S; Witt, Philip L; Gross, Michael T;
Hacke, Jon D; Genova, Perry A (1998). Simultaneous
Palpation of the Craniosacral Rate at the Head and Feet:
Intrarater and Interrater Reliability and Rate Comparisons. Physical Therapy. 78 (11): 117585. PMID
9806622.
[20] Halma, Kelly D.; Degenhardt, Brian F.; Snider, Karen T.;
Johnson, Jane C.; Flaim, M. Schaun; Bradshaw, Danielle
(2008). Intraobserver Reliability of Cranial Strain Patterns as Evaluated by Osteopathic Physicians: A Pilot
Study. The Journal of the American Osteopathic Association. 108 (9): 493502. PMID 18806078.
[21] Upledger, J E; Vredevoogd, J. (1983). Craniosacral Therapy. Eastland Press. ISBN 0-939616-01-7.

[10] Upledger, John E (1995). Craniosacral Therapy. Physical Therapy. 75 (4): 32830. PMID 7899490.

[22] Herring, Susan W. (2008). Mechanical Inuences on

Suture Development and Patency. In Rice, David P.
Craniofacial Sutures: Development, Disease and Treatment. Frontiers of Oral Biology. 12. Karger. pp. 41
56. doi:10.1159/000115031. ISBN 978-3-8055-8326-8.
PMC 2826139 . PMID 18391494.

[11] Upledger, JE (1978). The relationship of craniosacral

examination ndings in grade school children with developmental problems. The Journal of the American Osteopathic Association. 77 (10): 76076. PMID 659282.

[23] Morriss-Kay, Gillian M.; Wilkie, Andrew O. M. (2005).

Growth of the normal skull vault and its alteration in
craniosynostosis: Insights from human genetics and experimental studies. Journal of Anatomy. 207 (5):

63753. doi:10.1111/j.1469-7580.2005.00475.x. PMC

1571561 . PMID 16313397.
[24] Williams, P L; Warwick, R; Dyson, M; Bannister, L H.
(1989). Grays Anatomy (37th ed.). Edinburgh: Churchill
Livingstone. p. 468. ISBN 0-443-02588-6.
[25] McPartland, John M.; Giurida, Andrea; King, Jeremy;
Skinner, Evelyn; Scotter, John; Musty, Richard E. (2005).
Cannabimimetic Eects of Osteopathic Manipulative
Treatment. The Journal of the American Osteopathic Association. 105 (6): 28391. PMID 16118355.
[26] Greenman, PE; McPartland, JM (1995). Cranial ndings and iatrogenesis from craniosacral manipulation in
patients with traumatic brain syndrome. The Journal
of the American Osteopathic Association. 95 (3): 1828;
1912. PMID 7751168.
[27] Ernst, Edzard (2012). Craniosacral therapy: A systematic review of the clinical evidence. Focus on Alternative and Complementary Therapies. 17 (4): 197201.
doi:10.1111/j.2042-7166.2012.01174.x.
[28] Ernst, Edzard (2012). Up the garden path: craniosacral
therapy. Retrieved 15 December 2012.
[29] Jkel, Anne; Von Hauenschild, Phillip (2011).
Therapeutic Eects of Cranial Osteopathic Manipulative Medicine: A Systematic Review. The Journal
of the American Osteopathic Association. 111 (12):
68593. PMID 22182954.
[30] Agency for Healthcare Research and Quality (2012).
Best evidence statement (BESt). Craniosacral therapy
for children with autism and/or sensory processing disorder. U.S. Department of Health & Human Services.
Retrieved 19 May 2013.
[31] Craniosacral Therapy. Blue Cross Blue Shield of Tennessee Medical Policy Manual. Blue Cross Blue Shield of
Tennessee. 2012. Retrieved 19 May 2013.

