What is cranial osteopathy?
Cranial osteopathy was proposed in the 1930s by William Sutherland who believed that the bones in the skull move in a “cranial rhythm”. By manipulating this “rhythm” osteopaths believe that they can treat a range of different conditions. However, since the 1930s we have learnt a lot more about how the body works. We now know that the bones in the skull don’t move and the “cranial rhythms” proposed by William Sutherland don’t actually exist at all. In fact, even experienced practitioners don’t find the same cranial rhythyms as each other. Cranial osteopathy is therefore a fanciful concept based on something that doesn’t exist.
What can cranial osteopathy treat?
Some osteopaths claim to be able to treat a whole range of different conditions with cranial osteopathy. The most commonly targeted patient group is babies with osteopaths claiming to be able to treat colic, sickness, irritability, feeding difficulties, misshapen head, reflux, cerebral palsy and many others. However, there isn’t any evidence that cranial osteopathy is effective for any of these conditions. One thing that’s common to these conditions, with the exception of cerebral palsy, is that they often get better on their own. When parents take their baby to a cranial osteopath for treatment of, for example, colic and within a few days or weeks their baby has improved they assume that it is down to the osteopathic treatment. However, we know that babies outgrow colic at around 4-6 months of age. If their baby is having osteopathic treatment at this time it’s natural for the parents to assume that the colic improved due to the treatment. In reality, as cranial osteopathy is entirely fanciful, it’s much more likely that the baby simply outgrew the colic and the treatment didn’t have any effect at all.
What does the research tell us?
Most research on cranial osteopathy is of a very poor quality and tells us nothing about whether it’s effective as a treatment or not. There is one good quality trial that looked at the use of cranial osteopathy for children with cerebral palsy. The authors concluded “This trial found no statistically significant evidence that cranial osteopathy leads to sustained improvement in motor function, pain, sleep or quality of life in children aged 5-12 years with cerebral palsy nor in quality of life of their carers.” In other words, cranial osteopathy didn’t work.
I have written about a deeply flawed study of cranial osteopathy for infantile colic which is a perfect example of how NOT to design a study. Cranial osteopathy really isn’t effective for colic.
A systematic review and meta-analysis from 2019 seems to indicate a benefit of craniosacral therapy for chronic pain. However, there are major issues with the studies included in the review which render its conclusions invalid. These shortcomings are highlighted in an excellent article by Jonathan Jarry.
There is also a particularly appalling systematic review of manual therapies for infantile colic. This has been thoroughly addressed by Edzard Ernst so I won’t go into it any further here. Suffice to say it doesn’t provide any evidence for the effectiveness of cranial osteopathy.
The reality, having assessed all of the evidence, is that cranial osteopathy has not been found to be effective for ANY condition.
Is it safe?
Nobody really knows if cranial osteopathy is safe because it hasn’t been adequately studied to test its safety. The biggest risk from this kind of “treatment” is probably not the treatment itself but the potential for someone to use this when proper medical care should have been undertaken instead.
Let’s return to the questions posed in the title of this post:
Question: What is cranial osteopathy?
Short answer: Complete nonsense
Long answer: It’s a fanciful “treatment” based on theories that are completely at odds with our understanding of the way the human body actually works.
Question: What can cranial osteopathy treat?
Short answer: Nothing
Long answer: Nothing. At all. Ever. As it’s based on theories that are unfounded it’s unreasonable to expect it to provide any benefit to any health condition. There is also no scientific evidence to show that it works for any condition.
It’s quite surprising that more osteopaths don’t speak out against the use of cranial osteopathy. Osteopaths like to promote themselves as “healthcare professionals” but it’s going to be very hard for them to be accepted as such when they continue to allow complete nonsense like cranial osteopathy within their profession. Cranial osteopathy is based on something that doesn’t exist, has never been shown to be effective for any condition and it’s high time it ceased to be offered as a “treatment” option.
If you’d like to learn more about cranial osteopathy, here are some links you might find useful:
- Ben Goldacre on cranial osteopathy
- An excellent reading list on cranial osteopathy and the closely related craniosacral therapy
Last updated 09/01/21
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