Craniosacral therapy



Craniosacral therapy is a variant of osteopathy which claims all manner of benefits from manipulation of the head and neck. It is made entirely of woo. Even chiropractors and osteopaths don't think much of it.

Other names for it include cranial osteopathy, cranial therapy, biocranial therapy, craniopathy, and sacro-occipital technique.

Origin
Craniosacral therapy was "invented" by John Upledger around 1983, who claims it is so totally completely different than the cranial osteopathy invented in 1899 by early osteopath William Garner Sutherland that it needed a new name, despite it being completely the same practice of somewhere between a head tickle and a head massage that doesn't do anything.

While looking at a dismantled 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". This is excusable because it was 1899 and they were stupid then.

But nowadays, we know exactly what these bevels are; they're the places where the plates of the skull grew together in infancy. These flexible plates allow the large head of the infant to pass through the pelvis, which in humans is unusually narrow (due to walking upright and evolution and whatnot). This is called "moulding" and is why some infants born vaginally initially have a cone-shaped head. These plates start fusing together at around 3 months, generally finishing the process by about 9 months of age.

Theory and practice
In chapter 2 of his book CranoSacral Therapy: Touchstone of Natural Healing, John Upledger describes the patient's "Inner Physician":

By connecting deeply with a patient while doing CranioSacral Therapy, it was possible in most cases to solicit contact with the patient's Inner Physician. It also became clear that the Inner Physician could take any form the patient could imagine —an image, a voice or a feeling. Usually once the image of the Inner Physician appeared, it was ready to dialog with me and answer questions about the underlying causes of the patient's health problems and what can be done to resolve them. It also became clear that when the conversation with the Inner Physician was authentic, the craniosacral system went into a holding pattern.

Upledger goes on to recount successfully communicating, via the craniosacral system, with the inner physician of a four-month-old baby of French parents who had never been exposed to English. He diagnosed the root cause as "a toxin that was inhaled by the mother [...] over a period of about two-and-a-half hours while cleaning the grease off an antique automobile engine" in the fourth month of pregnancy.

Practitioners claim there are small, rhythmic motions of the cranial bones, which they attribute to cerebrospinal fluid pressure, or perhaps arterial pressure. The therapist places their hands on the patient's head and (apparently) tunes into the craniosacral rhythm, the regular flow of the cerebrospinal fluid, allowing cerebrospinal fluid to move through the spine more easily. They then lightly palpate the patient's body and focus on the communicated movements. After this, the theory becomes wildly inconsistent between different authorities and practitioners.

Treatment for colic
In the United Kingdom, parents are shelling out massive amounts of dosh for osteopaths to lightly tickle their babies' heads, as cranial osteopathy is a popular treatment for colic in infants. The cost for a light tickle? £30-£50. And you might only need 1 session, but possibly up to three! But you absolutely cannot do it yourself, because the touches are very soft and go in very specific places and make permanent changes! But not to the shape of the skull itself, because you could actually measure that (and it would be dangerous - baby skulls are actually very malleable because the plates generally don't finish growing together until 9 months).

Reality
Although cerebrospinal fluid does flow somewhat, there is no rhythm to it that is not from the heartbeat, and there is no evidence that what movement there is is detectable by putting one's hands on a person's body. Furthermore, it's ridiculous to think that you could change the "flow" of a fluid by giving someone a head massage; you would actually need to change the shape of the skull to do this — this is just basic fluid dynamics. In an adult, this is impossible to do unless, say, you fracture their skull, which is inadvisable.

Although it would be possible to change the shape of an infant's skull (for instance, laying on the back can cause some infants to develop a flat head, and this can be fixed by wearing a special helmet), it would be extremely dangerous for a practitioner to actually try to change the shape of an infant's skull with their bare hands in an hour-long session. Which is why, thankfully, most practitioners of cranial osteopathy on infants touch the infant's skull very lightly, more akin to a tickle than manipulation. Although completely ineffective at actually doing something, of course that is better than permanently injuring a child.

Effectiveness
None. Not only that, the therapists all seem to do different things &mdash; operator interreliability is about zero. Edzard Ernst notes that "the notion that CST is associated with more than non-specific effects is not based on evidence from rigorous randomised clinical trials" (and confirmed later on his blog that this was "a polite and scientific way of saying that CST is bogus" ).

Quackwatch notes only two deaths associated with it, one a chiropractor convincing an epileptic to stop taking her medication and the other a cerebral haematoma possibly induced in a two-day-old baby by a dentist placing a vibrating machine against its skull as part of this therapy; the perpetrator of the latter was not convicted, but the board did find this to be outside the remit of dentistry and revoked his license.