REFERENCES

Text and image sources, contributors, and licenses

7.1

Text

Craniosacral therapy Source: https://en.wikipedia.org/wiki/Craniosacral_therapy?oldid=748715595 Contributors: Alex.tan, Edward,

Ronz, Angela, Darkwind, Timwi, Selket, Goethean, Nurg, Sunray, Mr-Natural-Health, David Gerard, Bacchiad, Nyxie, Geni, Antandrus,
Quarl, Trobster, Ukexpat, Chris Howard, Discospinster, Nina Gerlach, LeeHunter, CDN99, Goswell, BDD, Pwqn, Ringbang, Bobrayner,
Woohookitty, John Gohde, RichardWeiss, Graham87, BD2412, Rjwilmsi, Ligulem, JdforresterBot, Srleer, Random user 39849958,
Chris Capoccia, Scott5834, Gaius Cornelius, Mupledge, Yvesn, 2over0, RealityCheck, Eykanal, A13ean, SmackBot, Sticky Parkin,
Apers0n, Commander Keane bot, Gilliam, Chris the speller, Keegan, Ryan Paddy, DocJohnny, Huji, Farseer, Jere, Kvcad, BullRangifer,
JzG, Bronayur, Doczilla, SquidThing, Crcreno, Afroblanco, CmdrObot, Awmerrell, MeekMark, Cydebot, Hopping, Daniel J. Leivick,
Charolastra charolo, DumbBOT, Blaise Joshua, Second Quantization, RogueNinja, Darklilac, MER-C, Rentaferret, .anacondabot, Swikid,
VoABot II, WhatamIdoing, Bleasdale, EagleFan, Loonymonkey, Thaxter, Scottalter, Yobol, R'n'B, Nono64, Oakbranch8, CFCF, TimBuck2, Oradej, McSly, Naniwako, Djleslie, Knulclunk, Wilhelm meis, Johnchitty, Cometman, Sojmed, TXiKiBoT, WatchAndObserve,
Philoprof, Apsedona, Noformation, Eubulides, Tgm1024, Doc James, Alzian, MatthewTStone, SieBot, Alexbrn, Drcblum, Helikophis,
Johndheathcote, Sanya3, PbBot, Hordaland, Stevecalloway, JamesStewart7, Silhign, Craniodaddy, VQuakr, Rockfang, Kellyfaboo, Mariarnaud, Tb1403, Sun Creator, Arjayay, Ahamm03, Kiera.bethwiller, Phynicen, Ribn, DumZiBoT, Roxy the dog, Jytdog, TwoPairsOfBoots,
Addbot, Grayfell, Skyring520, This is Paul, Neoplop, Verbal, Yobot, WikiDan61, DoctorDW, AnomieBOT, Acthom~enwiki, Krelnik, Citation bot, ArthurBot, Xqbot, Zad68, Simone de lima, Srich32977, Holanidop, Pinethicket, Zink Dawg, Jayhcic13, Tbhotch, Beichlin,
Noommos, Salvio giuliano, Sem2u, LisaDez, Harmonz, Messt77, Thedeeperwell, Donner60, Hazard-Bot, ChuispastonBot, Flaun, Rybski,
Skywalker4532, ClueBot NG, Mediarayz, Sleddog116, Puhlaa, DrATStill, CashelrockVa, Helpful Pixie Bot, Kenne4shack, Curb Chain,
Ludrup, Robmauss, CitationCleanerBot, MrBill3, Consciouscopy, Purebreathoove, Fylbecatulous, Juliatwelve, Rytyho usa, Danolmt,
Colindireland, Saedon, TylerDurden8823, Sammydavis999, MadGuy7023, Pierrezelast, Mogism, Cerabot~enwiki, Frosty, Leemon2010,
Heringcarmen, Vanamonde93, Peoplemapsdavid, Saturnrays, Acharya Narmaada R Das, Mvolz, Karinpower, Caroline1122, Tronvillain,
Donosauro, Edsmythe, Craniogal, Jrhambly, Surreyosteo, Gerrimc11, DKRC, The Voidwalker, Verdaderagua, Healing for all and Anonymous: 132

7.2

Images

File:Lock-green.svg Source: https://upload.wikimedia.org/wikipedia/commons/6/65/Lock-green.svg License: CC0 Contributors: en:File:

Free-to-read_lock_75.svg Original artist: User:Trappist the monk
File:Outline-body-aura.png Source: https://upload.wikimedia.org/wikipedia/en/a/ab/Outline-body-aura.png License: PD Contributors:
? Original artist: ?

7.3

Content license

Creative Commons Attribution-Share Alike 3.0