Including Cranial Osteopathy, Bio Cranial Therapy, and two chiropractic variants called Craniopathy and Sacro–Occipital Technique (SOT).

This page was last updated on 6th January 2013.


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 Up the garden path: craniosacral therapy

"In a nutshell: 1) ineffective therapies, such as CST [craniosacral therapy], may seem harmless but, through their ineffectiveness, they constitute a serious threat to our health; 2) bogus treatments become bogus through the false claims which are being made for them; 3) seriously flawed studies can be worse than none at all: they generate false positive results and send us straight up the garden path."  Edzard Ernst (12th December 2012)

Craniosacral Therapy: Demonstrable Nonsense

“Craniosacral therapy (CST) is an excellent example of a practice that is solidly in the demonstrable nonsense zone. The basic claim is that subtle manipulation of the bones of the skull can treat a variety of conditions and symptoms. It is now a classic medical pseudoscience that continues to thrive…practiced, mainly by osteopaths, chiropractors, and some physical therapists.” Steven Novella, MD, James Randi Educational Foundation (24th November 2012)

Craniosacral Therapy: Pure, Unadulterated Quackery

“Craniosacral therapy is one of the wackiest alternative therapies. It’s typically offered by chiropractors and other manipulation-based practitioners…Craniosacral therapy is an alternative medicine practice that supposedly allows the practitioner to “tune into the craniosacral rhythm” to treat problems such as pain, headache, and stress…There is no scientific evidence supporting the use of craniosacral therapy for any medical condition…Claims that spinal cord, brains, and bones of the skull change in size in a rhythmic respiratory-like motion are completely groundless. Neurons and supporting cells in the brain and nervous system lack necessary structures to induce intrinsically derived movement…There is no evidence for the existence of palpable rhythms created by movements of the brain. Because the supposed mechanism that generates these rhythms is biologically implausible it is most likely that they do not exist. Multiple studies have found that different practitioners are unable to identify the same “rhythm” within the same patients (there is low inter-examiner reliability.) The idea that the bones of the skull readily articulate with one another and the dura to function as a breathing apparatus is preposterous.” Dr Robert, Skeptical Health (20th January 2012)

Alas poor Craniosacral. A SCAM of infinite jest, of most excellent fancy.

“In reality what do CST practitioners do? They lightly massage your head. To treat everything from Downs to headache to PMS. It is an all purpose diagnostic and therapeutic intervention, like all SCAMs…There are no shortage of videos demonstrating the techniques of CST, one practitioner states she pushes the bones back into alignment with a 5 gram pressure, the weight of a nickel. I do not think a nickle's worth of pressure would move a skull bone a quantum amount, not even if dropped off the Empire State Building…Seriously. If your local Hospital or University offers CST, go elsewhere. They have a demonstrated commitment to the irreparably goofy.” Mark Crislip, Science Based Medicine (!6th December 2011)

Does Craniosacral Therapy Work?

“There is good, recent scientific evidence that the most important and basic assumption about how CST works is not true — research has (once again) shown that craniosacral therapists cannot actually move the bones of the skull enough to affect the pressure or circulation of the fluid surrounding the brain and spinal column; There is also a logical problem: the cranial bones do not move to relieve the pressure of dangerous swelling in the cranium, so they are probably not going to move for therapist’s fingers either; There is recent scientific evidence that CST therapists produce conflicting diagnoses of the same patients. That is, when asked to asses a patient, CST therapists came to mutually exclusive conclusions; Any effect that CST has must be a complex and subtle one, since it cannot be measured. Subtle effects of therapy certainly exist — just because it can’t be measured doesn’t mean it isn’t there. However, it seems unlikely that any therapist is wise and knowing enough to reliably produce a therapeutic effect by leveraging a phenomenon so subtle that it can’t be measured.” Paul Ingraham, Canadian science journalist, Save Yourself blog (7th December 2011)

