Craniosacral Therapy

Craniosacral Is a Gentle, Touch-Based Treatment

Craniosacral therapy is a form of treatment derived from osteopathic medicine. Doctors of osteopathy or “DOs” often incorporate different physical modalities, including touch-based or manipulation-based treatments. Craniosacral therapy is a hands-on modality that focuses heavily on the skull and base of the spine or sacrum, although craniosacral techniques can be applied anywhere on the body. Providers use a mindfulness-based approach to assess the body with their hands, then work to unwind the tension that is felt through light touch or slow movements in concert with body mechanics.

The craniosacral system challenges some components of standard medical beliefs, including that the adult skull bones are fused, and that there is a craniosacral rhythm, a pulse-like contractile rhythm in the skull that pumps cerebrospinal fluid from the brain down the spinal cord. Recent evidence has shown that skull sutures (joints) do maintain some movement throughout life and don’t necessarily fuse as we age (Kumar 2012). Other research appears to validate the concept of a craniosacral rhythm, although the ability of providers to reliably detect it with their hands has been called into question (Green 1999).   

Potential Benefits of Craniosacral Therapy

Chronic pain

Craniosacral therapy is often utilized for pain. Randomized controlled trials of craniosacral therapy on back pain, neck pain, fibromyalgia, migraine, elbow pain and pelvic pain have been published. For chronic low back pain, ten sessions of craniosacral were compared to ten sessions of massage therapy. While disability improvements were equivalent, craniosacral was more effective at pain reduction, decreasing pain levels by over 50% (Castro-Sanchez 2016).

For chronic neck pain, eight sessions of craniosacral therapy were compared to a sham protocol. Again, craniosacral therapy reduced pain levels over 50% in treated individuals (Haller 2016). A small study on migraine headaches also found moderate, significant improvements with craniosacral therapy (Arnadottir 2013).   

Fibromyalgia is a chronic pain condition that typically includes increased pain and pain sensitivity over the entire body. Standard treatments for fibromyalgia are often only minimally helpful with patients still suffering with residual symptoms. A trial of craniosacral for fibromyalgia, with ten sessions spaced over 20 weeks, found significant benefits. Of 18 tender points assessed, on average, pain was reduced at 13 sites for treated patients. While benefits were still significant at the one year mark following treatment, they had decreased significantly, with the authors arguing for the need of ongoing treatments (Castro-Sanchez 2011).

For “lateral epicondylitis,” or tennis elbow, craniosacral also showed benefits. Standard treatments for tennis elbow have a high failure rate. And tennis elbow can cause disability when severe. In a small study, a type of craniosacral treatment was applied to patients with chronic tennis elbow. Treated patients had a high degree of pain relief, with 73% of patients being pain free six months after treatment (Nourbakhsh 2008).

An overall review of the research concluded that craniosacral therapy has robust effects on chronic pain that lasts for at least six months following treatment (Haller 2019). While more research would help to confirm the findings, the preliminary data on craniosacral therapy for chronic pain is promising.      

Infant Colic

Colic is a condition of prolonged crying or fussiness in an infant not due to any discernible cause. The condition can be very frustrating for parents, often contributing to stress levels and lost sleep. Normally, colic goes away on its own, but due to the distress it can cause, safe, effective treatments are needed. 

Studies on craniosacral therapy for colic have shown benefits for reduced crying. A study in 2019 found that craniosacral therapy of just one to three sessions reduced crying by almost three and a half hours per day and increased sleep by just over three hours a night (Castejon 2019). The treatment was effective enough to lead to resolution of colic by day 24 in most of the treated children (Castejon 2022).


Craniosacral therapy is a hands-on physical modality that focuses on releasing tension throughout the body. The research on craniosacral for treating chronic pain is promising. Considering the concerns around standard pain treatments, including opiates, craniosacral could be a safer alternative. Beyond pain treatment, craniosacral may also be helpful for treating infant colic.    

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