What is Craniosacral Acupuncture?

Barbara and I first became interested in craniosacral energetics while we were attending acupuncture school in Seattle, Washington. Shortly after graduating, in September 1996, we took the Upledger Institute’s CranioSacral Therapy I course. Since then we have taken over 100 hours of craniosacral acupuncture workshops, studying closely with an experienced and highly skilled craniosacral acupuncturist who was trained by a well-known osteopath acupuncturist, Dan Bensky. Craniosacral energetic work when used in conjunction with acupuncture is an extremely effective tool for treating many conditions. We are constantly amazed at the results we are able to obtain combining these two modalities.

Craniosacral energetic work uses light-touch and gentle manual techniques to evaluate and treat a wide variety of conditions such as: headaches, sinus problems, sciatica, TMJ, shingles, spinal cord injuries, rheumatoid arthritis, osteoarthritis, whiplash, sprains, strains, some types of scoliosis, chronic back pain, cerebral palsy in children, chronic middle ear infections, cerebral ischemic episodes, visual disturbances, asthma, edema, fevers, mood disorders, etc. It has the added benefit of being able to restore autonomic nervous system flexibility.

The craniosacral rhythm was first discovered and described by William G. Sutherland, D.O. in the early 1900s. However, it was not until the extensive work of John E. Upledger, D.O. beginning in 1970 that we were able to have what many consider today to be the clearest explanation of the craniosacral system and its rhythm.

Dr. Sutherland maintained that the cerebrospinal fluid (CSF) was the initial recipient of the potency of the Breath of Life — the life force that is considered to be the spark that is the life principle in the human body.  The CSF is considered to be the agent by which this spark is conveyed to all the cells and tissues.  One of the chief aims of craniosacral therapy is to assist the craniosacral system in expressing this healing and ordering principle and to help whatever has become restricted or chaotic to reconnect with this potency.  If the potency of the Breath of Life cannot be expressed then disease and pathology will result.

Cerebrospinal fluid is a highly filtered fluid.  It has a number of vital functions in the human body such as: bathing the structures of the brain and spinal cord and acting as a shock absorbing fluid for the brain and spinal cord.  It is the fluid medium for exchange of messenger molecules, neuroactive polypeptides, throughout the central nervous system.  It is an important medium which carries neuroactive molecules from the central nervous system, the endocrine system and immune system as they communicate with each other and much more.  According to Franklyn Sills in his book Craniosacral Biodynamics recent research has shown that small quantities of cerebrospinal fluid leave the core of the body via dural sleeves, which cover the nerves as they leave the spinal canal and this is an accepted fact in German anatomy texts.

Dr. Upledger describes the craniosacral system as consisting of: 1) the three layered membrane system or meninges, 2) the cerebrospinal fluid and 3) the structures within the meninges which control fluid input and outflow for the system. It extends from the bones of the skull down the spinal dural membrane to the sacrum and coccyx.

The dural membrane is essentially impermeable to the CSF which it holds and therefore this membrane system is a semi-closed hydraulic system. The CSF enters the system by means of choroid plexuses and leaves the system by means of arachnoid villae. Both of these specialized tissue structures are under homeostatic control. Studies have shown that under normal conditions all of the bones of the skull (being moveable and not fused) move rhythmically to accommodate the changing fluid volumes inside of the dura mater membrane system.

The dural membrane boundaries of the craniosacral system are given shape by the fluid pressure within the system and by its more rigid aspects, the cranial bones, to which the membrane is firmly attached within the cranial vault. This allows us to regard the cranial bones functionally as hard places in the dural membrane. The cranial bones are therefore used as indicators in diagnosis and as handles in treatment. It is by virtue of these common bony attachments between the dura and the connective tissues that abnormal dural membrane tension patterns cross the dural boundary to connective tissues outside the system. Conversely, it is via these bony anchorings that connective tissues outside the dural membrane system are able to transmit tensions into the system.

