Helping hands: craniosacral therapy is emerging as a new treatment for pain and dysfunction

Cardiovascular and respiratory rhythms influence many bodily functions. An imbalance in these systems adversely affects the development of the brain and spinal cord, which may result in sensory, motor and neurological dysfunction.

Another body rhythm, the craniosacral system, exists not only in humans but in animals possessing a brain and spinal cord. Consisting of the membranes and cerebrospinal fluid that surround and protect the brain and spinal cord, it extends from the bones of the skull, face and mouth-which make up the cranium--down to the sacrum, or tailbone. For nearly 25 years, osteopathic physician and surgeon John Upledger, D.O., has been the chief proponent of using the craniosacral system to evaluate and treat medical problems associated with pain and dysfunction.

Upledger's research and clinical work with the craniosacral rhythm led to the development of light-touch manipulative therapy. Relying on the patient's natural self-corrective physiological activities, craniosacral therapy has been effective in treating poorly understood dysfunctions, chronic pain, lowered vitality and recurring infections. It also encourages the body's natural mechanisms to improve the functioning of the brain and spinal cord, dissipate the negative effects of stress, and enhance general health and resistance to disease.

Due to its influence on the body's functions, craniosacral therapy is used today by a variety of healthcare professionals. They include bone disease specialists, medical doctors, chiropractors, psychiatrists, psychologists, dentists, physical therapists, occupational therapists, acupuncturists and licensed body workers. A gentle, non-invasive technique, the therapist seldom applies pressure that exceeds five grams or the equivalent weight of a nickel. Examination is done by testing for movement in various parts of the system. Often, when movement testing is completed, the restriction has been removed and the system is able to self-correct.

Trained therapists are able to palpate, or feel, the motion of the craniosacral system anywhere on a patient's body. Valuable information can be gained quickly with regard to rate, amplitude, symmetry and quality of craniosacral motion. The regions of the craniosacral system that can be easily palpated are the bones of the skull, sacrum and coccyx because they attach to the membranes enclosing the cerebrospinal fluid. This fluid is filtered out of the blood in a dynamic feedback loop. Pressures build as the amount of cerebrospinal fluid increases, bathing the brain and spinal cord in an action similar to a semi-closed hydraulic system. When the fluid moves--normally at a rate of six to 12 cycles per minute--the membra-nes containing the fluid move.

Palpation is possible with all the other bones of the spine and pelvis. However, due to their less direct effect on the hydraulic system, it is more difficult to detect the motion. The same is true of the facial bones and temporo-mandibular joints in the jaw.

The history of the craniosacral system's discovery is fairly recent. In the early 1900s, William G. Sutherland, M.D., as an osteopathic student in Kirksville, Missouri, was struck by an idea. He found the bones of the skull provided the opportunity for movement in relationship to each other. For more than 20 years he pondered the prospect of moveable bones in the adult skull. He performed' makeshift experiments on himself with helmet-like devices designed to impose variable-controlled and sustained pressures on different parts of his head. His wife then recorded personality changes he displayed in response to different pressure applications. He described head pains and problems with coordination related to the varied pressures.

In the early 1930s, Sutherland published the first article on his work under a pseudonym in the Minnesota Osteopathic Journal Based on experiments, he developed a system of examination and treatment for the bones of the skull. With some patient success, Sutherland organized a small group of bone specialists who studied cranial work with him. His system became known as cranial osteopathy. Since so little was known about how it worked, and results with patients seemed at times to be miraculous, Sutherland's system acquired an understandably esoteric reputation.

Fast forward to 1970. During a surgery on a patient's neck, Upledger viewed the rhythmical movement of a membranous boundary of what appeared to be a hydraulic system. None of his colleagues nor any of the medical texts had an explanation for his observation. He discovered the dura mater, the outer layer of the meningeal membrane in the neck, visibly moved in and out at about 10 cycles per minute. He concluded pressure inside the membrane sac was fluctuating rhythmically.

Two years later, Upledger attended a seminar that explained Sutherland's ideas and taught some of his evaluation and treatment techniques. Coupling his scientific background with a tactile sensitivity, Upledger was quick to understand how a hydraulic system might function inside a membranous sac encased within the skull and canal of the spinal column. He incorporated and refined Sutherland's techniques with success.