Free
The Somatic Connection  |   January 2017
Manual Craniosacral Therapy May Reduce Symptoms of Migraine Headache
Author Notes
  • University of California, San Diego School of Medicine 
Article Information
The Somatic Connection   |   January 2017
Manual Craniosacral Therapy May Reduce Symptoms of Migraine Headache
The Journal of the American Osteopathic Association, January 2017, Vol. 117, 59. doi:10.7556/jaoa.2017.011
The Journal of the American Osteopathic Association, January 2017, Vol. 117, 59. doi:10.7556/jaoa.2017.011
Arnadottir TS, Sigurdardottir AK. Is craniosacral therapy effective for migraine? tested with HIT-6 questionnaire. Complement Ther Clin Prac. 2013;19:11-14. 
Physical therapy researchers in Iceland studied the effect of craniosacral therapy (CST) on participants with migraine headache. Participants aged 18 to 50 years were recruited if they had a diagnosis of migraine and reported that they had had 2 or more migraine headaches in the month preceding the study. Participants were allowed to continue their usual activities of daily life and any medications they were taking but were not allowed to have any other form of alternative treatment. 
The outcome measure was the Short-Form Headache Impact Test (HIT-6), which covers quality of life aspects such as “pain, social participation, general activity, vitality, intellectual activity and biological suffering.” The HIT-6 has been standardized and validated with 4 levels of influence on the life of the participant: little or no influence, some influence, considerable influence, and highest influence (“very seriously affect life of the individual”). 
The 20 participants (18 women, 2 men) were randomly assigned to 1 of 2 groups, A or B. The HIT-6 was filled out 4 times every 4 weeks: first, at baseline; second, after group A received CST and group B waited; third, after group B received CST and group A waited; and fourth, 4 weeks later. 
Craniosacral therapy was applied by 1 of 4 therapists who were trained in CST, which is a technique similar to cranial osteopathic manipulative medicine. In this study, the therapists followed the sequence of the so-called 10-step CST, which are diaphragm, cranial bone, and facial bone “releases.” 
Results showed significant lowering of HIT-6 scores immediately after CST and then at 4 weeks after receipt of CST (P=.004). The study was limited by the small number of participants, the potential skill level differences between providers of CST, and the lack of a control group. This study was selected for review because it was a well-designed pilot, it adds to the evidence base for application of manual medicine in head pain, and it confirms my own experience in applying cranial osteopathic manipulative medicine to patients with migraine headache.