Craniosacral therapy
Craniosacral therapy (CST) is an alternative medicine practice that claims to use gentle touch to adjust non-existent rhythms and movements within the skull and spine. Despite its growing popularity, particularly for infants and children, the therapy faces significant scientific scrutiny. Join us as we explore the fascinating claims of CST and compare them with established anatomical and physiological understanding. Craniosacral therapy is based on fundamental misconceptions about human anatomy and physiology, particularly regarding the movement of adult skull bones. Despite claims of effectiveness for a wide range of conditions, medical research and systematic reviews consistently find no significant scientific evidence to support any health benefits. The practice of craniosacral therapy is characterized by scientists and medical professionals as pseudoscience and quackery, with potential risks, especially for vulnerable populations like children.
AI Summary
Craniosacral therapy (CST) is an alternative medicine practice that claims to use gentle touch to adjust non-existent rhythms and movements within the skull and spine. Despite its growing popularity, particularly for infants and children, the therapy faces significant scientific scrutiny. Join us as we explore the fascinating claims of CST and compare them with established anatomical and physiological understanding.
- Craniosacral therapy is based on fundamental misconceptions about human anatomy and physiology, particularly regarding the movement of adult skull bones.
- Despite claims of effectiveness for a wide range of conditions, medical research and systematic reviews consistently find no significant scientific evidence to support any health benefits.
- The practice of craniosacral therapy is characterized by scientists and medical professionals as pseudoscience and quackery, with potential risks, especially for vulnerable populations like children.
What is Craniosacral Therapy?
Craniosacral therapy, often shortened to CST, is a form of alternative medicine. Practitioners claim that a gentle, light touch—often no heavier than the weight of a nickel—can detect and influence subtle, rhythmic movements in the bones of the skull and the membranes surrounding the brain and spinal cord. The goal? To improve the flow of cerebrospinal fluid and purportedly alleviate a wide array of health issues.
At its core, CST rests on a belief that the bones of the human skull, which are largely fused in adults, possess a distinct, rhythmic motion—a 'craniosacral pulse.' Practitioners assert they can palpate, or feel, this pulse, and then apply specific pressures to adjust these supposedly mobile cranial bones. This, they claim, can lead to therapeutic outcomes across the body.
A Contested Foundation
However, this foundational premise immediately clashes with established medical science. The joints between the bones of the adult skull, known as sutures, are generally considered immovable synarthroses—meaning they are fixed and designed for structural stability, not rhythmic motion. To suggest they can be 'adjusted' is to contradict basic human anatomy.
Leading medical experts, including neurophysiologists and anatomists, have pointed out that the conceptual basis of CST is simply inconsistent with known human physiology. The idea of a detectable, rhythmic craniosacral pulse that can be therapeutically manipulated lacks biological plausibility and scientific support. As one critic famously put it, it 'looks like pure nonsense' to anyone with a basic understanding of anatomy.
The Journey of an Idea
The roots of CST can be traced back to cranial osteopathy, devised in the 1930s by an American osteopath named William Garner Sutherland. He observed the beveled edges of cranial sutures, comparing them to fish gills, and hypothesized that they indicated a subtle, respiratory-like mobility.
Decades later, in the 1970s, osteopathic physician John Upledger further developed these ideas into what became Craniosacral Therapy. Upledger and a research team at Michigan State University studied Sutherland's theories. Yet, subsequent independent reviews of this research found no good evidence for the effectiveness of CST or the existence of the purported cranial bone movement.
Does it Work? The Scientific Verdict
Despite practitioners' claims of CST being a panacea—a cure-all for conditions ranging from headaches and chronic pain to autism and even cancer—the scientific evidence paints a very different picture. Rigorous medical research has consistently found no significant evidence that CST confers any health benefit.
Studies designed to test the efficacy of CST have often been of poor methodological quality. When tested, practitioners frequently cannot even reliably identify the purported 'craniosacral pulse,' with different therapists often arriving at conflicting and mutually exclusive diagnoses for the same patient.
A 2012 systematic review of randomized clinical trials, considered the gold standard for medical evidence, concluded that there's no evidence CST offers more than non-specific, placebo-like effects. The author, Professor Edzard Ernst, wryly noted that this was 'a polite and scientific way of saying that CST is bogus.'
While a 2019 review suggested some limited relief for chronic pain, even its conclusions were disputed by institutions like McGill University's Office for Science and Society, citing the consistently poor methodological quality of the individual studies included in the analysis.
Safety and Risks
Beyond the lack of proven effectiveness, there are serious concerns about the safety of craniosacral therapy. Manipulations of the head and spine can be harmful, particularly for vulnerable populations such as children and infants, where pediatricians have expressed alarm.
The American Cancer Society, for instance, strongly cautions against using CST on children under two years old. They also recommend that anyone with cancer or chronic conditions consult their doctor before undertaking any therapy involving manual manipulation, due to potential risks and the danger of delaying effective treatment.
Tragically, there have been reported deaths resulting from CST spinal manipulation. In one small study, participants with head injuries experienced a worsening of their symptoms after receiving craniosacral therapy. These incidents underscore that even 'gentle touch' can carry risks when applied without a sound scientific basis.
Furthermore, if CST is chosen as the sole treatment for serious conditions, it can have dire adverse consequences by replacing proven medical interventions. This is a critical concern for conditions like cancer, where timely and evidence-based treatment is paramount.
