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Craniosacral Therapy

Craniosacral work is difficult to define succinctly because, firstly, there is a lot of unfamiliar terminology that needs defining and, secondly, the work is experientially-oriented. As a practitioner of craniosacral work for almost 20 years now, I find it much easier to put my hands on somebody and feel a number of things that are happening, rather than describe what I feel with words. Having said that, I will now attempt to give you a basic understanding of craniosacral work and how it might be a part of your healthcare regimen.

Craniosacral work addresses a specific system in the body that is used to assess and treat a variety of problems, many of which relate to proper neurological functioning. In this regard, craniosacral work has particular potential for helping individuals with a wide range of conditions. They include chronic pain syndromes unsuccessfully treated by other approaches, head neck or back injuries, and a number of stress-related conditions including insomnia, headaches, fatigue, anxiety and TMJ syndrome.

A definition

I have tried to define craniosacral work simply, as follows: A physiological system made up of cranial bones, the sacrum and the membrane structures that connect these two areas of the body. There is a distinct rhythm within this system (the craniosacral rhythm) created by the flow of cerebrospinal fluid through the membrane complex. A craniosacral practitioner assesses this rhythm and uses the information to diagnose and treat imbalances within the body.

Craniosacral work revolves around the functioning of the central nervous system. Because the nervous system is really the master controller of the entire system, even subtle imbalances can have profound effects on a person's health and well-being.

How it works

To understand how craniosacral therapy works it is necessary to briefly discuss the anatomy of the central nervous system, with particular emphasis on the structures that make up the craniosacral system.

The brain and spinal cord, essentially the core of our being, are encased in both bone and connective tissue (the brain in the bones of the skull, the spinal cord in the vertebral column at the base of which is the sacral bone) The connective tissue I refer to here are actually the three specialized membranes called the meninges, or dura. The meninges are wrapped tightly around the brain and spinal cord, much like a stocking. In fact, the entire body is encased in connective tissue, called fascia, that acts as a sheath around various structures in the body, including bones, muscles, and organs and aids in the transmission of nervous impulses.

So the craniosacral system includes the bones of skull, mouth and face and the sacrum. For those of you unfamiliar the sacrum is the triangular bone that sits between the two ileum (or pelvic bones) and forms the rear portion of the pelvic girdle. The brain and spinal cord are lubricated with cerebrospinal fluid and this fluid is pumped out the brain at specific intervals. The system functions as a semi-closed hydraulic system with the fluid moving up and down the spinal cord as pressures build from increased output. Just as the pumping action of the heart can be determined by palpation of the pulse at the wrist or neck, the cranial rhythm can be palpated very easily at certain points on the body (i.e. the bones of the skull in certain locations and the sacrum, since that is where the meninges attach to bone) For more experienced practitioners, the rhythm can be palpated anywhere on the body.

So the cranial rhythm is the rhythm of the cerebrospinal fluid through the meninges that encase the central nervous system. The craniosacral therapist can detect changes in the amplitude and frequency of the cranial rhythm and use this information to help the body rebalance the way the nervous system, among other systems, are functioning.

Under normal circumstances a person is continually regulating this physiological process. When an individual loses that ability to self-regulate, for whatever reason, be it trauma, poor circulation or poor anatomical alignment, areas of restriction and diminished function are created. Meaning parts of the body are not responding rhythmically to the gentle urging of the cerebrospinal fluid pulsations. As you can imagine, this can apply to any number of clinical scenarios, although the bulk of cranial work in my practice is performed on patients with neurological problems, chronic pain and long-standing psychological issues such as depression and anxiety. In addition, endocrine, or hormonal, imbalance is also a common finding in my practice. Craniosacral work can effect hormone secretions due the connection with pituitary and pineal glands, located deep inside the skull and in close contact with the meningeal system.

Other common reasons for inhibition of proper functioning of the craniosacral system are scarring or adhesions, inflammation and vascular accidents. So any abnormalities in the structure and/or function of the nervous system, the musculoskeletal system, endocrine or respiratory system have the potential to alter functioning in the craniosacral system, and conversely, an imbalance in the craniosacral system can cause imbalances in these other physiological systems.

So how is it done?

The craniosacral technique uses gentle, light-force manipulation of the aforementioned structures in the body, including the cranial bones. The technique relies largely on the body's inherent ability for self-correction and therefore is quite non-invasive and does not cause "side effects," so to speak. The skilled practitioner can detect a weakened cranial rhythm, asymmetry in the rhythm, and areas of restriction and then employs particular techniques, always gently, to accommodate proper movement of the structures involved.