The craniosacral rhythm, according to Dr. Upledger, results from variations in pressure between arterial blood, cerebrospinal fluid and venous blood. He recognized that the formation of CSF is periodic and rhythmical, not continuous. There are normally 6-12 cycles per minute. During the flexion phase, CSF is secreted into the ventricular system of the brain at a significantly more rapid rate than it is reabsorbed back into the venous circulation. Once this expansion reaches a certain threshold stretch receptors in the skull sutures reflexively stop the secretion of CSF. Because the reabsorption of CSF into the venous system is continuous, the pressure decreases and the extension or relaxation phase begins. As the CSF pressure in the ventricles drops, the sutures compress because CSF volume within the craniosacral system is reduced. CSF production is turned on again as a new flexion phase follows the extension phase. In this way the craniosacral rhythm is produced.

Craniosacral motion is a rhythmical motion felt in the whole body in response to the craniosacral system’s rhythm. This motion is probably related to the effect of the fluctuation of the CSF upon the nervous system, which in turn influences the tonus of the body tissues. Trained practitioners are able to palpate the motion of the craniosacral system anywhere on a patient’s body and by monitoring this wavelike motion can determine any restriction or dysfunction in the craniosacral system.

Impairments to this normal physiological motion within the body are called restrictions. They can result from inflammation, adhesions, musculoskeletal dysfunctions and neuroreflexes. The dissipation of a restriction is called a release. A release is sensed as a softening of the obstacle against which the physiological motion was fighting. When a resistance melts there is a palpable relaxation of the tissues.According to Mantak Chia in his book Iron Shirt Chi Kung I (p. 66) “The cranium of the skull has long been regarded by Taoists as a major pump for the circulation of energy from the lower to the higher centers.”

What role does fascia play in the craniosacral system? Fascia is the slightly mobile, continuous sheath of connective tissue, which invests all of the muscles, bones and organs of the body. It is fascia, which allows for the rhythmical internal and external rotation of the total body in compliance with the flexion and extension activities of the craniosacral system. During the flexion phase the body rotates externally and broadens. During the extension phase the body rotates internally and seems to narrow slightly. Because body fascia is a single system abnormal tension patterns in the fascia may be transmitted from one body part to another.

Any loss of mobility of fascial tissue in a specific area can be used as an aid in the location of the disease process, which has caused that lack of mobility. Probably via the nervous system this fascial system is normally kept in motion. Areas of injury or clinically significant change produce fascial immobility. Fascial immobility will almost always appear as an asymmetry or abnormal alteration in the craniosacral motion. While the asymmetry of motion will not indicate what the problem is, it will tell us where the problem is. Once located, we must rely upon other diagnostic methods (in our case Traditional Chinese Medicine) to determine the exact pathological nature of the problem. This asymmetry of motion can be used in diagnosis, treatment and prognosis. Restoration of symmetrical craniosacral motion to the area of restricted motion can be used as a prognostic tool. As the asymmetry is eliminated and normal physiological motion is restored one may confidently predict that the problem is being or has been restored.

Ongoing body problems outside of the craniosacral system ultimately reflect into the craniosacral system and can be discovered there by a skilled practitioner. Many lamina of fascia attach to the skull and sacrum. Muscles pulling upon these fascia can affect the function of the craniosacral system. Inflammation, adhesion, postural stress and musculoskeletal dysfunctions all interfere with the free gliding of the fascia. Through fascial continuity, an injury which results in fascial contracture or edema may affect the craniosacral system. This may cause dysfunction of the central nervous system which, in turn, can produce bizarre clinical results.

Examination and diagnosis is done by testing for movement of the whole body. Evaluation and treatment of structural restrictions can be done by feeling the restrictions patterns anywhere in the body.  Very gentle releases are used on the body for enhancing the movement of extra-cranial restrictions.  Combining these gentle craniosacral releases along with acupuncture allows us to be very specific in our treatments.

The treatment techniques used in craniosacral work are non-intrusive and indirect. These techniques release restrictions or abnormal barriers to motion by encouraging motion in the direction of ease – which is usually opposite to the direction of the restriction.