Cranial Osteopathy in Dentistry

“An important point to reiterate here is that the emphasis in the dental application of cranial osteopathy is not merely to treat illness or facilitate the flow of the CSF as in “regular” osteopathy; it claims to actually bodily move the facial and cranial bones to more ideal positions to improve orthodontic and TMD outcomes…For Cranial Osteopathy to be viable treatment, there needs to be good evidence anatomically and histologically that the sutures are indeed movable (by hand, no less) to a significant degree, and evidence that doing so is therapeutically beneficial. Neither appears to exist. Although Cranial Osteopathy can provide a modicum of basic research to support its claims, it falls far short of what is needed to establish a scientific foothold in the dental-medical community. Osteopathic applications are woefully lacking in any substantive research but instead rely on anecdotal evidence as the foundation of its validity and applicability…If there’s harm in the Cranio-dental movement, besides a lot of money wasted by dentists on dubious courses and by patients on dubious treatment, it may be that it seems to be a particularly attractive gateway to more bizarre alternate treatment philosophies – one that seems to appeal to surprisingly smart and educated dentists. By granting dentists a license to practice, the public trusts us to apply evidential knowledge to the management of their dental problems. This implies that we must critically examine new hypotheses, decide if there is rational evidence for them, reject the pseudo-science, and apply the knowledge that sifts through for the benefit of the patients we serve.” Grant Ritchey, Science Based Medicine (17th October 2011)

Craniosacral therapy

“The evidence proffered to support craniosacral therapy is primarily anecdotal in nature, often taking the form of customer testimonials or case studies put forward by craniosacral practitioners. The mechanism by which CST practitioners claim they can detect the rhythms of cerebrospinal fluid and by which they claim to influence the body into healing itself are biologically implausible. To date, no robust evidence has been produced that would validate these claimed mechanisms. Because of this and because there is no good evidence that CST is effective for any condition, it seems likely that any effect perceived by those visiting a CST practitioner is due to placebo.” The Nightingale Collaboration (2011)

Osteopathy: For Crying Out Loud…

“Of all the conditions that Cranial Osteopaths claim to treat, infantile colic is perhaps one of the most common…So here is a clear statement that there is insufficient evidence to recommend cranial osteopathy (or other manual therapies) for management of colic. It is important to note that these conclusions do not simply relate to the level of evidence required by the [UK] ASA/CAP codes when advertising or making website claims, but to the level of evidence available to justify offering osteopathy as a treatment for colic.” Skeptic Barista blogspot (17th May 2011)

Craniosacral: What is it good for…

"...the CSTA [CranioSacral Therapy Association of the UK] say that it is possible CST could work, because there is no evidence to show that it doesn’t! 

During a conversation with the ASA [Advertising Standards Authority] it was mentioned that they were expecting to hear from the CSTA’s solicitors. The [ASA's] adjudication says that the CSTA maintain that the wording they used was not proscribed by law. They said that in the strictest terms of contractual law, their leaflet merely advised readers on the potential of their services.  Well if the evidence isn’t there to support your claims, I suppose you may as well look for a legal get out clause. But in doing that they are forgetting that treatment claims should be based on the best research evidence available, not try hiding behind contractual law…

This all started with a leaflet picked up in a local health food store, the title of that leaflet was What Is Craniosacral Therapy? Based on the contents of that leaflet, the CSTA’s evidence and their spirited defence, the ASA’s answer was ….. Unsubstantiated, Untruthful, and Misleading."   SkepticBarista blog (7th September 2010)

CranioSacral: It’s about more than the evidence...

"One often overlooked, but I feel important area, is the actual training of the therapists. This is particularly important when the therapist is claiming to be able to treat serious medical conditions… somehow CST therapists claim to be able to effectively diagnose and treat many of the same medical conditions [as MDs]. Within the NHS treatment of these conditions can require the attention of doctors who have undergone specialist training to allow them to deal effectively with what are often complex medical conditions. You simply cannot spend a few days a year, learning unproven therapy techniques and claim to have the knowledge required to offer these treatments."  SkepticBarista blog (29th August 2010)

What is Craniosacral Therapy?

“…having had a quick look at craniosacral therapy, what it is, what it claims to treat and the evidence to support those claims, has my opinion about it being quackery changed? Yes, it’s not just quackery, it’s potentially dangerous quackery that needs to be challenged” SkepticBarista blog (9th May 2010)

Infant Dies After Craniosacral Therapy: Therapist Gets Off Scot–Free

Update on the link below about a formerly healthy, three-month-old girl, who died in the Netherlands after manipulation of the neck and the vertebral column (called “holding”) by a craniosacral therapist. The case was investigated by the Netherlands Health Care Inspectorate and the Public Prosecutors Office.  The Inspectorate decided not to press charges against the craniosacral therapist when he promised never to apply this treatment again. The Dutch Public Prosecutors Office is still investigating the case and may yet decide to prosecute. Anaximperator Blog (17th January 2010)