Patients often ask me how so little force can change the positioning of the bones or other structures. If you think about it from the perspective of pure physics it makes sense. The craniosacral practitioner uses a minimal amount of force (approximately the weight of a nickel) over a long period of time (anywhere from 30 seconds to several minutes depending on individual circumstances, how quickly the person's body responds). A more forceful manipulation may exert many times more pressure on the system in just a second, or fraction of a second. Therefore with craniosacral work, the amount of energy put into the body is the same as say, some chiropractic adjustments, just over a longer period of time. With a short and more forceful adjustment the body must adjust quickly to the changes, literally forced, upon it.

With craniosacral work we are more interested in larger areas, indeed the entire body; including all the soft tissue structures, not simply the bones. In addition, we are trained to follow the body's self-correcting processes and use our intention as a means to help foster balance. During a craniosacral treatment many patients experience different sensations in their bodies, sometimes strong images will come into the patient's mind, others feel releases of emotion or tension and still others simply fall asleep. It depends on the individual response and oftentimes patients will report after two or three treatments they can feel their own cranial rhythm, either during the treatment or spontaneously during times when their bodies are still.


As mentioned earlier, the most effective craniosacral work is done when the body's self-corrective abilities are tapped into by the practitioner and obstacles removed, or areas of restriction reintegrated into the entire system. Because of this, patients do not experience any "side effects". Although infrequently, sometimes patients do feel worse after a treatment for a short period of time before they feel better, or notice benefits. This may be due to areas of the body "waking up," so to speak, and therefore being more sensitive than previously. Also, the rebalancing process can sometimes take longer than the duration of the treatment and the body needs some extra time to adjust to the new flow of energy through it.

How to discuss this therapy with your physicians

Craniosacral work is difficult to explain succinctly and therefore may be challenging to discuss with your conventional physicians. The good news is, it is a very gentle and safe type of work, so there is little to no risk involved in receiving treatment. That's why when my patients ask me about this work I give them some general articles on it but also encourage them to receive a treatment and experience it firsthand. Most people find it one of the most relaxing experiences they have had and the implications clinically are wide reaching. The thing I love most about craniosacral work is that it is truly holistic medicine, integrating all aspect's of one's self and working with the body instead of against it.

History and background

Dr. William Sutherland discovered the very existence of the craniosacral system in the earlier part of the 20th century. Dr. Sutherland was an osteopathic physician who for 20 years contemplated and conducted limited research into the idea that the bones of the skull were movable. By applying different pressures and constraints on different cranial bones he described problems with coordination and corresponding areas of pain as well as different mental/emotional reactions.

Dr. Sutherland developed a system of examining and assessing the movements of the bones of the skull. He also developed methods to adjust, or more accurately, to help his patients self-correct the movements of these bones. In other words, he developed methods for treatment of the imbalances he discovered. The body of work of Dr. Sutherland created is called cranial osteopathy.

In the early 1930s, Dr. Sutherland published his findings, but initially the osteopathic community was not accepting of his work, as is so often the case with new discoveries. Nothing was known about the craniosacral system and his treatments sometimes produced miraculous effects, giving it an air of something quite esoteric and possibly even fraudulent.

Although the approach to healing known as cranial osteopathy was practiced by a small number of physicians who studied with Sutherland, it wasn't until the 1970s that further research was conducted by Dr. John Upledger, again another osteopathic physician. Dr. Upledger was a surgeon and during a brain surgery saw with his naked eye rhythmic movements within the membranes that surround the brain and spinal cord. It was this system that Dr. Upledger later researched and called the craniosacral system. In 1975, Upledger joined the faculty at Michigan State University as a clinician-researcher to study the way this system functioned in the body.

There are three schools, if you will, of craniosacral work. They are, for the most part, similar, but they have slightly different approaches to the therapy. I mention them just briefly so that if you search for a practitioner you won't be totally unfamiliar with some of the terms. The sutural approach, popularized by Dr. Sutherland, focuses primarily on the mobility of the cranial bones. The meningeal approach incorporates the membrane system into its work and is the style I use. The reflex approach is incorporated by Dr. De Jarnette, a student of Dr. Sutherland's in the 1920s. This school, the sacro-occipital school, uses techniques to turn off stress signals affecting different organs in the body. Please contact the office if you have further questions.