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October 26, 2009

Evidence For Craniosacral Therapy

Our last musculoskeletal lab covered Craniosacral Therapy. For the past year or two, our physical therapy curriculum has pounded evidence-based practice into our head. And so, shortly after class one of my classmates distributed a synopsis of three articles disputing the existence of the craniosacral rhythm, a critical palpation skill for the practice of craniosacral therapy. Also, they found literature about inconsistency between practitioners who claim they can palpate the rhythm -- this is called inter-rater reliability. (See extended entry section for citations to articles.)

I've been aware for years about the controversy surrounding craniosacral therapy and the source and existence of craniosacral rhythm, thanks to sites such as QuackWatch.com and several other sites. Controversies surround many alternative treatments such as acupuncture, reflexology, and even chiropractic.

I can only speak from my experience with craniosacral therapy. In October 1991, I was involved in a car accident and experienced whiplash. I had pain like someone was sticking an icepick in the back of my skull whenever I looked up at the sky (neck extension). In May 1992, I asked my physician for a prescription to physical therapy. Physical therapist, John Macy, PT, performed craniosacral therapy on me and I was free of pain. In fact, after six sessions of physical therapy, I was in better condition than I had been before the accident.

I was so impressed that I decided that I wanted to do bodywork. The course of my life changed from frivolous artist to a person on a mission to serve human kind and free them from pain. I took my first craniosacral class from the Upledger Institute in 1995, started massage school in 1997, and became a licensed massage therapist in 1999. After six years as a massage therapist, I decided I wanted to do more and have access more people in need. I was accepted to the graduate program for physical therapy at UAB in March 2007 and started their 3 year program in January 2008.

In a way, I've come full circle. I love craniosacral therapy. It's beautiful work. Nothing could induce relaxation faster in my clients than a cranial base release. But it was my classmate who circulated the synopsis about craniosacral research (all dated in the late 1990s) that put a fire under me to search for more current literature regarding craniosacral therapy. I'll admit, I had a heck of a time finding positive literature for craniosacral therapy. (See extended entry section for citations to articles.)

And that made me wonder: Why isn't there more current literature that discusses the discoveries that they teach us in CS continuing education seminars, such as the discovery of nerve endings and blood supply in the cranial sutures? Anatomy and physiology literature aside, I was able to find literature about how craniosacral therapy has a positive impact on urinary tract infections in MS patients, GERD and ear infections in children, fibromyalgia, and, also, a reliable measurement tool for craniosacral outcomes.

While we may not be able to fully describe the how and why of craniosacral therapy, but clearly there is some benefit to the treatment. Even in proven treatment protocols, some therapies do not work for some people. So before we throw the "craniosacral baby" out with the bathwater, we must acknowledge the efficacy of some treatments for some conditions some of the time. Our instructors tell us that evidence-based physical therapy practice is still in its infancy, and if we use only those tools found to be efficacious in the literature, our hands would be virtually tied with regard to patient care.

tags: massage massagetherapy wellness massage therapy bodywork health

Posted by linda at October 26, 2009 3:00 PM