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Craniosacral Therapy Research

June 2, 2013 Written by JP       [Font too small?]

Cheerio! I’m back in jolly old England to share some of the local healing tradition. The inspiration for today’s column comes courtesy of the Royal London Hospital for Integrated Medicine (RLHIM). There, patients are offered the best of both complementary and conventional care in an outpatient setting. The RLHIM administers an impressive array of holistic healing modalities including aromatherapy, homeopathy and reflexology. Also popular at this healing institution is a form of bodywork known as craniosacral therapy or CST.

During a typical CST session, a practitioner gently manipulates the cranium in order to facilitate the proper flow of cerebrospinal fluid. Some researchers theorize that stasis of the cerebrospinal fluid can negatively influence the human body by affecting cellular metabolism, impeding the removal of waste products and even interfering with transport of hormones and neurotransmitters. It should also be noted that the exact application of CST varies considerably. In many instances, emotional comforting and counseling is simultaneously provided alongside the customary light physical touch, making this a true mind-body experience.

Over the last several years, numerous studies have been published attesting to the relative efficacy and safety of craniosacral therapy. Some of the highlights of the trials report that CST: a) improves pain-related conditions such as fibromyalgic soreness and tenderness, migraine symptoms and pelvic girdle pain which affects upwards of 30% of pregnant women; b) additionally reduces anxiety, depression and insomnia in patients living with fibromyalgia; c) was found to benefit the quality of life in asthmatics; d) decreases the incidence of lower urinary tract symptoms associated with multiple sclerosis. Most of the studies, even the most promising of the lot, concluded that CST should be used in conjunction with other care. It is rarely used as a solitary approach for chronic conditions or diseases.

Documented reports of harm caused by craniosacral therapy do exist. However, they appear to be exceedingly rare and can most likely be avoided by seeking out reputable practitioners. The best way to find just such a person is to get a referral from an integrative physician. There are also organizations based in the United States and in England that can assist anyone interested in giving CST a trial. A few of the better known contacts are: The American Craniosacral Therapy Association (www.acsta.com) and The Craniosacral Therapy Association of the UK (www.craniosacral.co.uk). As is often the case, finding the right practitioner can make all the difference. Recently, Dr. Wayne Dyer reported his first success with CST after many years of failed, sporadic attempts. A CST practitioner by the name of Kate Mackinnon was the key to his CST success. For anyone interested, Kate recently published a book (“From My Hands and Heart”) about how to apply CST to any comprehensive wellness routine.

Note: Please check out the “Comments & Updates” section of this blog – at the bottom of the page. You can find the latest research about this topic there!

To learn more about the studies referenced in today’s column, please click on the following links:

Study 1 - Cerebrospinal Fluid Stasis and Its Clinical Significance (link)

Study 2 - Effects of Craniosacral Therapy as Adjunct to Standard Treatment for (link)

Study 3 - Is Craniosacral Therapy Effective for Migraine? Tested with HIT-6 (link)

Study 4 – Credibility of Low-Strength Static Magnet Therapy as an Attention (link)

Study 5 - A Randomized Controlled Trial Investigating the Effects of Craniosacral … (link)

Study 6 - Influence of Craniosacral Therapy on Anxiety, Depression and Quality of (link)

Study 7 - Effect of Craniosacral Therapy on Lower Urinary Tract Signs and (link)

Study 8 – The Impact of Acupuncture and Craniosacral Therapy Interventions on (link)

Study 9 - Death of an Infant Following ‘Craniosacral’ Manipulation of the Neck (link)

Study 10 - Chiropractic Care, Including Craniosacral Therapy, During Pregnancy (link)

Craniosacral Therapy May Improve Fibromyalgia-Related Quality of Life

Source: Evid Based Complement Alternat Med. 2011;2011:178769. (link)

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Posted in Alternative Therapies, Mental Health, Women's Health

10 Comments & Updates to “Craniosacral Therapy Research”

  1. Iggy Dalrymple Says:

    Be sure and look BOTH ways before crossing the street.

  2. JP Says:

    Indeed! Look left. Look right. Thanks, Iggy! I may survive London yet!

    Be well!

