Research Webpage: Research into Craniosacral Therapy.

As Craniosacral Therapists in our clinical practice, we mostly rely on anecdotal evidence provided by satisfied clients to their family and friends. From time to time, we’re asked to provide clinical evidence confirming the effectiveness of craniosacral therapy, and an evidence-base for its use. Evidence-based Practice (EBP) is becoming increasingly required in all therapies both within complementary and within conventional medicine. In order to encourage interest in research and hence interest in promoting CST we would like to start this webpage as an information resource for our profession, both for students doing research projects and clinicians looking for evidence to support their treatment approach.

We’re increasingly finding medical professionals wanting to use our services for some of their patients but reluctant to do so by the lack of evidence-based research. Fortunately, there is increasing acceptance that outcome based data collection is more relevant to complementary therapies than clinical trials and we will give more information on our plans to start such data collection after the next Council meeting due on 11 May 2009.

We hope this webpage will help support and promote the need for effectiveness evidence within CST. There are a few small studies that, taken together, provide a glimpse of how effective treatments can be provided by craniosacral therapy. These are summarised below.

The first two studies are taken from cranial osteopathy. CST is a very similar therapy to cranial osteopathy being historically derived from it and, thus, we can plausibly extrapolate from these studies.

Craniosacral studies.

  1. The first is a study into the effectiveness of CV4 and resting position techniques with tension type headaches. This was a study of 60 volunteers randomly allocated into three groups: one received a CV4 treatment; another a resting position technique; and the third no treatment. The group receiving CV4 treatments achieved a significant improvement compared with the no treatment group; whereas there was no significant difference between the resting position and no treatment groups. The research team concluded the positive CV4 results warranted further investigation in a larger trial. i
  1. The second study tested whether cranial osteopathy helped in the treatment of infantile colic. In this case, 28 babies were split into two groups, one receiving cranial osteopathic treatment over 4 weeks; the other not. The evidence was reviewed by the New Zealand Guidelines Group commissioned and funded by the New Zealand Ministry of Health to research and publish the evidence for the effectiveness of CAM therapies. The improvement in the treatment group was sufficiently statistically superior for them to conclude that cranial osteopathic treatment can benefit infants with colic; and that a larger double-blind study is warranted. (The main study reviewed was that carried out by Hayden C and Mullinger B in 2006).ii
  1. A University of North Carolina study compared using CST for migraine with ‘treatment as usual’ methods plus treatment with low strength static magnets primarily for the purpose of testing their methodology for use in a larger randomised trial. The authors concluded the results of using CST were sufficiently favourable to justify carrying out a larger studyiii
  1. A CST study carried out through the University of Westminster was reported in Fulcrum: patient outcome measures were collected over a three year period from June 2001 at the University of Westminster clinic for a range of conditions, using modified MYMOP reporting forms. The authors reported that patients treated in the craniosacral teaching clinics felt that their symptoms improved.iv
  1. Another outcome study carried out by Dr Rachel Harrison during 2007-8 on behalf of the Upledger Institute UK is reported on the CSS website.v This was a mix of patients provided by Upledger practitioners trained to SER2 and beyond (73 patients); and those selected by Doctors at Dr Harrison’s NHS General Practice as likely to benefit from CST (57 patients). The combined results suggested that unsettled babies, patients with headache/migraine, neck, back pain, stress, anxiety and depression may respond well to CST.

Research evidence for impact of CST on tissues and body fluids.

There is evidence supporting elements of CST theory:
  1. Cranial bone motion in the form of cranial compliance.vi
  2. Cerebrospinal fluid motion.vii
  3. Magnetic resonance scans demonstrate that CST treatment can produce immediate changes in brain tissue.viii
  4. Doppler scans demonstrate an alteration in cerebral blood flow, possible mediated by the autonomic nervous system.ix

Case histories reported by Journalists

This is what is known as anecdotal evidence, being specific to that client and that therapist and as such cannot be generalised to the population as a whole. Such case studies are of value in providing positive evidence and give a sense of how effective CST treatments could be should larger scale trials be proven to support such effects.

Further evidence

Members are invited to provide information about any clinical studies of which they’re aware by email to dellis26@btinternet.com. If you have any critical comments regarding these studies that would also be added to this page.

David Ellis

April 2009

Note re references: website references sometimes disappear but were available at the date this note was published!

i Journal of Osteopathic Medicine Volume 4 Issue 2 October 2001: 62-4. An abstract can be found at www.sciencedirect.com by inserting the Journal name, Volume, Issue and page numbers in their search box.

ii www.cam.org.nz Click on Complementary and Alternative Therapies Evidence-based Summaries then on 'Does Osteopathy help infantile Colic’.

iii www.biomedcentral.com/1472-6882/8/28/

iv B Isbell and S Carroll The effectiveness of craniosacral treatment Fulcrum issue 41, (Spring/Summer 2007): 2-5.

vwww.cst1.org Click on Research.

vi Rogers JS, Witt PL (1997) The controversy of cranial bone motion. J Orthop Sports Phys Ther 26(2): 95-103

vii Cardoso ER, Rowan JO, Galbraith S (1983) Analysis of the cerebrospinal fluid pulse wave in intracranial pressure. Neurosurgery 59(9): 817-21; and Green C, Martin CW, Bassett K, Kazanjian A (1999) A systematic review of craniosacral therapy: biological plausibility, assessment reliability and clinical effectiveness. Complementary Ther Med 7(4): 201-7

viii Pick MG (1994) A preliminary single case magnetic resonance imaging investigation into maxillary frontal-parietal manipulation and its short term effect upon the intracranial structures of an adult human brain. J Manipulative Physil Ther 17: 168-73

ix Sergueef N, Nelson K E, Glonek T (2002) The effect of cranial manipulation on the Traube-Hering-Mayer oscillation as measured by laser-dopler flowmetry. Altern Ther Health Med 8(6): 74-76

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