Craniosacral therapy
What is it: A structured, subtle manual approach aimed at optimizing craniosacral function.AKA: CST- ⬤ Minimal research: Very little scientific study exists, with no or very few peer-reviewed studies. Insufficient data for conclusions.
- ⬤⬤ Limited research: Few studies exist, mostly small trials or case reports. Findings are preliminary and lack strong validation.
- ⬤⬤⬤ Moderately researched: Multiple studies, including mid-sized trials, exist. Some findings are replicated, but more research is needed.
- ⬤⬤⬤⬤ Well-researched: Supported by substantial evidence, including at least one large trial or meta-analysis.
- ⬤⬤⬤⬤⬤ Extensively studied: Numerous large studies and meta-analyses exist. Findings are widely accepted with strong scientific consensus.
- ⬤ Extremely Difficult to Access: Rare, experimental, or highly specialized. Requires multiple referrals, long wait times, travel, and strict follow-up.
- ⬤⬤ Difficult to Access: Limited to select centers with moderate barriers. Requires referral, potential travel, and wait times of weeks to months.
- ⬤⬤⬤ Moderately Accessible: Available in larger hospitals or clinics. Requires a basic referral, with moderate wait times and some coordination.
- ⬤⬤⬤⬤ Easy to Access: Widely available in most clinics. Minimal referral, short wait times, and simple preparation or follow-up.
- ⬤⬤⬤⬤⬤ Trivial to Access: Easily found in pharmacies or clinics. No referral needed, minimal wait, and straightforward access.
- ⬤ Up to $100
- ⬤⬤ Up to $500
- ⬤⬤⬤ Up to $2000
- ⬤⬤⬤⬤ Up to $10,000
- ⬤⬤⬤⬤⬤ More than $10,000
To calculate the reported effectiveness for a patient view, the model first analyses whether it can be ascertained that the person writing the review has had direct experience of the treatment for themselves or a loved one. If so, it then uses sentiment analysis to rate their view from 1-5 on how effective this treatment was for them, with 1 being the least effective, and 5 the most effective.
5 Resources
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1 Research paper
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5 Expert views
Contributed in this guide
27 Patient views
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Page contents
Basics: What you need to know
Craniosacral Therapy (CST) is a specific hands-on technique developed by osteopathic physician John Upledger. It uses a gentle touch to examine and relieve tension in the membranes and cerebrospinal fluid that surround the brain and spinal cord. By subtly adjusting these structures, practitioners aim to encourage natural healing responses that may be relevant for those experiencing persistent or complex symptoms such as those observed in Long Covid.
History and development
- Pioneered by John Upledger: During the 1970s, Dr. Upledger’s research into subtle cranial rhythms led him to create a structured protocol for CST, culminating in the founding of the Upledger Institute.
- Founded on osteopathic principles: Early developments built on osteopathic insights that emphasized the interplay of bone, soft tissue, and fluid in maintaining overall health.
- Refined manual techniques: The Upledger Institute standardized specific hand placements and pressure levels designed to release restrictions in the craniosacral system.
- Global adoption: Over time, CST has spread internationally, with accredited programs training practitioners to maintain standard methods and ensure consistent practice.
What is known
- Gentle manual therapy: CST relies on light pressure—often no more than the weight of a nickel—to sense and correct subtle changes in cranial and spinal tissues.
- Beneficial for tension: Practitioners report that CST techniques may help relieve tension in the head, neck, and spinal areas, potentially easing headaches and some forms of chronic pain.
- Potential nervous system regulation: Some evidence suggests this therapy might promote relaxation, improve sleep, and calm an overactive stress response, which can be relevant for certain post-viral conditions.
- Lesser-known secondary effects: Some recipients notice emotional releases, or improvements in jaw tension and sinus function, possibly because of the interconnected nature of cranial structures.
What is not known
- Unclear mechanism: Though some clinical reports support CST’s benefits, the exact physiological process remains controversial and insufficiently explained by mainstream research.
- Limited empirical data: Research studies are still relatively small in scale, and large, controlled trials examining the benefits for complex or emerging conditions like Long Covid are scarce.
- Variability in response: Individual responses can differ significantly; it remains uncertain why some people notice improvement while others do not.
- Potential symptom flare: In certain cases, particularly in individuals with heightened sensitivity, the therapy may temporarily intensify physical symptoms or emotional responses.
- Light-touch assessment: Practitioners gently feel for rhythmic motions in the craniosacral system to identify possible restrictions.
- Subtle pressure adjustments: Small corrective movements are applied to release tension in the membranes around the spinal cord and brain.