There is a technique based on interference waves of injury and disease, which makes use of the whole body motion as it responds to the craniosacral rhythm. A normal body will move into internal and external rotation in synchrony with the craniosacral rhythm. Injury and disease areas set up interference waves similar to those that occur when one drops a marble into a still pool of water. By observing the interference patterns created by the marble one can tell exactly where it entered the pool. These waves form arcs, the radii of which intersect at exactly the point where it hit the water. The same is true of the wave activity, which we perceive in the human body. We are using our hands to perceive the natural, symmetrical wave motion of the body. A restriction due to injury or disease sets up an interference wave pattern, which superimposes itself upon the normal physiological motion of the body. When we locate manually where the interference waves are coming from, we are able to find the source of the problem. In this way we are able to diagnose and treat restrictions of the organs and body such as the liver, kidney, shoulder, knee, etc.

Hugh Milne in the Heart of Listening observes that acupuncture and acupressure have addressed the energy field of the human head for four thousand years, as witnessed by Chinese records of acupuncture and “the art of listening.” He also notes that shiatsu has incorporated cranial work using visualization, pressure and “kime” (directed energy work) for almost a hundred years.. In his book Craniosacral Biodynamics Franklyn Sills notes that in Chinese medicine the emphasis is on the balance of qi and the potency of jing in the body and that jing, or essence, is sensed to be an inherent ordering principle in the human body that is intimately related to its fluid systems. He goes on to point out that within the heart of all motion is a stillness that organizes. Stillness is at the heart of all polarities and polarity motions, such as the classic yin and yang polarities.

Meridians represent the outer energetic layers of the body and the organs pertain to the interior. They both represent an indivisible energetic unit. Problems of the internal organs can affect the relevant meridians and problems, which start in the meridians, can penetrate into the interior. Craniosacral acupuncture is a means of connecting the two. Through needling a change is created in the fascial sheet and this is reflected in the craniosacral rhythm. This relationship between the two modalities is extremely useful in confirming our diagnosis as well as providing feedback during the treatment. Acupuncture points have an intimate connection with the craniosacral rhythm and can alter the rhythm with only slight pressure or needling of the appropriate point.

Using Traditional Chinese Medicine to diagnose which TCM pattern is most predominant and integrating it with our craniosacral palpation and diagnosis we are able to pinpoint the precise location and nature of the presenting problem and select the most suitable acupuncture points based on our diagnosis. Applying pressure to these points creates an immediate response in the amplitude of the craniosacral rhythm. For example, if our diagnosis finds that the kidney is restricted we might press the acupuncture point, Kid-2, and wait for the response. If the amplitude increases and we no longer feel pulled to the kidney this not only confirms our diagnosis but also lets us know that Kid-2 is a good point to use. We test the suitability of other points in the same way.

The positive effects of craniosacral acupuncture depend to a large extent upon the patient’s own natural healing processes. Our light, hands-on, approach and gentle needling technique assists the hydraulic forces inherent in the craniosacral system and the energy moving in the meridians to improve the body’s internal environment. Our clinical application of acupuncture and craniosacral techniques attempts to restore proper movement, which in turn illicit improved pathology. Through our compassionate, heart-centered treatments we not only treat many conditions very effectively but we encourage the patient to resonate and identify with their own healing and wellness.

Maciocia, Giovanni, The Foundations of Chinese Medicine, Edinburgh: Churchill, Livingstone 1989

Matsumoto, Kiiko and Stephen Birch, Hara Diagnosis: Reflections on the Sea,Brookline, MA: Paradigm Publications 1988

Milne, Hugh, The Heart of Listening, Berkeley: North Atlantic Books 1995

Ross, Jeremy, Acupuncture Point Combinations, Edinburgh: Churchill, Livingstone 1995

Sills, Franklyn, Craniosacral Biodynamics, Berkeley: North Atlantic Books 2001

Stux, Gabriel, Bruce Pomeranz, Basics of Acupuncture, Berlin: Springer-Verlag 1995

Upledger, John E D.O., F.A.A.O. and John D. Vredevoogd, M.F.A. Craniosacral Therapy, Seattle: Eastland Press 1983

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Compassionate Acupuncture and Healing Arts, providing craniosacral acupuncture, herbal and nutritional medicine in Durham, North Carolina. Phone number 919-475-1005.