Quackery Exposed: Cranial Sacral Therapy

Cranial Sacral Therapy was started by an osteopath. Osteopathy will be explained first. 

What is osteopathy?

Osteopathy or osteopathic medicine is a medical practice that is based on the idea that all the body's systems are interrelated. They focus on the whole person. There are more than 114,000 osteopathic doctors in the United States. 

Osteopathy started with little medical science because it started when medical science was in its infancy but has evolved with medical medicine. Osteopathy has adopted medical science as it evolved. Osteopathy is not quackery. 

A key principle in Osteopathy is that many diseases result or cause problems within the body's musculoskeletal system. This includes muscles, nerves and bones. Practitioners do pay extra attention to all body parts to try to prevent or treat issues. 

Osteopathic doctors believe that touch can be healing. All practitioners are trained in osteopathic manipulative treatment. This is sometimes called manual manipulation or OMT. This is a hands on method to help diagnose and treat illnesses. Not all of osteopathic doctors use it regularly.

Osteopathy is used to treat:
  • arthritis
  • foot, ankle, hip and knee pain
  • back pain, neck pain and sciatica
  • Hand, shoulder and elbow pain
  • headaches
  • tennis and golfers elbow
  • postural problems due to pregnancy, sports injury, driving, work strain or digestive issues
  • neuralgia
When osteopathic doctors suspect a different condition than they treat, they refer out to specialists. 

Like other branches of medicine that are legitimate, quackery has stemmed from it. Speakers at Autism One like Dr. Shawn Centers

History of Osteopathy

Osteopathic medicine was started in 1874. It was founded by Andrew Taylor Still. He may have had a MD degree but it is not known for sure.  It is based on the theory that 26 bones making u the skull are intricately jointed in such a way as to permit very slight motion. This will allow for rhythmically and very slight expansion and contradiction of the brain inside , and permits the cerebrospinal fluid to ebb and flow as it washes away brain toxins. 

He thought he was correcting problems with the body's structure. He claimed that diseases were caused by mechanical interference with nerve and blood supply and were curable by manipulation of "deranged, displaced bones, nerves, muscles- removing all obstructions- thereby setting the machinery of life moving."

He thought this would help the body heal itself. This was practiced during the Civil War. Still believed that spine problems can send nerve signals out to all the organs and make you sick. He developed manipulation treatments, similar to chiropractic, with the goal of restoring nerves to a healthy state and promoting circulation so the body could heal itself. 

In his autobiography, Still states that he caused a bald man to grow hair three inches long in one week. He said he could "shake a child and stop scarlet fever, croup, diphtheria and cure wooping cough in three days by wring of its neck."

He started his first osteopathic medical school in Kirksville, Missouri in 1892. 

Osteopathy started when the medical field was in its infancy. As medical science developed, osteopathy gradually incorporated all of its theories and practices. There is an osteopathic license in all 50 states. 

Education Needed to be an Osteopathic Doctor

Osteopathic doctors (DO)  receive a similar education to medical doctors. DO are offered additional perspectives. Both MD and DO attended four years of medical school followed by graduate medical education through internships and residencies. Residencies are normally three to four years. They prepare the DO to practice a specialty such as family medicine, pediatrics, obstetrics or sports medicine. 

DO also received additional training in addition to basic medical training. They are specially trained in the musculoskeletal system. This allows them to have a deeper understanding of the body's nerves, muscles and bones. Both MD and DO are required to pass certification exams to be licensed. 

CranioSacral Therapy Was Invented By a Osteopathic Doctor

CranioSacral Therapy or cranio osteopathy was started by an Osteopath William G Sutherland (1873-1954) He published his first article in the early 1930s. 

CranioSacral therapy is a manual hands on form of therapy that involves the manipulation of the cranial bones in the skull. It is an alternative treatment approach. It aims to release restrictions around the spinal cord and brain to restore body function. Manipulating the skull bones to influence the cerebrospinal fluid is a controversial idea that has not even been proven in animal test subjects. Other research has shown that its breathing is what causes cerebrospinal fluid to circulate. 

The patient is laying down when the therapist uses their hands to focus on regions of the head, neck and spine. The therapist keeps physical contact throughout the session. Each session can be 15 minutes to over an hour. 

The therapist performs gradual, gentle series of manipulations intended to promote muscular and emotional release. Their goal is to tune into the craniosacral rhythm of the patients body, working to move the muscles and bones in time with that rhythm. 

Conditions Craniosacral therapy claims to treat

  • chronic pain
  • fibromyalgia
  • migraines
  • complex regional pain syndrome
  • fascial adhesions
  • multiple sclerosis
  • neuralgia
  • neurodegenerative diseases
  • temporo-mandibular joint syndrome
  • stroke
  • post concussion syndrome
  • speech delay
  • epilepsy
  • scoliosis
  • autism
  • traumatic brain injury

The science: 

Literary Reviews of Several Studies

1. There was a 1999 review that was published in Complementary Therapies in Medicine. It states that the research thus far is of low quality and inadequate. They cannot support hte use of CST. This review was performed by C. Green and A. Kazanjian. The purpose of this research was to research and critically review the scientific basis of CST ans a therapeutic intervention. 