- Fluid flow support: By easing tight spots, the therapy is believed to improve cerebrospinal fluid circulation and help balance the nervous system.
- Whole-body interplay: Adjustments can affect connective tissues and fascia, potentially promoting overall postural and structural balance.
- Mild headache: Some individuals report short-term head or neck discomfort after sessions.
- Increased fatigue: A temporary energy drop can occur, possibly due to the body’s adjustment process.
- Emotional release: Feelings of sadness or anxiety may surface as tension resolves.
- Symptom flare-ups: In cases of sensitive conditions, symptoms might intensify briefly before improving.
- Debate on efficacy: Some critics question the scientific foundation and proven outcomes.
- Subjectivity in therapy: Because practitioners rely on touch to palpate subtle cranial rhythms, the effects can appear anecdotal.
- Insufficient large-scale studies: Many believe more rigorous trials are needed to confirm long-term benefits.
- Holistic acceptance: Others see it as a gentle, integrative option to complement conventional treatments.
Patient views
Experiences
- Patients report significant relief from neck, shoulder, and head pain after CST.
- CST helps some patients feel calmer and less overstimulated.
- Some patients experience improved tolerance for music and sensory input.
- CST sessions provide a sense of emotional and nervous system reset.
Challenges
- Relief from CST can be temporary, lasting only a few days.
- Effectiveness of CST depends heavily on the practitioner's skill.
- Some patients see no improvement despite multiple sessions.
- CST can be expensive and is often not covered by insurance.
Tips
- Choose a highly skilled and experienced CST practitioner.
- Be patient; multiple sessions may be needed for results.
- Combine CST with other gentle therapies for better outcomes.
- Monitor your body's response to CST and adjust frequency accordingly.
To calculate the reported effectiveness for a patient view, the model first analyses whether it can be ascertained that the person writing the review has had direct experience of the treatment for themselves or a loved one. If so, it then uses sentiment analysis to rate their view from 1-5 on how effective this treatment was for them, with 1 being the least effective, and 5 the most effective.
Patient view
I personally feel very stuck in fight or flight. My specialist has theorized that I have CCI which would cause the body to stay in high alert mode and be unable to fully process toxins etc.
I’m trying cranial sacral therapy now. I’ve only done one session so I can’t say if it will help long term, but I did feel significantly different afterwards. A couple of days later, I was able to listen to 2 songs and sing along. (I’m on the moderate side of severe, and can’t tolerate music the past 2 years.)
September 2024 • /r/cfs
Patient view
Yes, craniosacral therapy and Perrin technique have helped reduce it
September 2024 • /r/cfs
Expert views
What they liked
- Experts appreciate CST's gentle, non-invasive approach for Long Covid.
- Seen improvements in symptoms like fatigue and cognitive function.
- Believed to help balance the nervous system and reduce stress.
- May improve lymphatic drainage and brain-body connection.
What they didn't like
- Some experts find CST's benefits inconsistent across patients.
- Lack of robust scientific evidence supporting CST for Long Covid.
- Concerns about its effectiveness for severe or complex cases.
- May not address root causes of Long Covid symptoms.
What are they unsure about
- Experts are unsure how CST directly impacts Long Covid mechanisms.
- Unclear if CST benefits are long-lasting or temporary.
- Questions remain about its role in severe dysautonomia cases.
- More research needed on CST's effects on lymphatic and nervous systems.
5 expert views
Expert view
Dr. Peter Rowe discusses craniosacral therapy (CST) and other manual physical therapy techniques as potential treatments for ME/CFS and Long Covid. CST involves hands-on methods to improve mobility and reduce neuromuscular strain. The goal is to help patients tolerate exercise by first addressing restricted movement. Techniques include neural mobilizations, muscle energy methods, and myofascial release. Dr. Rowe highlights a study where mild mechanical strain was applied to patients, showing symptom changes and post-exertion malaise. He notes that sicker patients may not show significant changes on a 10-point scale, emphasizing methodological considerations.
October 2014 • Investigator Report: Neuromuscular Strain in ME/CFS
Expert view
Dr. Raymond Perrin, in a podcast episode, shared his experience with craniosacral therapy (CST) and its potential benefits for Long Covid and related conditions like ME/CFS. He described how CST, which involves working on the head and spine, helped a patient recover from symptoms by addressing issues in the autonomic nervous system, particularly the sympathetic nervous system. Dr. Perrin theorized that CST helps balance the autonomic nervous system, which controls automatic body functions like blood flow and organ activity. His work led to further research and the development of the Perrin Technique, which focuses on improving the body's drainage systems to aid recovery.
