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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
patient’s spine and pelvis. Practitioners believe that this
manipulation regulates the flow of cerebrospinal fluid and
aids in “primary respiration”.[2] Craniosacral therapy was
developed by John Upledger, D.O. in the 1970s, as an offshoot osteopathy in the cranial field, or cranial osteopathy, which was developed in the 1930s by William Garner

From 1975 to 1983, Upledger and neurophysiologist and
histologist Ernest W. Retzlaff worked at Michigan State
University as clinical researchers and professors. They
assembled a research team to investigate the purported
pulse and further study Sutherland’s theory of cranial
bone movement. Upledger and Retzlaff 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 offer conclusive proof for the efCST may relieve the symptoms of stress or ten- fectiveness of craniosacral therapy and the existence of
sion, “available scientific 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 fluid pressure
quackery.[5] Cranial osteopathy has received a similar as- or arterial pressure. The premise of CST is that palpasessment, with one 1990 paper finding there was no sci- tion of the cranium can be used to detect this rhythmic
entific basis for any of the practitioners’ claims the paper movement of the cranial bones and selective pressures
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


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 five ideas:[7]


History and conceptual basis

1. Inherent motility of the central nervous system
2. Fluctuation of the cerebrospinal fluid

Cranial osteopathy, a forerunner of CST, was originated
by osteopath William Sutherland (1873–1954) 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 fish, indicating articular mobility for a respiratory mechanism.”[7]

3. Mobility of the intracranial and intraspinal dural
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. Sutherland’s discovery regarding
the flexibility of skull sutures led to the early research behind CranioSacral Therapy – and both approaches affect
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 fluid fluctuation is described
by practitioners as an interaction between four main components: arterial blood, capillary blood (brain volume),
venous blood and cerebrospinal fluid (CSF).[15][16]

although CST may relieve the symptoms of stress or tension. He attempted to hold examined. the Ernst criticized a 2011 systematic review performed by cranial bones begin to move together and fuse as a nor.”[7] together by a membrane known as a fontanelle where two sutures join. "[w]hen such sutures are and its practice called quackery. of the closure of the cranial sutures have reported mixed This review concluded that the evidence base surrounding findings.[4] According to Gray’s Anatomy.entific basis for any of the practitioners’ claims the paper [6] ment within the spinal meninges. Between the first and second year of life. reThere is research which demonstrates examiners are un. and focuses intently on the communicated movements.”[28] Ernst gree of cranial motion have yielded mixed findings.[2] Cranial osteopathy has received a similar asIn 1970. Upledger observed during a surgical procedure sessment. . In the ab(the eighth decade of life has been reported).[18] a principle which lacks scientific support.[25] by a lack of inter-rater agreement among examiners. A practitioner’s feeling of being in tune with a patient is described as entrainment.” a sentiment which bones are joined. and coronal sutures tak.on his blog that he had chosen the wording as “a polite sidered controversial and studies of the existence and de. well-designed randomized controlled studies have found that the sutures never rigidly fuse.craniosacral therapy and its efficacy was sparse and comlescence while other studies indicate greater individual posed of studies with heterogeneous design. but complete fu. Retrieved 2016-10-21. Whether craniosacral motion can be reliably palpated remains a subject of de. 2.[17] There are few reports of adverse events from CST treatThe authors of this research conclude this “measurement ment.insufficient to draw conclusions.[30][31] it has been characterized as pseudoscience. Alternative medicine adverse effects from treatment was 5%. 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.“available scientific evidence does not support claims that craniosacral therapy helps in treating cancer or any other traspinal dural membranes disease”.[14] trials.[14] Studies examining the age studies and including studies with healthy volunteers. as indicated by the endocannabinoid system.5 Mobility of the cranial bones dence from rigorous randomised clinical trials.Jakel and von Hauenschild for inclusion of observational [27] mal part of development. 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. and may feel light-headed.4 Reception bate with studies producing mixed results.[22] but are instead bound methodological quality of the included[19][20] According to the American Cancer Society.and scientific way of saying that CST is bogus.[14] some sence of rigorous. sagittal shows the effects may actually be brought about able to measure craniosacral motion reliably.3 6 REFERENCES Fluctuation of the cerebrospinal fluid session.quackwatch.[26] practitioners have interpreted this result as a product of entrainment between patient and practitioner. the cranial bones are echoed an August 2012 review that noted the “moderate not rigidly fused to each other.4 Mobility of the intracranial and in. ing place in the fourth decade of life. the incidence of decisions potentially erroneous”. While sometimes thought to be caused by an increase in endorphins. In one study of craniosacral manipulation in paerror may be sufficiently large to render many clinical tients with traumatic brain syndrome. Closure has been reported to occur during ado. with one 1990 paper finding there was no scion the neck what he described as a slow pulsating move.[24] 5 See also 3 Treatment The therapist lightly palpates the patient’s body.[18] Patients often report feelings of deep relaxation during and after the treatment • List of ineffective cancer treatments 6 References [1] “Why Cranial Therapy Is Silly”.[5] tied by sutural ligament and periosteum. www.[14] also commented that the quality of five of the six trials he Cranial sutures are the areas in which the eight cranial had reviewed was “deplorably poor. He concluded that “the notion that CST is associated with more than non-specific effects is not based on evi2.”[27] Commenting specifically on this conclusion Ernst commented The extent to which cranial bones are able to move is con.[21] review of randomized clinical trials of craniosacral therapy. During infancy.2 2.The evidence base for CST is sparse and lacks a demonsion of all sutures not occurring until advanced age[23] strated biologically plausible mechanism. almost complete immobility results”.

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