A Lack of Oversight
Unlike mainstream medical professions, craniosacral therapy often operates in an unregulated environment. Many regions lack defined training programs, professional bodies, or external oversight to ensure standards or safety. This makes it challenging to hold practitioners accountable and further highlights the need for caution.
Article
Craniosacral therapy
Craniosacral therapy (CST) or cranial osteopathy is a form of alternative medicine that uses gentle touch to feel non-existent rhythmic movements of the skull's bones and supposedly adjust the immovable joints of the skull to achieve a therapeutic result. CST is a pseudoscience and its practice has been characterized as quackery. It is based on fundamental misconceptions about the anatomy and physiology of the human skull and is promoted as a cure-all for a variety of health conditions.
Medical research has found no significant evidence that either CST or cranial osteopathy confers any health benefit, and attempts to manipulate the bones of the skull can be harmful, particularly for children or infants. The basic assumptions of CST are not true, and practitioners produce conflicting and mutually exclusive diagnoses of the same patients.
Effectiveness and safety
Craniosacral therapy
Practitioners of CST claim it is effective in treating a wide range of conditions, sometimes claiming it is a cancer cure, or a cure-all. Practitioners particularly advocate the use of CST on children. The American Cancer Society cautions that CST should never be used on children under age two. Pediatricians have expressed concern at the harm CST can cause to children and infants.
There is no evidence that CST is of use for people with autism and its use is potentially harmful. As of 2018 at least two deaths had been reported resulting from CST spinal manipulation. In a small study, participants with head injuries suffered worsening symptoms as a result of CST. Additionally, if used as the sole treatment for serious health conditions, choosing CST can have serious adverse consequences; the American Cancer Society recommends those with cancer or chronic conditions should consult their doctor before starting any therapy consisting of manual manipulation.
According to the American Cancer Society, although CST may relieve the symptoms of stress or tension, "available scientific evidence does not support claims that craniosacral therapy helps in treating cancer or any other disease". Cranial osteopathy has received a similar assessment, with one 1990 paper finding there was no scientific basis for any of the practitioners' claims the paper examined.
The evidence base for CST is sparse and lacks a demonstrated biologically plausible mechanism. In the absence of rigorous, well-designed randomized controlled trials, it is a pseudoscience, and its practice quackery. Tests show that CST practitioners cannot in fact identify the purported craniosacral pulse, and different practitioners will get different results for the same patient. The idea of a craniosacral rhythm cannot be scientifically supported.
Systematic reviews
In October 2012, Edzard Ernst conducted a systematic review of randomized clinical trials of craniosacral therapy. He concluded that "the notion that CST is associated with more than non-specific effects is not based on evidence from rigorous randomised clinical trials." Commenting specifically on this conclusion, Ernst wrote on his blog that he had chosen the wording as "a polite and scientific way of saying that CST is bogus." Ernst also remarked that the quality of five of the six trials he had reviewed was "deplorably poor," a sentiment that echoed an August 2012 review that noted the "moderate methodological quality of the included studies."
Ernst criticized a 2011 systematic review performed by Jakel and von Hauenschild for including observational studies and including studies with healthy volunteers. This review concluded that the evidence base surrounding craniosacral therapy and its efficacy was sparse and composed of studies with heterogeneous design. The authors of this review stated that currently available evidence was insufficient to draw conclusions.
A 2019 systematic review found limited evidence that CST may bring some relief for up to six months for people with chronic pain. However, the conclusions of this study were disputed by the Office for Science and Society at McGill University due to the poor methodological quality of the individual studies that made up the analysis.
Regulation
Edzard Ernst wrote that in 2005 in the United Kingdom, a foundation of then-Prince Charles issued a booklet listing CST as one of several popular alternative therapies, but admitted that the therapy was unregulated and lacked either a defined training program or the oversight of a professional body. Ernst wrote that this makes the therapists practising CST "less regulated than publicans."
History
Craniosacral therapy
Cranial osteopathy, a forerunner of CST, was devised in the 1930s by William Garner Sutherland. 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."
CST was invented by John Upledger, as an offshoot of cranial osteopathy. 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. Later, independent reviews of these studies concluded that they presented no good evidence for the effectiveness of craniosacral therapy or the existence of the proposed cranial bone movement.
Conceptual basis
Craniosacral therapy
Practitioners of both cranial osteopathy and CST assert that there are small, rhythmic motions of the cranial bones attributed to cerebrospinal fluid pressure or arterial pressure. The premise of CST is that palpation of the cranium can be used to detect this rhythmic movement of the cranial bones and selective pressures may be used to manipulate the cranial bones to achieve a therapeutic result. However, there is no evidence that the bones of the human skull can be moved by such manipulations.
The fundamental concepts of cranial osteopathy and CST are inconsistent with the human skull, brain, and spine's known anatomy and physiology. Edzard Ernst has written "to anyone understanding a bit of physiology, anatomy etc. [CST] looks like pure nonsense."
In common with many other varieties of alternative medicine, CST practitioners believe all illness is caused by energy or fluid blockages which can be released by physical manipulation. They believe that the bones of the skull move in a rhythmic pattern which they can detect and correct.
The therapist lightly palpates the patient's body, and focuses intently on the communicated movements. A practitioner's feeling of being in tune with a patient is described as entrainment.
Comparing CST to cranial osteopathy, Upledger 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." 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 name CranialSacral therapy."