What is Craniosacral Therapy?

by Jun 14, 2021

Sometimes called cranial sacral therapy, this modality is a hands-on technique that uses gentle touch to release tension in the central nervous system.  Developed by osteopath John Upledger in the 1970s, CST is mostly practiced by osteopaths, but is also commonly performed by chiropractors and massage therapists.

The focus of CST is to promote the movement of fluids in and around the central nervous system, with the goal of enhancing the body’s natural healing abilities.  The central nervous system, which is composed of the brain and spinal cord, controls most functions of the body.  As such, a disruption of cerebrospinal fluid flow can contribute to pain and dysfunction.

Knowing all that, how exactly does CST work?  What can you expect from a CST treatment?

What to Expect from Craniosacral Therapy

As with most bodywork modalities, CST is usually performed on a flat treatment table.  CST may be combined with other techniques, such as stretching and massage, or it can be the only technique used for the entire session.  A CST treatment can be anywhere from 30 to 90 minutes long, and a patient can expect to be fully clothed the entire time.

The practitioner will begin the CST by applying less than 5 grams of touch to the patient’s skull and/or sacrum.  If the patient is lying supine, the practitioner will first apply touch to the occipital protuberance and frontal bone of the skull.  After assessing the cranium, the practitioner may reach under the patient’s lower back and palpate the sacrum.  However, sometimes the entire session just involves palpating the cranial bones.  Should the client receive CST while prone, the session may start with one hand gently cupped on the occipital bone and the other lightly placed on the sacrum.

The light pressure, weighing less than a nickel, allows the therapist to detect the subtle pulsating of the craniosacral rhythm — the next section will elaborate on this.

How Does Craniosacral Therapy Work?

The craniosacral system, which consists of the membranes and fluids surrounding the brain and spinal cord, has a subtle yet palpable rhythm.  The pulses of craniosacral rhythm come from the slight narrowing and widening of the skull, as well as the gentle lengthening and shortening of the spine.  These subtle movements, occurring 6-12 times per minute, are carried out in an effort to properly circulate cerebrospinal fluid.  The only way a practitioner can feel this movement is through the extremely light touch I keep talking about.  Any pressure any heavier than 5 grams, I reiterate, won’t be able to feel the faintness of the rhythm.

Once the craniosacral rhythm is detected and assessed, the practitioner will address any disruptions found in the circulation.  Ideally, the cerebrospinal fluid should have a consistent pattern of movement.  When the membranes and fluids of the Dura Mater flow with constant rhythm, the brain and spinal cord are adequately lubricated with cerebrospinal fluid.  The Dura Mater, also called the dural tube, is the fascia encasing the brain and spinal cord.  The dural tube delivers nutrients to the central nervous system and circulates hormones, neurotransmitters, and immune cells.  A well-nourished central nervous system, having all of its structures in balance, will function optimally.  An unbalanced central nervous system increases the chance of developing pain and illness.

So, to encourage a balanced flow, the practitioner will slowly pull the occiput towards the top of the massage table, as a slight stretch of the spine may open up congested areas in the craniosacral system.  When a release in tension is felt, the practitioner will ask the patient to take deep breaths to initiate a relaxation response, which will decrease muscle tension and stress while craniosacral system resets.  As the muscles relax, the practitioner will notice slight changes in skull bone movement and direct focus to those affected areas.

There is a plethora of benefits that come from any type of massage, and one of the more commonly known ones is improved circulation.  However, most of us think of the enhanced flow of blood and lymph, as manual glides literally push congested blood and lymph out of a sticky area.  A tight fascial layer presses down into the muscle below, impeding the flow of blood and lymph that is supposed to circulate through the two structures…I’ve talked all about this in my myofascial release blog and my blood circulation blog.  Ok, let’s go back to where I left off one paragraph ago.  Mindful touch along the skull bones and sacral landmarks can guide the flow of cerebrospinal fluid into proper circulation as well.  But it takes a far gentler approach for a practitioner to locate and treat congestion in the craniosacral system.  When practitioners notice change in the flow of cerebrospinal fluid, they follow the direction of the flow with light touch, mindfully pressing the fluids and tilting the head until the rhythm loses its stagnant areas and regains balance.

The approach used on the cranium can also be applied to the sacrum.  Either while supine or prone, the practitioner will apply the same amounts of pressure and gentle stretching to the sacrum to realign cerebrospinal fluid circulation and allow the body to relax.

Who Can Benefit from Craniosacral Therapy?

Though it’s worth trying out for any type of discomfort, craniosacral therapy has been shown to be most effective for the following conditions:

  • Chronic muscle pain
  • Anxiety
  • Migraines
  • Sinus issues
  • Multiple Sclerosis
  • Temporomandibular Joint Pain
  • Epilepsy
  • Fibromyalgia – The musculoskeletal pain that accompanies fibromyalgia responds well to gentle treatments.
  • Autism – It’s common for children with autism to not like being touched.  With its gentle approach, craniosacral therapy can slowly introduce them to calming touch.  In addition to feeling more comfortable with touch, the therapy can reduce anxiety and encourage restful sleep.

Is Craniosacral Therapy Safe for Everyone?

Possibly, but it’s best to err on the side of caution.  Consult your physician before scheduling your treatment session if you have experienced any of the following:

  • Cerebral edema
  • Recent concussion
  • Blood clots
  • Aneurysm
  • Traumatic brain injury
  • Chiari malformation

Now You Know!

I recommend watching this helpful video, especially if you’re a visual learner.  It gives a detailed idea of what to expect from craniosacral therapy.


Katrina Jenkins

Katrina Jenkins

Author, Licensed Massage Therapist

Katrina Jenkins graduated from Towson University in 2013 with a Bachelor’s Degree in Health Science and worked as a nurse’s aide briefly before pursuing her true passion. She graduated from the Massage Therapy Institute of Colorado in April 2016 with honors and completed the Touch of Healers Scholarship Program the following summer. She has been a part of the Moyer Total Wellness Team since the summer of 2017.


Cleveland Clinic. (n.d.). Craniosacral Therapy Technique: What Is It, Benefits, Risks & Technique. [online] Available at: https://my.clevelandclinic.org/health/treatments/17677-craniosacral-therapy [Accessed 27 May 2021].

Haller, H., Lauche, R., Sundberg, T., Dobos, G. and Cramer, H. (2019). Craniosacral therapy for chronic pain: a systematic review and meta-analysis of randomized controlled trials. BMC Musculoskeletal Disorders, 21(1).

Kratz, S.V., Kerr, J. and Porter, L. (2017). The use of CranioSacral therapy for Autism Spectrum Disorders: Benefits from the viewpoints of parents, clients, and therapists. Journal of Bodywork and Movement Therapies, 21(1), pp.19–29.

Schweitzer, S. (n.d.). A Beginner’s Guide to Craniosacral Therapy. [online] Cranial Therapy Centre – Toronto. Available at: https://www.cranialtherapycentre.com/a-beginners-guide-to-craniosacral-therapy/ [Accessed 27 May 2021].

Photo Credit

Canva by Stills

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