Craniosacral therapy

Craniosacral therapy, cranial osteopathy or cranial therapy is a method of alternative medicine purportedly used to assess and enhance the functioning of the craniosacral system, which consists of the membranes and cerebrospinal fluid of the central nervous system. Proponents claim that measurements of craniosacral motion are indicative of breath/heart rate, and that by lightly pressing on the cranial sutures of the skull they can remove restrictions in the flow of cerebrospinal fluid, relieving stress, decreasing pain, and enhancing overall health[1][2][3]. These claims have been shown to be without basis,[4][5][6][7] and numerous studies done that support the claims have been severely criticized for poor methodology.[8]

History

Cranial therapy was introduced by osteopathic doctor William Sutherland in the early 1900s. Sutherland theorized that the bones of the skull could be moved along their sutures, and towards the end of his life Sutherland began to sense a "power" which generated corrections from inside his clients' bodies without the influence of external forces applied by him as the therapist. Similar to Qi and Prana, this contact with what he called "the Breath of Life" changed his entire treatment focus to one of spiritual reverence and subtle touch.[9] This spiritual approach to the work has come to be known as "Biodynamic Craniosacral therapy", and has had further contributions by such practitioners as Dr. Roland Becker, James Jealous, and Franklyn Sills.

In 1970, osteopath John E. Upledger observed during a surgical procedure on the neck what he described as a pulse within the craniosacral system. He then discovered the work done by Sutherland, and thought that if movement of the cranial bones were possible, the pulse he had observed would be explained. From 1975 to 1983, Upledger worked at Michigan State University as a clinical researcher and professor, and set up a team of anatomists, physiologists, biophysicists, and bioengineers to investigate the pulse he had observed and study further Sutherland's theory of cranial bone movement. Upledger went on to publish his results, which purported to show support for both the concept of cranial bone movement and the concept of a cranial pulse,[10][11][12] but these results have been criticized as highly unreliable.[8]

In 1985 Upledger established the Upledger Institute, a health center dedicated to the education and certification of practitioners in craniosacral and related therapies. The Karuna Institute also offers training in craniosacral therapy.

Criticisms

Skeptics exist both inside and outside the osteopathic profession.

Lack of evidence for the existence of the "cranial rhythm"

The scientific evidence for cranial bone movement is insufficient to support the theories claimed by craniosacral practitioners. Scientific research has long supported the theory that the cranial bones fuse during adolescence, making movement impossible.[13] Further, while evidence exists for cerebrospinal fluid pulsation, it is caused by the functioning of the cardiovascular system and not by the workings of the craniosacral system.[5]

Lack of evidence linking "cranial rhythm" to disease

While anecdotal evidence exists in support of the link between the "cranial rhythm" and general health, no research to date has supported this claim.[8]

Lack of evidence "cranial rhythm" is detectable by practitioners

Operator interreliability has been very poor in the studies that have been done. Five studies showed an operator interreliability of zero.[4] The one study showing some operator interreliability has been criticized as deeply flawed.[8

References
1 .The Upledger Institute (2001). Craniosacral Therapy. Retrieved March 27, 2004.
2 . Ferrett, Mij (1998). What Is Craniosacral Therapy? Retrieved March 27, 2004.
3 .The Sutherland Society General information on Cranial Osteopathy Retrieved January 24, 2006
4 . a b S.E. Hartman, J.M. Norton (2002) Interexaminer reliability and cranial osteopathy. Scientific Review of Alternative Medicine. 6(1): 23-34 PDF full report
5 . b Ferre JC, Chevalier C, Lumineau JP, Barbin JY (1990) Cranial osteopathy, delusion or reality? Actualites Odonto-Stomatologiques 44: 481-494 PMID: 2173359
6 . 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): 908-916 PMID: 8090842
7 . Rogers JS and others (1998) Simultaneous palpation of the craniosacral rate at the head and feet: intrarater and interrater reliability and rate comparisons. Physical Therapy 78(11): 1175-1185 PMID: 9806622
8 .a b c d Green C and others (1999) A systematic review and critical appraisal of the scientific evidence on craniosacral therapy. BCOHTA PDF full report
9 . The Cranial Academy Osteopathy in the Cranial Field Retrieved January 24, 2006.
10 . Upledger JE (1977) The reproducibility of craniosacral examination findings: a statistical analysis. J Am Osteopath Assoc 76(12):890-899 PMID: 7899490
11 . Upledger JE (1978) The relationship of craniosacral examination findings in grade school children with developmental problems. J Am Osteopath Assoc 77(10): 760-776. PMID: 659282
12 . Upledger JE, Karni Z (1979) Mechano-electric patterns during craniosacral osteopathic diagnosis and treatment. J Am Osteopath Assoc 78(11):782-791 PMID: 582820
13 . Madeline LA, Elster AD. (1995) Suture closure in the human chondrocranium: CT assessment. Radiology 196(3):747-756 PMID: 764463