Infant Dies after Craniosacral Therapy

"A formerly healthy, three-month-old girl died after manipulation of the neck and the vertebral column by a so called "craniosacral therapist." During continued and deep bending of the neck, the patient developed incontinence of faeces, atonia and respiratory arrest followed by aystolia. Based on findings at the physical examination of the body, an additional MRI examination and the autopsy, it is likely that the cause of death was a local neurovascular or a mechanic respiratory-induced problem. This is the second report of infant death after forced manipulation of the neck. As long as there is no scientific evidence for the efficacy and safety of forced manipulation of the neck and the vertebral column, we advise against this treatment for newborns and infants." English translation of a report in the Dutch Medical Journal (May 2009) [Micha Holla, Marloes M. IJland et al. Ned Tijdschr Geneeskd, 2009]

Craniosacral Therapy

“In spite of the biological implausibility of craniosacral therapy, it has been studied. Not surprisingly, no study has concluded craniosacral therapy is efficacious for any disease or condition, or even that the proposed cranial system exists in the first place.” Campaign for Science Based Healthcare (2009)

Cranial Osteopathy: its fate seems clear

"This treatment regime lacks a biologically plausible mechanism, shows no diagnostic reliability, and offers little hope that any direct clinical effect will ever be shown… Until outcome studies show that these techniques produce a direct and positive clinical effect, they should be dropped from all academic curricula; insurance companies should stop paying for them; and patients should invest their time, money, and health elsewhere." Steve E. Hartman, Dept. of Anatomy, College of Osteopathic Medicine, University of New England (Chiropractic & Osteopathy, 8th June 2006)

Osteopathy in the Cranial Field

A review of H. H. King and E. M. Lay in Foundations for Osteopathic Medicine, 2nd Ed. Concludes that advocates of cranial osteopathy still proffer: (1) the same biologically untenable mechanism proposed by Sutherland 65 years ago, (2) no indication of diagnostic reliability, and (3) no properly controlled research showing efficacy. Analysis by Steve E. Hartman, PhD, and James M. Norton, PhD, The Scientific Review of Alternative Medicine, Vol. 8, No.2 (Fall/Winter 2004-05) [pdf]

Cranial osteopathy

What you need to know. Article by Ben Goldacare, Bad Science (23rd September 2004)

Wired to the kitchen sink: studying weird claims for fun and profit'

"I recently heard of craniosacral therapy. It is a method some osteopathic physicians use to restore health by adjusting the bones of the skull and sacrum. Anatomists can demonstrate that the skull bones are fused together in adulthood and cannot move. Other fallacies inherent in the therapy are too numerous to list: craniosacral therapy is totally implausible and has been thoroughly debunked elsewhere. So how could anyone in his right mind believe in it?" Four-page article by Harriet Hall, MD, Skeptical Inquirer (May-June 2003)

Craniosacral Therapy is Not Medicine

Letter written by Steve E. Hartman, PhD, and James M. Norton PhD, College of Osteopathic Medicine, University of New England. Published in Physical Therapy (November 2002) [pdf]

Head cases: an examination of craniosacral therapy

"Despite the dearth of evidence for the efficacy of CST (craniosacral therapy), CS therapists continue to promote its use for people of all ages and babies in particular. This is disingenuous. Patients are being taken for a ride by people who, while being scornful of scientific medicine, seduce patients into believing they need to have sessions of a worthless therapy for their wellbeing……It is time that health professionals, and the public, took a long, hard look at CST and exposed it for what it really is — medieval mysticism dressed up in quasi-scientific garb." Views of Brid Hehir, a Camden NHS Primary Care Trust user involvement manager. Spiked Online (12th February 2002)

Some Notes on Cranial Manipulative Therapy

"Several papers have been published on the alleged mechanisms of cranial manipulation, but fail to answer the important consumer health questions of safety and efficacy." William T. Jarvis, Ph.D., National Council Against Health Fraud (NCAHF 2001)

Unconventional Dentistry

"Dental claims and uses of CS (Craniosacral Therapy) defy science and logic." This article also questions the use of other CAM therapies in dentistry. Journal of the Canadian Dental Association (November 2000) [pdf]

Sacro-Occipital Technique

Samuel Homola, D.C., takes a critical look at Sacro-Occipital Technique (SOT) in Chapter 11 of his book 'Bonesetting, Chiropractic and Cultism'. (Chirobase)