颅骶疗法简介

田劲梅 田钟琦

Indications for and Benefits of Craniosacral Therapy

Cranial sacral therapy, also written as craniosacral therapy, is abbreviated as CST. Just like its name, the therapy mainly addresses the head (cranial) and pelvis (sacral). In many cases, it also involves neck, back, and spinal column. The therapist applies very gentle force on these body areas to try to work on the flow of cerebrospinal fluid. By the very light touch, the therapist may be able to release the abnormal compression on the central nervous system. It is a non-invasive manual therapy drawing more and more attention from the public. (10)(12)

Although the CST has showed some effects on various conditions and even diseases, the principles backing up it are not well established. The explanations to its effects include: bioenergy, fluid dynamics, mind-body medicine, functional medicine, autonomic nerve system balance, and the basic anatomy/physiology theories. Scientific support for these explanations is in need. (11)(12)

CST is a therapeutic tool which is being used by many alternative and complimentary health practitioners, for examples, osteopath, chiropractor, physical therapist, massage therapist, and naturopathic doctors. (10) (11)

What education is required for this modality?

There are various schools and certificate programs teaching CST. Usually, it is a 4-to-5-day program, regularly scheduled for 2 to 3 years. There is no specific requirement for practicing CST and it has not been legislated. (11)(12)

What are the benefits of it?

There are evidences supporting that CTS has some benefits on the following conditions: general chronic pain(7), migraine headache(15), chronic neck pain(8)(16), chronic low back pain(2), infantile colic(3), concussion recovery(20), low back and pelvic pain during pregnancy(18), severe traumatized patients(19), postural control on nonspecific chronic low back pain(5), mental stress(4), chronic peripheral vestibular pathology(1), autism spectrum disorders(17), autonomous nervous system discomforts(6).

Are there any controversies surrounding this subject? Any concerns/precautions when using it? Is there adequate research behind it?

There are tons of controversies surrounding this subject. CTS has been criticized a lot about its effect on human health. It is regarded as pseudoscience and quackery practice by many people. Because of the feature of the very gentle approach of CTS, its safety has little doubt. But its effectiveness needs more proof. (9)

Not too many concerns/precautions when using it because it is such a gentle treatment. It is not suitable though for acute injury, medical emergencies, any bleeding intention, aneurysms, severe head trauma, skull fracture, acute spinal injuries, severe psychosis, and other conditions for which medical attention is needed. (10)

A systemic review on cranial osteopathic manipulation medicine stated, “The currently available evidence on the clinical efficacy of cranial OMM is heterogeneous and insufficient to draw definitive conclusions. Because of the moderate methodological quality of the studies and scarcity of available data, further research into this area is needed.” (Jakel, A. 2011) (13) A systemic review on CST specifically concluded, “This review revealed the paucity of CST research in patients with different clinical pathologies. CST assessment is feasible in RCTs and has the potential of providing valuable outcomes to further support clinical decision making. However, due to the current moderate methodological quality of the included studies, further research is needed.” (Jakel, A. 2012) (14)

References:

1.     Atay F, Bayramlar K, Sarac ET. Effects of Craniosacral Osteopathy in Patients with Peripheral Vestibular Pathology. ORL J Otorhinolaryngol Relat Spec. 2021;83(1):7-13. doi: 10.1159/000509486. Epub 2020 Sep 9. PMID: 32906128.

2.     Castro-Sánchez AM, Lara-Palomo IC, Matarán-Peñarrocha GA, Saavedra-Hernández M, Pérez-Mármol JM, Aguilar-Ferrándiz ME. Benefits of Craniosacral Therapy in Patients with Chronic Low Back Pain: A Randomized Controlled Trial. J Altern Complement Med. 2016 Aug;22(8):650-7. doi: 10.1089/acm.2016.0068. Epub 2016 Jun 27. PMID: 27347698.

3.     Castejón-Castejón M, Murcia-González MA, Martínez Gil JL, Todri J, Suárez Rancel M, Lena O, Chillón-Martínez R. Effectiveness of craniosacral therapy in the treatment of infantile colic. A randomized controlled trial. Complement Ther Med. 2019 Dec;47:102164. doi: 10.1016/j.ctim.2019.07.023. Epub 2019 Aug 13. PMID: 31780018.

4.     Fornari M, Carnevali L, Sgoifo A. Single Osteopathic Manipulative Therapy Session Dampens Acute Autonomic and Neuroendocrine Responses to Mental Stress in Healthy Male Participants. J Am Osteopath Assoc. 2017 Sep 1;117(9):559-567. doi: 10.7556/jaoa.2017.110. PMID: 28846122.

