Craniosacral Therapy for Migraines

Can controversial treatment offer any real relief?

Woman having head massage
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Migraines remain one of the most puzzling and problematic conditions facing Americans today. Approximately 20 percent of the U.S. population suffers from migraines with pain ranging from moderate to debilitating.

Even more disconcerting is variability of treatment approaches, some of which work well for some individuals but not so well for others. For this reason, people will often turn to complementary therapies to aid in the traditional treatment of migraines.

Current Treatment Options

Traditional treatments of migraines are typically focused on preventive medications such as topiramate, sodium valproate, propranolol, and metoprolol, each of which offers different mechanisms of action. Other treatment options include acupuncture, chiropractic manipulation, physiotherapy, massage, and even surgically implanted neurostimulators for chronic intractable migraines.

The success rates of these treatments can vary significantly since the underlying cause of migraines is still unknown. As such, treatments tend to be focused avoiding possible triggers (stress, fatigue, certain foods) and relieving the immediate symptoms of migraines.

Craniosacral Therapy for Migraines

Joining the ranks of alternative treatments is a technique known as craniosacral therapy (CST). The technique was developed in the 1970s by Dr. John Upledger, an osteopathic practitioner and co-founder of the Upledger Institute in Florida.

CST is a form of light touch therapy in which a practitioner will barely tough of the spine, skull, and pelvis under the presumption that it can manipulate and regulate the flow of cerebrospinal fluid and aid in what Upledger refers to as "primary respiration."

Practitioners of CST contend that these fluids place pressure on the skull and cause small, rhythmic movements of the cranial bones.

It is believed that by lightly touching parts of the body, a practitioner can detect these movements and selectively relieve pressure to correct imbalances and provide relief of the stress and tension that may trigger migraines.

How Craniosacral Therapy is Performed

Craniosacral therapy is performed on fully clothed individuals. Sessions can last anywhere from 45 minutes to more than an hour. Using light touch (what Upledger describes as "no more than the weight of a nickel"), the practitioner will "monitor" the rhythm of the cerebrospinal fluid to detect potential restrictions and imbalances.

The therapist will then use manual techniques to "release" these problem areas, thereby relieving undue pressure on the brain and spinal cord. By doing so, CST is purported to avert or lessen the severity of migraines as well as other health conditions such as fibromyalgia, scoliosis, and autism.

Criticism of Craniosacral Therapy

While craniosacral therapy has been described as being beneficial in providing relief of stress and tension, there has been no reliable evidence that it provides any of the therapeutic benefits it suggests.

A 2012 systematic review of clinical studies looked at six randomised trials investigating the benefits of CST.

The study was highly critical of the low-quality design of many of the studies which met the criteria of inclusion, including one which involved healthy subjects. The report ended by concluding that there was no evidence that CST offered any therapeutic benefits at all.

The American Cancer Society, in its own review of the CST, supported those conclusions, stating that the scientific evidence did not support the claims that CST was effective in treating any disease.

Osteopathic practitioners have been no less critical. As early as 1999, a study published in the journal Complementary Therapies in Medicine concluded that the evidence supporting CST was "low grade" and that "critical appraisal found insufficient evidence to support craniosacral therapy."

Sources:

Green, C.; Martin, C.; Bassett, K. et al. "A systematic review of craniosacral therapy: biological plausibility, assessment reliability, and clinical effectiveness." Complementary Therapies in Medicine. 1999; 7(4):201-207.

Ernst, E. "Craniosacral therapy: a systematic review of the clinical evidence." Focus on Alternative and Complementary Therapies. 2012; 17: 197–201. doi:10.1111/j.2042-7166.2012.01174 .

Russell, J. and Rovere, A. (eds.) "Craniosacral Therapy". American Cancer Society Complete Guide to Complementary and Alternative Cancer Therapies (2nd Edition). Atlanta, Georgia: American Cancer Society.

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