Cranial Osteopath Exeter

Here at the Estuary Clinic Topsham, Exeter we have a team of highly qualified cranial osteopath specialists, registered with the general osteopathic council.

What is cranial osteopathy?

Cranial osteopathy is one of the most gentle and subtle fields within osteopathy. It is not focused just on the bones of the skull, but addresses the whole body, with an emphasis on the central nervous system, the meninges, the cerebro-spinal fluid and the sacral bone. These structures are vital for an individual’s existence and well-being and even the slightest dysfunction can cause ailments within any of the bodily systems.

Traditional osteopathy recognizes that external forces and stressors can cause restrictions in the joints, ligaments and muscles of the body. In the same way cranial osteopaths acknowledge that postural imbalance or trauma can restrict not just the cranial bones, but compromise any structure below.

What is a cranial osteopathy treatment like?

A cranial treatment begins like any other osteopathic treatment – during the case history the patient explains the current complaint, systemic health and previous medical history. Then the osteopath will look at their posture and movement, to see how they are related to the patient’s complaint. Afterwards the patient relaxes on the treatment couch, while the practitioner gently places his/her hands on the head, spine and sacrum to assess, diagnose and treat any dysfunctions found.

A cranial treatment is, however, not necessarily confined to these areas, as the osteopath might find restrictions in other tissues and areas of the body that need to be addressed. After the treatment, the patient often feels relaxed and sleepy. So, it is advised to get enough rest after and drink a lot of water, which helps the body to detox after the changes that have occurred.

Who can benefit from cranial osteopathy?

Baby in distress

One of the first major traumas in life is birth. The baby’s skull at this time is soft, the sutures between the bones haven’t osified, and the cranium gets compressed whilst going through the narrow birth canal. Often it takes some time for the skull bones to overcome the stress, but if there has been excessive pressure in an unusual position, the nerves that go through the cranium can be irritated and cause problems such as: improper latching, colic, irritability. Parents often notice thebaby being more relaxed and that their symptoms reduce after a cranial treatment.

Back pain in pregnancy

The trauma is not confined to the baby, but extends to the mother. The ligamentous laxity that occurs throughout pregnancy helps the pelvic bones widen to allow the birth. As the pelvis is the reciprocal end of the spinal cord, and is directly attached to the cranium through the meninges, a difficult birth can affect all of the structures in the spinal column and cranium.

As life goes on, one can experience many traumas, falls on the head, daily stress and anxiety. Overcoming past traumas and a build-up of stress is important for one’s well-being and cranial osteopathy can help with relaxation.

Impeded circulation can cause congestion and headaches. Furthermore, recent studies have consolidated the importance of proper circulation. The ‘glymphatic system’ – responsible for cleansing the central nervous system from metabolic waste products – was recently discovered by scientist (Yang et al., 2013). They demonstrated that neurodegenerative diseases, such as Alzheimer’s, are associated with aggregation of such waste products. Cranial osteopathy addresses tight tissues, reducing fluid build up, and therefor aims to help with any congestion problems.

Recent studies

Cranial osteopathy has been one of the most controversial, intriguing and progressive fields within osteopathy. After many years, cranial osteopathy is finally being recognized and widely accepted not just within the osteopathic profession. More and more studies are being conducted to evaluate the effects of cranial osteopathy – some very convincing.

In 2009, Berkovitz conducted a series of case studies, demonstrating that cranial osteopathy has a potentially beneficial effect on acute and chronic cases of vertigo.
Cranial osteopathy has also demonstrated to have beneficial effects on the visual function of adults with cranial asymmetry (Sandhouse et al., 2010).
Cranial osteopathy appears to be a potential treatment for otitis media: due to the location of the eustation tube in the temporal bone it is prone to compromise during difficult delivery. Several studies have demonstrated positive results in treating the condition with cranial techniques (Mills et al., 2003; Steele et al., 1997).
Venous and sinus drainage techniques have been demonstrated to be successful in treating headaches and sinus congestion symptoms (Huard, 2002).
A pilot study on cranial osteopathy has demonstrated some beneficial effects on the gait training on patients with Parkinson disease (Müller, T, & Pietsch, A 2013).
Heyden and Mullinger (2009) have demonstrated that osteopathic cranial treatment can be beneficial for infants with colic.
And a case study conducted in 2006 (Lancaster and Crow) reports that a woman diagnosed with Bell’s palsy fully recovered after several cranial treatments.

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Meet the practitioners

Anna Nikova M.Ost Osteopath
BSc (Hons) Osteopathy, Acupuncture MBAcC

Cranial Osteopathy in detail

The anatomy behind cranial osteopathy The human skull consists of 22 bones, single or paired. The inner surface is lined with membranes – the meninges – which protect and cradle the brain. They extend down the spinal cord and attach to the sacral bone. Inside the meninges flows the cerebrospinal fluid – a clear liquid which serves for protection, nutrition, electrolyte balance and cleansing of the cranium and spinal canal. From the brain and the spinal cord, a.k.a. the central nervous system (CNS), nerves extend to the organs and muscles. In the cranium they pass through very narrow foramen, situated in or between the different skull bones and tiny apertures in the membranes.

Simple trauma, systemic disease, musle strain, improper posture – they can all cause the CNS and the supporting structures to be compromised. The balance and coordination between the 22 skull bones is as precise as a Swiss watch – if one is out of line it affects the whole of this system. A compromised position of a skull bone can create a twist in the meninges or vise versa. In this case the narrow passage ways of the nerves and the flow of the cerebro-spinal fluid are also affected. The same scenario can also be caused by an injury or imbalance to the sacrum, which pulls the meninges and influences the structures described above.