    JP

  3. Rob Says:

    I applaud your committment to reading and referencing the research on the topics you cover JP. These studies for CST though seem really poor quality. Some of them don’t have a control group, some of the ones that do have sham controls that are markedly different from CST, they all have small sample sizes, the one for anxiety/depression/pain has all of the subjects also taking medications for those issues, etc. Generally as well, the physiological basis for how CST would work apart from other manual therapies isn’t agreed on or established or even practiced the same way amongst its practitioners. A systematic review from 2012 did not have a favourable conclusion: http://onlinelibrary.wiley.com/doi/10.1111/j.2042-7166.2012.01174.x/abstract

  4. JP Says:

    Hi Rob,

    Thank you for your kind comments and your thoughtful critique of the data. I appreciate it.

    It may surprise you to know that I largely agree with your position. Studies on mind-body therapies, such as CST, often lack the sort of blinding or control I’d like to see. I also understand that the proposed mechanisms behind CST have yet to be verified in scientific experiments. Nevertheless, I suspect there’s something of value at work here. Other reviewers have been more generous with their analysis of the published data: http://www.jaoa.org/content/111/12/685.long In addition, some reputable researchers in the CAM field have personally relayed a significant amount of anecdotal/clinical data to me. My hope is that the studies currently underway will help elucidate the true potential (or lack thereof) of CST. Either way, I’ll keep you posted. Please do the same!

    http://clinicaltrials.gov/ct2/results?term=craniosacral+therapy&Search=Search

    Be well!

    JP

  5. Rob Says:

    Hi JP,
    Will do. Pain, anxiety, and depression are all problems that respond readily to placebo effects and biases so it’s doubly important any trial design/methods try to account for this if they are serious about wanting to give a fair, objective test of the therapy as opposed to it being simply a promotional tool. People are just going to naturally “feel better” when they see a practitioner, in a nice relaxing setting, and have some kind of physical touch they are told is therapeutic. We want to know if there is more than this expected baseline response going on though…
    Cheers,
    Rob

  6. liverock Says:

    HiJP

    You may not know this but the buses in London are painted red so that tourists who are used to traffic coming from another direction in their own country can more easily see a bright red colored bus.

    Also for those tourists who fail to see the red bus, any blood spilt as a result will not be noticable on the bus paintwork to frighten onlookers!!

  7. JP Says:

    Hi Liverock,

    Very clever planning indeed! Ha! :-)

    Be well!

    JP

  8. JP Says:

    Update 06/25/15:

    http://www.ncbi.nlm.nih.gov/pubmed/25694375

    Ortop Traumatol Rehabil. 2014 Nov-Dec;16(6):605-15.

    Utility of craniosacral therapy in treatment of patients with non-specific low back pain. Preliminary report.

    BACKGROUND: Non-specific low back pain is an increasingly common musculoskeletal ailment. The aim of this study was to examine the utility of craniosacral therapy techniques in the treatment of patients with lumbosacral spine overload and to compare its effectiveness to that of trigger point therapy, which is a recognised therapeutic approach.

    MATERIAL AND METHODS: The study enrolled 55 randomly selected patients (aged 24-47 years) with low back pain due to overload. Other causes of this condition in the patients were ruled out. The participants were again randomly assigned to two groups: patients treated with craniosacral therapy (G-CST) and patients treated with trigger point therapy (G-TPT). Multiple aspects of the effectiveness of both therapies were evaluated with the use of: an analogue scale for pain (VAS) and a modified Laitinen questionnaire, the Schober test and surface electromyography of the multifidus muscle. The statistical analysis of the outcomes was based on the basic statistics, the Mann-Whitney U test and Wilcoxon’s signed rank test. The statistical significance level was set at p≤0.05.

    RESULTS: Both groups demonstrated a significant reduction of pain measured with the VAS scale and the Laitinen questionnaire. Moreover, the resting bioelectric activity of the multifidus muscle decreased significantly in the G-CST group. The groups did not differ significantly with regard to the study parameters.

    CONCLUSIONS: 1. Craniosacral therapy and trigger point therapy may effectively reduce the intensity and frequency of pain in patients with non-specific low back pain. 2. Craniosacral therapy, unlike trigger point therapy, reduces the resting tension of the multifidus muscle in patients with non-specific lumbosacral pain. The mechanism of these changes requires further research. 3. Craniosacral therapy and trigger point therapy may be clinically effective in the treatment of patients with non-specific lumbosacral spine pain. 4. The present findings represent a basis for conducting further and prospective studies of larger and randomized samples.