A systematic search was performed with the following databases:
  • Medline
  • Embase
  • Healthstar
  • Mantis
  • Allied and Alternative Medicine
  • Scisearch
  • Biosis
The criteria for qualitifed studies were 
  • craniosacral interventions and health outcomes
  • validity of craniosacral assessment
  • pathophysiology of the craniosacral system
They concluded that the available research contained low grad evidence and used inadequate research protocols. There was one study that reported negative side effects in outpatients with TBI. The systematic review and critical evaluation did not have sufficient evidence to support CST. 

2. Jakel A and Von Hausenchild P did a systematic review to evaluate clinical benefits of craniosacral therapy. They were published in the Complementary Therapies in Medicine in 2012. These two doctors performed computer literature searches using the following databases for studies in 2011 and 2012:
  • Embase/Medline
  • Medline In-Process
  • The Conchrane Library
  • CINAHL
  • AMED
The studies were identified according to specific eligibility requirements. Included studies describing observational or randomized controlled trials (RCT) in where CST as the only treatment method and studies in the English language. 

Out of all the databases used, only 7 studies qualified to be included. Three studies were RCT and four were observational studies. Positive clinical outcomes were reported for pain reduction and improvement in general wellbeing of patients. 

The methodological Downs and Black quality scale was used. The review of the CST research in patients were with different conditions. Due to the quality of study methods used in the studies, further research is needed. 

CST use with Fibromyalgia 

  • There was a study in 2010 that examined the effects of CST on people who have fibromyaliga. This study included 92 people. They either recieved CST or a placebo therapy for 20 weeks. There was improvements in medium term pain reported with CST use. 
  • There was another study on CST that suggests that it may reduce anxiety and improve quality of life for those with fibromylagia

CST use with Asthma

  • There was a study performed on people with asthma using CST and acupuncutre.  This reported that both therapies had potential benefiet when along side traditional asthma treatment. There was no benefit using without traditional treatment. 

Conclusions that Science Makes

The research for CST is very limited and lack quality. This was highlighted in various systematic reviews. CST therapists should never use CST on a person in place of medical treatment or other therapy that is scientifically proven. 

What CranioSacral Therapy claims to do for autistics

The manipulations and adjustments performed are aimed to improve circulation, mitigate pressure and encourage the flow of cerebrospinal fluid. The idea behind this is to rid the nervous system of the toxins they claim autistics have. There is no scientific study of quality proving that this is an effective treatment for autism (autism cannot be treated as it is not an illness or disease). There is only a survey measuring opinions. That is hardly scientific evidence. 

According to Autism Parents Magazine, the benefits of CST for autistics are: 
  • It delivers a healthy dose of bonding hormones
    • Because it delivers oxytocin, they claim it can help with social challenges and possible physical discomfort. They have a theory that autistic people produce less oxytocin that typical people but there is no proof. "Having a compassionate individual place hands on the body with the caring intention of lessening discomfort and improving one's daily life can help kick start oxytocin production, creating feelings of connection and increased well being." 
  • It provides a meditative experience
    • Because this practice takes place in a quiet, meditative space, they claim that recipients can typically relax their bodies and minds, and feel more in control of their mood and actions in every day situations. 
  • It promotes relaxation
    • They claim several autistic people struggle with muscular tension. "Craniosacral therapy can melt way that tension.Those with ASD, in particular, may have difficulty slowing down and relaxing." 
  • It can build the patients trust in their therapist
    • "By developing a routine of regularly anticipated appointments with a craniosacral therapist, the patient can develop a mutually beneficial relationship with his or her therapist." I
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A parent in the UK wrote that she tried it with her son. "At the end of the course of treatment I saw no big changes in Jack's behavior, though he had become more willing to stay up in his bedroom watching 'Thomas the Tank Engine' videos rather than insisting to stay with us until he fell asleep." It does not work. It makes no logical sense. 


Sources:
https://www.webmd.com/pain-management/osteopathic-medicine

https://www.medicalnewstoday.com/articles/70381#what_to_expect

https://quackwatch.org/consumer-education/qa/osteo/

https://www.autismparentingmagazine.com/craniosacral-therapy-for-asd/

http://www.mugsy.org/cranial.htm

https://my.clevelandclinic.org/health/treatments/17677-craniosacral-therapy

https://www.academyofosteopathy.org/osteopathic-medical-education`

https://www.ncbi.nlm.nih.gov/books/NBK117037/

https://www.iahe.com/docs/articles/final-publication-cst-for-asd-feb-2017.pdf

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