5.     Ghasemi C, Amiri A, Sarrafzadeh J, Dadgoo M, Jafari H. Comparative study of muscle energy technique, craniosacral therapy, and sensorimotor training effects on postural control in patients with nonspecific chronic low back pain. J Family Med Prim Care. 2020 Feb 28;9(2):978-984. doi: 10.4103/jfmpc.jfmpc_849_19. PMID: 32318454; PMCID: PMC7113991.

6.     Girsberger W, Bänziger U, Lingg G, Lothaller H, Endler PC. Heart rate variability and the influence of craniosacral therapy on autonomous nervous system regulation in persons with subjective discomforts: a pilot study. J Integr Med. 2014 May;12(3):156-61. doi: 10.1016/S2095-4964(14)60021-2. PMID: 24861836.

7.     Haller H, Lauche R, Sundberg T, Dobos G, Cramer H. Craniosacral therapy for chronic pain: a systematic review and meta-analysis of randomized controlled trials. BMC Musculoskelet Disord. 2019 Dec 31;21(1):1. doi: 10.1186/s12891-019-3017-y. PMID: 31892357; PMCID: PMC6937867.

8.     Haller H, Lauche R, Cramer H, Rampp T, Saha FJ, Ostermann T, Dobos G. Craniosacral Therapy for the Treatment of Chronic Neck Pain: A Randomized Sham-controlled Trial. Clin J Pain. 2016 May;32(5):441-9. doi: 10.1097/AJP.0000000000000290. PMID: 26340656; PMCID: PMC4894825.

9.     https://www.mcgill.ca/oss/article/controversial-science-news-quackery/people-who-opt-craniosacral-therapy-should-have-their-head-examined

10.  https://www.healthline.com/health/cranial-sacral-therapy

11.  https://www.upledger.com/therapies/faq.php

12.  https://www.naturalhealers.com/blog/craniosacral-therapy/

13.  Jäkel A, von Hauenschild P. Therapeutic effects of cranial osteopathic manipulative medicine: a systematic review. J Am Osteopath Assoc. 2011 Dec;111(12):685-93. PMID: 22182954.

14.  Jäkel A, von Hauenschild P. A systematic review to evaluate the clinical benefits of craniosacral therapy. Complement Ther Med. 2012 Dec;20(6):456-65. doi: 10.1016/j.ctim.2012.07.009. Epub 2012 Aug 22. PMID: 23131379.

15.  King HH. Manual Craniosacral Therapy May Reduce Symptoms of Migraine Headache. J Am Osteopath Assoc. 2017 Jan 1;117(1):59. doi: 10.7556/jaoa.2017.011. PMID: 28055092.

16.  King HH. Craniosacral Therapy Shown Beneficial in Management of Chronic Neck Pain. J Am Osteopath Assoc. 2016 Jul 1;116(7):486-7. doi: 10.7556/jaoa.2016.095. PMID: 27367955.

17.  Kratz SV, Kerr J, Porter L. The use of CranioSacral therapy for Autism Spectrum Disorders: Benefits from the viewpoints of parents, clients, and therapists. J Bodyw Mov Ther. 2017 Jan;21(1):19-29. doi: 10.1016/j.jbmt.2016.06.006. Epub 2016 Jun 17. PMID: 28167177.

18.  Liddle SD, Pennick V. Interventions for preventing and treating low-back and pelvic pain during pregnancy. Cochrane Database Syst Rev. 2015 Sep 30;2015(9):CD001139. doi: 10.1002/14651858.CD001139.pub4. PMID: 26422811; PMCID: PMC7053516.

19.  Stub T, Kiil MA, Lie B, Kristoffersen AE, Weiss T, Hervik JB, Musial F. Combining psychotherapy with craniosacral therapy for severe traumatized patients: A qualitative study from an outpatient clinic in Norway. Complement Ther Med. 2020 Mar;49:102320. doi: 10.1016/j.ctim.2020.102320. Epub 2020 Jan 16. PMID: 32147031.

20.  Wetzler G, Roland M, Fryer-Dietz S, Dettmann-Ahern D. CranioSacral Therapy and Visceral Manipulation: A New Treatment Intervention for Concussion Recovery. Med Acupunct. 2017 Aug 1;29(4):239-248. doi: 10.1089/acu.2017.1222. PMID: 28874926; PMCID: PMC5580370.