    Be well!

    JP

  9. JP Says:

    Updated 09/06/15:

    http://journals.lww.com/clinicalpain/pages/articleviewer.aspx?year=9000&issue=00000&article=99251&type=abstract

    Clin J Pain. 2015 Sep 3.

    Craniosacral Therapy for the Treatment of Chronic Neck Pain: A Randomized Sham-controlled Trial.

    OBJECTIVES: With growing evidence for Craniosacral Therapy (CST) effectiveness for pain management, the question about CST efficacy remained unclear. This study therefore aimed at investigating CST in comparison to sham treatment in chronic non-specific neck pain patients.

    METHODS: 54 blinded patients were randomized to either 8 weekly units of CST or light touch sham treatment. Outcomes were assessed before and after treatment (week 8) and a further 3 months later (week 20). The primary outcome was pain intensity on a visual analogue scale; secondary outcomes included pain on movement, pressure pain sensitivity, functional disability, health-related quality of life, well-being, anxiety, depression, stress perception, pain acceptance, body awareness, patients’ global impression of improvement and safety.

    RESULTS: In comparison to sham, CST patients reported significant and clinically relevant effects on pain intensity at week 8 (-21▒mm; 95%-CI: [-32.6|-9.4]; P=0.001; d=1.02) as well as at week 20 (-16.8▒mm; 95%-CI: [-27.5|-6.1]; P=0.003; d=0.88). Minimal clinically important differences in pain intensity at week 20 were reported by 78% of the CST patients, while 48% even had substantial clinical benefit. Significant differences at week 8 and 20 were also found for pain on movement, functional disability, physical quality of life and patients’ global improvement. Pressure pain sensitivity and body awareness were significantly improved only at week 8; anxiety only at week 20. No serious adverse events were reported.

    DISCUSSION: CST was both specifically effective and safe in reducing neck pain intensity and may improve functional disability and quality of life up to 3 months post intervention.This is an open-access article distributed under the terms of the Creative Commons Attribution-Non Commercial-No Derivatives License 4.0 (CCBY-NC-ND), where it is permissible to download and share the work provided it is properly cited.

    Be well!

    JP

  10. JP Says:

    Updated 06/28/16:

    http://www.ncbi.nlm.nih.gov/pubmed/27347698

    J Altern Complement Med. 2016 Jun 27.

    Benefits of Craniosacral Therapy in Patients with Chronic Low Back Pain: A Randomized Controlled Trial.

    OBJECTIVES: To evaluate the effects of craniosacral therapy on disability, pain intensity, quality of life, and mobility in patients with low back pain.

    DESIGN: A single-blinded randomized controlled trial.

    PATIENTS: Sixty-four patients with chronic nonspecific low back pain (mean age ± SD, 50 ± 12 years; 66% female) who were referred for physical therapy at a clinical unit of the Health Science School of the University of Almeria (Spain).

    INTERVENTIONS: Participants were randomly assigned to an experimental group (10 sessions of craniosacral therapy) or a control group (10 sessions of classic massage).

    OUTCOME MEASURES: Disability (Roland Morris Disability Questionnaire [RMQ, primary outcome] and Oswestry Disability Index), pain intensity (10-point numeric pain rating scale), kinesiophobia (Tampa Scale of Kinesiophobia), isometric endurance of trunk flexor muscles (McQuade test), lumbar mobility in flexion, hemoglobin oxygen saturation, systolic blood pressure, diastolic blood pressure, hemodynamic measures (cardiac index), and biochemical estimation of interstitial fluid. These outcomes were registered at baseline, after treatment, and 1-month follow-up.

    RESULTS: No statistically significant differences were seen between groups for the main outcome of the study, the RMQ (p = 0.060). However, patients receiving craniosacral therapy experienced greater improvement in pain intensity (p ≤ 0.008), hemoglobin oxygen saturation (p ≤ 0.028), and systolic blood pressure (p ≤ 0.029) at immediate- and medium-term and serum potassium (p = 0.023) level and magnesium (p = 0.012) at short-term than those receiving classic massage.

    CONCLUSIONS: Ten sessions of craniosacral therapy resulted in a statistically greater improvement in pain intensity, hemoglobin oxygen saturation, systolic blood pressure, serum potassium, and magnesium level than did 10 sessions of classic massage in patients with low back pain.

    Be well!

    JP

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