An Overview of Craniosacral Therapy (CST)

The treatment has been suggested for migraines, back pain, and other conditions

Craniosacral therapy (CST) is a form of touch therapy that has been used for treatment and prevention of migraines, as well as several other chronic pain conditions. The technique was developed in the 1970s by Dr. John Upledger, an osteopathic practitioner and co-founder of the Upledger Institute in Florida.

CST is a non-invasive technique in which a practitioner lightly touches the spine, skull, and pelvis under the presumption that it can manipulate and regulate the flow of cerebrospinal fluid (CSF) and aid in what Upledger refers to as "primary respiration." The technique and this explanation have been met with skepticism.

Close up of physiotherapist pressing his thumb on the neck of a woman
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How Craniosacral Therapy Is Performed

Craniosacral therapy is done while you are fully clothed. Sessions can range from 45 minutes to more than an hour, and they are usually performed by an osteopath, chiropractor, or massage therapist.

Practitioners of CST contend that cerebrospinal fluid places pressure on the skull and causes small, rhythmic movements of the cranial bones. Using light touch (what Upledger describes as "no more than the weight of a nickel"), the practitioner "monitors" the rhythm of cerebrospinal fluid to detect potential restrictions and imbalances.

Manual techniques are then used to selectively "release" these problem areas, thereby relieving undue pressure on the brain and spinal cord that are said to contribute to conditions such as migraines, fibromyalgia, and scoliosis.

What Research Says

Overall, it has been difficult to verify whether craniosacral therapy works, but there have been efforts to define outcomes. More research is certainly needed to determine whether or not the treatment is truly effective for these or any other conditions, but here's a look at a few existing studies:

  • Migraines: A few small studies suggest that craniosacral therapy may be beneficial in migraine treatment. One study reported a reduction of self-reported migraine symptoms after four weeks of treatment with CST. However, there was no control group. All participants in the study were treated with craniosacral therapy, meaning that it's uncertain as to if the effects were due to the therapy alone or other variables. Another small research study published results stating that CST reduced the need for pain medication in 70 percent of participants. The participants were treated at several different locations, for varying durations, and by 10 different practitioners working independently.
  • Back pain: There is some evidence that it may reduce back pain based on the results of a research study which showed that the response to CST was better than the response to classic massage.
  • Post-concussive syndrome: The therapy has been considered a possible option for management of pain and sleeping problems caused by post-concussive syndrome.
  • Autism: Another research study reported improved mood, emotional stability, and communication after treatment with CST in children diagnosed with autism. The results were based on parent and therapist reports.


In addition to skepticism about the effects of CST itself, there is a great deal of controversy regarding the explanation that practitioners provide in terms of why it works. While craniosacral therapy may reduce some pain symptoms, there has been no reliable evidence that it works by adjusting cerebrospinal fluid flow as described.

CSF normally flows freely around the spine and brain. A blockage in CSF flow causes serious consequences, including increased pressure around the nerves that control vision and vision loss. Chronic problems with CSF flow require surgical intervention with placement of a device called a ventriculoperitoneal (VP) shunt, which puts into question why CST would work as suggested.

A 2006 study used rabbits to assess changes in CSF pressure and bone position in response to CST using invasive tests and diagnostic imaging. There were no changes in CSF pressure or bone positions in response to CST. While this was not a human study (such an invasive human study is not safe or feasible), the results are consistent with most experts' expectations of the effects of light touch on CSF flow and bone structure.

Although a few studies suggest that CST may be of some benefit, medical experts believe that improved symptoms may be the consequence of gentle massage effects and not changes in CSF flow.

A Word From Verywell

Alternative treatment for conditions like migraines may be effective for some people. CST, like massage and acupressure, is a non-invasive and relatively safe technique. Unlike chiropractic manipulation, which can be associated with serious side effects, the light touch utilized in CST is highly unlikely to induce any physical damage. So, while you can try it without much concern, know that it may not deliver the results you seek.

9 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
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By Cathy Wong
Cathy Wong is a nutritionist and wellness expert. Her work is regularly featured in media such as First For Women, Woman's World, and Natural Health.