The pioneer in the field was W.G. Sutherland. In anatomy classes he was taught that the bones of the skull do not move. However, after observing the bevel-like articulations of the different bones, Sutherland set to investigate if this fusion was really the case. He created a helmet, which he used to slightly compress various parts of his own head. Then depending on the area of the skull being compromised, Sutherland began to experience different problems, from gastric responses to mental confusion (Sills, 2001). Prior to Dr. Sutherland’s work, the body was treated as if the head was incapable of having a dysfunction. However, he demonstrated that lesions of the cranium cause compensatory changes throughout the neuromuscular system.

Furthermore, Dr Sutherland observed that the mobility of the skull bones is dictated by an inherent regular rhythm, which he named the Primary Respiratory Mechanism (also known as the Breath of Life, Involuntary Mechanism and others). He implied that it expresses potency and a vital life force, independently from breathing and cardiac cycles. He described the motility to be also inherent to the sacrum bone, the meninges, the cerebro-spinal fluid and the central nervous system.

The cranial rhythm is very subtle and requires in-depth training for a cranial osteopath to be able to observe and diagnose it. It is expressed throughout the body, but most prominently in the head and the sacrum. If there is any compromise in the expression of this rhythm, it is likely that the structures in the area are also compromised. The cranial osteopath focuses on that structure and aims to restore the optimal function of the whole body. Sutherland’s five phenomena and the palpatory experiences of cranial practitioners have been supported with various studies (review by King, 2009). One of the most noteworthy are the studies drawing a parallel between the Primary Respiratory Mechanism and Traube-Hering and Meyer (THM) oscillations. The THM oscillations are waves in the arterial blood pressure and measured by a Doppler flowmeter. They have been shown to occur at a similar time and rate as the PMR, palpated by practitioners (Nelson et al., 2001).

Berkowitz, M 2009, ‘Application of osteopathy in the cranial field to successfully treat vertigo: a case series’, AAO Journal, 19, 3, pp. 27-32, CINAHL Plus with Full Text, EBSCOhost
Hayden, C, & Mullinger, B 2009, ‘Reprint of: a preliminary assessment of the impact of cranial osteopathy for the relief of infantile colic… Originally published in a previous issue of Complementary Therapies in Clinical Practice. Complement Ther Clin Pract (2006) 12, 83-90’, Complementary Therapies In Clinical Practice, 15, 4, pp. 198-203, CINAHL Plus with Full Text, EBSCOhost

Huard Y. Inﬂ uence of the venous sinus technique on cranial hemody- namics. In: King HH, ed. Proceedings of international research conference: Osteopathy in Pediatrics at the Osteopathic Center for Children in San Diego, CA 2002. American Academy of Osteopathy: Indianapolis, IN, 2005: 32–36.

King, H., 2009, ‘Osteopathy in the Cranial Field,’ in Foundations of Osteopathic Medicine, Third Edition, Lippincott Williams & Wilking, p. 728 – 748

Lancaster, D, & Crow, W 2006, ‘Osteopathic manipulative treatment of a 26-year-old woman with Bell’s palsy’, JAOA: Journal Of The American Osteopathic Association, 106, 5, pp. 285-289, CINAHL Plus with Full Text, EBSCOhost

Mills MV, Henley CE, Barnes LLB, et al. The use of osteopathic manipu- lative treatment as adjuvant therapy in children with recurrent acute otitis media. Arch Pediatr Adolesc Med 2003;157:861–866. 122.

Müller, T, & Pietsch, A 2013, ‘Comparison of gait training versus cranial osteopathy in patients with Parkinson’s disease: A pilot study’, Neurorehabilitation, 32, 1, pp. 135-140, CINAHL Plus with Full Text, EBSCOhost

Nelson KE, Sergueff N, Lipinski CL, et al. The cranial rhythmic impulse related to the Traube-Hering-Meyer oscillation: comparing laser-Doppler ﬂ owmetry and palpation. J Am Osteopath Assoc 2001. [Online] Available at: http://www.ncbi.nlm.nih.gov/pubmed/11329812

Parsons J. & Marcer N., (2006) ,Osteopathy – Models for Diagnosis, Treatment & Practice, page 182-184, Churchill Livingstone Elsevier

Sandhouse, M, Shechtman, D, Sorkin, R, Drowos, J, Caban-Martinez, A, Patterson, M, Shallo-Hoffmann, J, Hardigan, P, & Snyder, A 2010, ‘Effect of osteopathy in the cranial field on visual function–a pilot study’, JAOA: Journal Of The American Osteopathic Association, 110, 4, pp. 239-243, CINAHL Plus with Full Text, EBSCOhost

Steele KM, Kukulka G, Ilker CL. Effect of osteopathic manipulative treatment on childhood otitis media outcomes. Poster presented at the American Osteopathic Association 102 Annual Meeting and Scientiﬁ c Seminar 1997 (Oct) grant # 94-12-400.

Sills, F., 2001, Craniosacral Biodynamics, North Atlantic Books,U.S., p.1-20.

Yang L, Kress BT, Weber HJ, Thiyagarajan M, Wang B, Deane R, Benveniste H, Iliff JJ, Nedergaard M., 2013. Evaluating glymphatic pathway function utilizing clinically relevant intrathecal infusion of CSF tracer. Journal of Translational Medicine. 2013 May 1;11(1):107. [online] available at: http://www.ncbi.nlm.nih.gov/pubmed/23635358

by Anna Nikova
Reviewed: 20/11/14