January 2025 • Long Covid Podcast
What and who it targets
Sleep disturbance sufferers
Promotes relaxation and better sleep.
Chronic fatigue sufferers
Relieves tension and promotes relaxation.
Pain management group
Eases muscle tension and discomfort.
Neurological symptom patients
Addresses headaches and nervous system imbalances.
Relevant research
How much evidence on this?
- Few studies directly assess CST for Long Covid.
- Research spans less than 5 years.
- Small sample sizes in available studies.
- Limited peer-reviewed publications on CST for Long Covid.
Research focusing on
- CST may improve mental and physical wellbeing.
- Recovery tips include combining CST with physiotherapy.
- CST techniques differ from standard physiotherapy.
- Researchers exploring CST's role in fatigue management.
What needs more research?
- Long-term effects of CST for Long Covid unclear.
- Optimal frequency and duration of CST sessions unknown.
- Mechanisms behind CST's effects on Long Covid symptoms unclear.
- Effectiveness compared to other mind-body therapies uncertain.
- ⬤ Minimal research: Very little scientific study exists, with no or very few peer-reviewed studies. Insufficient data for conclusions.
- ⬤⬤ Limited research: Few studies exist, mostly small trials or case reports. Findings are preliminary and lack strong validation.
- ⬤⬤⬤ Moderately researched: Multiple studies, including mid-sized trials, exist. Some findings are replicated, but more research is needed.
- ⬤⬤⬤⬤ Well-researched: Supported by substantial evidence, including at least one large trial or meta-analysis.
- ⬤⬤⬤⬤⬤ Extensively studied: Numerous large studies and meta-analyses exist. Findings are widely accepted with strong scientific consensus.
Research
This study looked at how a community-based program combining psychoeducation and mind-body approaches, including craniosacral therapy (CST), could help people with Long Covid. It used surveys and health questionnaires to measure changes in participants' mental, physical, emotional, and spiritual well-being.
The study found that participants experienced improvements in their overall well-being, as shown by an increase in their scores on the Warwick Holistic Health Questionnaire. Feedback from participants also indicated that they found the program helpful in managing their Long Covid symptoms.
For people living with Long Covid, this study suggests that combining psychoeducation with therapies like CST could provide meaningful support for improving overall well-being. It highlights the potential of community-based programs to address the complex challenges of Long Covid.
This observational study provides useful insights but has limitations due to its small sample size of 25 participants and lack of a control group. The findings are promising but should be interpreted with caution and validated by further research.
August 2022 • European journal of integrative medicine
Accessibility
- ⬤ Extremely Difficult to Access: Rare, experimental, or highly specialized. Requires multiple referrals, long wait times, travel, and strict follow-up.
- ⬤⬤ Difficult to Access: Limited to select centers with moderate barriers. Requires referral, potential travel, and wait times of weeks to months.
- ⬤⬤⬤ Moderately Accessible: Available in larger hospitals or clinics. Requires a basic referral, with moderate wait times and some coordination.
- ⬤⬤⬤⬤ Easy to Access: Widely available in most clinics. Minimal referral, short wait times, and simple preparation or follow-up.
- ⬤⬤⬤⬤⬤ Trivial to Access: Easily found in pharmacies or clinics. No referral needed, minimal wait, and straightforward access.
- ⬤ Up to $100
- ⬤⬤ Up to $500
- ⬤⬤⬤ Up to $2000
- ⬤⬤⬤⬤ Up to $10,000
- ⬤⬤⬤⬤⬤ More than $10,000
Method to access
- Book appointments directly with craniosacral therapy practitioners or specialized clinics.
- Some clinics offer package deals for multiple sessions.
- At-home options include purchasing devices like the CranioCradle for self-use.
Cost
- Individual sessions typically cost $120–170.
- Package deals may reduce costs, e.g., 6 sessions for $800.
- At-home devices like the CranioCradle cost approximately $50.
Insurance cover
- Generally not covered by insurance.
- May be eligible for reimbursement through HSA or FSA accounts with a Letter of Medical Necessity.
- Coverage varies by region and insurance provider.
Locations
- Craniosacral Center of Grand Rapids offers specialized packages.
- Phoenix Infinity LLC provides therapy in Virginia, DC, and Maryland.
- Team Rehabilitation includes CST in its Post-COVID Recovery Program.
- Other clinics can be found by searching for craniosacral therapy practitioners in your area.
Frequently asked questions
Key resources
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