Craniosacral Therapy
DESCRIPTION
Craniosacral therapy is defined as a structured diagnostic process that evaluates the mobility of the osseous cranium, the related mobility of the skull and sacrum and the palpation of the CRI (craniosacral rhythm impulse) throughout the body. Craniosacral therapy, as developed by John Upledger, is taught through the Upledger Institute in Palm Beach Gardens, Florida to lay people as well as to chiropractors, dentists, physical therapists and other licensed health care workers. In the mid-1970s, Upledger, an osteopathic physician, reported the detection of a craniosacral rhythm that he believed to be the pulse of flow of the cerebrospinal fluid. Upledger maintains that removing restrictions of the flow of cerebrospinal fluid via craniosacral osteopathic manipulative techniques improves symptoms or problems.
Craniosacral therapy (i.e., CST, craniosacral motion, craniosacral rhythm) is based on the theory that movement restrictions at the cranial sutures of the skull negatively affect rhythmic impulses conveyed through the cerebral spinal fluid from the cranium to the sacrum. All structures, which are in contact with the cerebral spinal fluid, including the brain, spinal cord and their protective membranes, are seen as part of the cranio-sacral system. All other structures of the body are believed to be affected indirectly through innervations arising from, or returning to, the central nervous system, or directly through mobility of the musculoskeletal system. (Green C, et al., 1999).
The foundation of craniosacral therapy, cranial therapy (i.e., cranial osteopathy, craniosacral treatment) is the manipulation of the cranial bones. Cranial therapy, as developed in the early 1900's by Dr. William Sutherland, is also based on a connection of the cranium to the sacrum via the dura. Both craniosacral therapy and cranial therapy are used for a wide variety of ailments (e.g., acute systemic infectious conditions, chronic pain problems, localized infection, dysfunction of viscera, depression, strabismus, auditory problems, autism). At present, physicians and scientist are attempting to verify whether a craniosacral rhythm does in fact exist and whether the bones of the cranium are actually mobile.
POLICY
Craniosacral therapy for the diagnosis and/or treatment of all diseases and conditions is considered investigational.
IMPORTANT REMINDER
We develop Medical Policies to provide guidance to Members and Providers. This Medical Policy relates only to the services or supplies described in it. The existence of a Medical Policy is not an authorization, certification, explanation of benefits or a contract for the service (or supply) that is referenced in the Medical Policy. For a determination of the benefits that a Member is entitled to receive under his or her health plan, the Member's health plan must be reviewed. If there is a conflict between the Medical Policy and a health plan, the express terms of the health plan will govern.
ADDITIONAL INFORMATION
Well-designed studies in peer review journals regarding the application of craniosacral therapy are lacking.
SOURCES
Centre for Health Services and Policy Research. (1999, May). A systematic review and critical appraisal of the scientific evidence on craniosacral therapy. Retrieved December 7, 2011 from http://www.chspr.ubc.ca/files/publications/1999/bco99-01J_cranio.pdf.
Flynn, T. W., Cleland, J. A., & Schaible, P. (2006). Craniosacral therapy and professional responsiblity. Journal of Orthopaedic & Sports Physical Therapy, 36 (11), 834-836.
Mann, J. D., Faurot, K. R., Wilkinson, L., Curtis, P., Coeytaux, R. R., Suchindran, C., et al. (2008). Craniosacral therapy for migraine: Protocol development for an exploratory controlled clinical trial. BMC Complementary and Alternative Medicine, 8 (28). (Level 3 Evidence - Independent study)
Mataran-Penarrocha, G. A., Castro-Sanchez, A. M., Garcia, G. C., Moreno-Lorenzo, C., & Zafra, M. D. (2009). Influence of craniosacral therapy on anxiety, depression and quality of life in patients with fibromyalgia. Evidence-Based Complementary and Alternative Medicine, 2011, 1-9.
National Guideline Clearinghouse. (2011). Pain management guideline. Retrieved December 7, 2011 from http://www.guidelines.gov.
Winifred S. Hayes, Inc. Medical Technology Directory. (2009, May; last update search March 2011). Craniosacral therapy. Retrieved December 7, 2011 from www.Hayesinc.com/subscribers. (21 articles and/or guidelines)
ORIGINAL EFFECTIVE DATE: 7/1/2001
MOST RECENT REVIEW DATE: 1/12/2012
ID_BT
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