Craniosacral therapy for chronic pain: a systematic review and meta-analysis of randomized controlled trials

Abstract

ObjectivesTo systematically assess the evidence of Craniosacral Therapy (CST) for the treatment of chronic pain.MethodsPubMed, Central, Scopus, PsycInfo and Cinahl were searched up to August 2018. Randomized controlled trials (RCTs) assessing the effects of CST in chronic pain patients were eligible. Standardized mean differences (SMD) and 95% confidence intervals (CI) were calculated for pain intensity and functional disability (primary outcomes) using Hedges’ correction for small samples. Secondary outcomes included physical/mental quality of life, global improvement, and safety. Risk of bias was assessed using the Cochrane tool.ResultsTen RCTs of 681 patients with neck and back pain, migraine, headache, fibromyalgia, epicondylitis, and pelvic girdle pain were included. CST showed greater post intervention effects on: pain intensity (SMD = -0.32, 95%CI = [− 0.61,-0.02]) and disability (SMD = -0.58, 95%CI = [− 0.92,-0.24]) compared to treatment as usual; on pain intensity (SMD = -0.63, 95%CI = [− 0.90,-0.37]) and disability (SMD = -0.54, 95%CI = [− 0.81,-0.28]) compared to manual/non-manual sham; and on pain intensity (SMD = -0.53, 95%CI = [− 0.89,-0.16]) and disability (SMD = -0.58, 95%CI = [− 0.95,-0.21]) compared to active manual treatments. At six months, CST showed greater effects on pain intensity (SMD = -0.59, 95%CI = [− 0.99,-0.19]) and disability (SMD = -0.53, 95%CI = [− 0.87,-0.19]) versus sham. Secondary outcomes were all significantly more improved in CST patients than in other groups, except for six-month mental quality of life versus sham. Sensitivity analyses revealed robust effects of CST against most risk of bias domains. Five of the 10 RCTs reported safety data. No serious adverse events occurred. Minor adverse events were equally distributed between the groups.DiscussionIn patients with chronic pain, this meta-analysis suggests significant and robust effects of CST on pain and function lasting up to six months. More RCTs strictly following CONSORT are needed to further corroborate the effects and safety of CST on chronic pain.Protocol registration at ProsperoCRD42018111975.

Effectiveness of craniosacral therapy in musculoskeletal pain disorders

“…As part of craniosacral therapy, relaxation of fascial restrictions is also performed [2]. The full mechanism of craniosacral therapy is not yet fully understood, although the current scientific knowledge indicates that the effectiveness of this type of techniques may be due to the stimulation of the parasympathetic nervous system in response to the therapy [4].…”

Image Features of Resting‐State Functional Magnetic Resonance Imaging in Evaluating Poor Emotion and Sleep Quality in Patients with Chronic Pain under Artificial Intelligence Algorithm

“…It was found that unique functional connection patterns of these subregions derived from the RS-fMRI data further confirmed the validity of the segmentation results [ 22 ]. The above shows that the clustering algorithm has a certain value in RS-fMRI optimization, which reflects the application value of deep learning algorithms in the medical field [ 23 , 24 ]. After that, the RS-fMRI image optimized by the BIRCH clustering algorithm was adopted for the examination of chronic pain patients, and the display results of the RS-fMRI image between the patients with mood and sleep disorders and relatively normal patients were compared.…”

Osteopathy and Mental Health: An Embodied, Predictive, and Interoceptive Framework

“…Osteopaths are typically involved in the care of individuals presenting with a range of clinical conditions ( Sciomachen et al, 2018 ), but most frequently those presenting with musculoskeletal disorders ( Johnson and Degenhardt, 2019 ). To date, there is a growing but still limited 2 body of evidence supporting the efficacy and effectiveness of osteopathic treatment in chronic pain conditions ( Haller et al, 2020 ; Licciardone et al, 2020 ; Rehman et al, 2020 ; Franzetti et al, 2021 ) in particular musculoskeletal disorders like back pain ( Licciardone et al, 2005 ; Franke et al, 2014 , 2015 , 2017 ; Verhaeghe et al, 2018 ; Switters et al, 2019 ; Dal Farra et al, 2021 ); however, some counterevidence is available as well ( Posadzki and Ernst, 2011 ; Orrock and Myers, 2013 ; Nguyen et al, 2021 ). Furthermore, there is sparse evidence suggesting that osteopathic treatment may benefit other physical health conditions ( Müller et al, 2014 ; Cicchitti et al, 2015 ; Cerritelli et al, 2016 , 2017b ; Ruffini et al, 2016 ; Lanaro et al, 2017 ).…”