Ten randomized controlled trials (RCTs) involving a total of 681 patients were examined using a meta-analysis. Pain intensity and functional impairment improved more significantly compared to conventional treatment, compared to manual/non-manual sham treatments, and compared to active manual treatments. Even after 6 months, craniosacral treatment showed greater improvements in pain intensity and limitations compared to sham treatments. Conclusion: In patients with chronic pain, this meta-analysis indicates significant and robust effects of craniosacral treatment on pain and function, lasting up to six months.
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Methodology: PubMed, Central, Scopus, PsycInfo, and Cinahl were searched through August 2018. Only randomized controlled trials (RCTs) assessing the effects of craniosacral therapy in chronic pain patients were included. Standardized mean differences (SMD) and 95% confidence intervals (CI) were calculated for pain intensity and functional impairment as primary outcomes. Hedges’ correction was used for small samples. Secondary outcomes included physical/mental quality of life as well as global improvement and safety. The risk of bias was assessed using the Cochrane tool. Results: Craniosacral treatment showed larger post-intervention effects on: pain intensity (SMD = -0.32, 95% CI = [-0.61, -0.02]) and functional impairment (SMD = -0.58, 95% CI = [-0.92, -0.24]) compared to usual care; pain intensity (SMD = -0.63, 95% CI = [-0.90, -0.37]) and functional impairment (SMD = -0.54, 95% CI = [-0.81, -0.28]) compared to manual/non-manual sham treatment; and on pain intensity (SMD = -0.53, 95% CI = [-0.89, -0.16]) and functional impairment (SMD = -0.58, 95% CI = [-0.95, -0.21]) compared to active manual treatments. After six months, craniosacral treatment showed greater effects on pain intensity (SMD = -0.59, 95% CI = [-0.99, -0.19]) and disability (SMD = -0.53, 95% CI = [-0.87, -0.19]) compared to sham treatment. Secondary outcomes were all significantly better in patients treated with craniosacral therapy than in other groups, with the exception of six-month mental quality of life versus sham treatment. Sensitivity analyses showed robust effects of craniosacral treatment across most risk-of-bias domains. Five of the 10 RCTs reported safety data. No serious adverse events occurred. Minor adverse events were distributed equally across groups. In patients with chronic pain, this meta-analysis suggests significant and robust effects of craniosacral treatment of up to six months on pain and function. Further RCTs strictly following CONSORT are required to investigate the effects and safety of CST in chronic pain. Haller H, Lauche R, Sundberg T, Dobos G, Cramer H. Craniosacral therapy for chronic pain: a systematic review and meta-analysis of randomized controlled trials. BMC Musculoskelet Disord. 2019;21(1):1. doi:10.1186/s12891-019-3017-y
