Saturday, December 22, 2007

Ifirst want to apologize for the time between posts. I've been pretty busy at work, and have found it hard to find time to write. However, I get an "Evidence Express" email everyday from the folks over at Evidence in Motion, and today's included a link to an article from the Poughkeepsie Journal out of New York. The article was on craniosacral therapy and how proper rhythm is needed to ensure a healthy living.

Craniosacral Therapy (CST) is not new, but what is disturbing, is we know it's a bunch of hogwash, and journalist are still writing about it. For the fortunate not exposed to this lunacy, here are some of CST practitioners claims (BTW, you'll find PT's, DC's, Osteopaths and Massage therapist all using this):

  1. The "founder" and his Upledger Institute states:
    "Using a soft touch generally no greater than 5 grams, or about the weight of a nickel, practitioners release restrictions in the craniosacral system to improve the functioning of the central nervous system."
  2. That one can feel the craniosacral rhythms of the cerbrospinal fluid.
  3. And that is is effective in treating:
    • Migraine Headaches
    • Chronic Neck and Back Pain
    • Motor-Coordination Impairments
    • Colic
    • Autism
    • Central Nervous System Disorders
    • Orthopedic Problems
    • Traumatic Brain and Spinal Cord Injuries
    • Scoliosis
    • Infantile Disorders
    • Learning Disabilities
    • Chronic Fatigue
    • Emotional Difficulties
    • Stress and Tension-Related Problems
    • Fibromyalgia and other Connective-Tissue Disorders
    • Temporomandibular Joint Syndrome (TMJ)
    • Neurovascular or Immune Disorders
    • Post-Traumatic Stress Disorder
    • Post-Surgical Dysfunction

(Emphasis Added)
Wow! Those are some pretty broad claims. In fact, the CST claims have met all 7 of 7 of my "How to Spot Woo" post I made previously. Here are some truths:
  1. Some people get better with CST. There is no doubt in this. But some people get better with magnets, with "energy manipulation", with homeopathic water, get the point. The truth, though, is there is no research that shows people can get better BECAUSE of CST.
  2. 5 grams IS NOT enough force to get movement of a cranial bone. A study by Downey and associates easily showed this.
  3. Study after study shows CST providers cannot show reliability of "feeling" the craniosacral rhythm either between different providers or even within the person using repeated measures. To clarify, it's like your doctor diagnosing your heart problem by listening to your heart with a stethoscope, but at worse than chance, 2 doctors can't agree with what they hear, and worse, the same doctor hears something different when he listens a second time. Read studies done by Rogers here, and Wirth-Pattullo here.
  4. According to a large systematic review of CST related literature, the British Columbia Office of Health Technology Assessment concluded that -
The benefit of craniosacral therapy has not been demonstrated using well-designed research. The available studies are of low grade evidence as rated by the Canadian Task Force on Preventive Health Care (20) ranking system, and are of poor quality when judged using standard critical appraisal criteria. Inadequacies in the studies cited above preclude any statement attesting to craniosacral therapy effectiveness.
What does John Upledger counter with? The pathetic argument that many of these snake oil salesman use:
[P]ositive patient outcomes as a result of CranioSacral Therapy should
weigh greater than data from designed research protocols involving
human subjects, as it is not possible to control all of the variables of such


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