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Is Craniosacral Therapy Effective? A Systematic Review and Meta-Analysis.

Luis Ceballos-Laita1, Edzard Ernst2, Andoni Carrasco-Uribarren3

  • 1Department of Surgery, Ophthalmology and Physiotherapy, University of Valladolid, 42004 Soria, Spain.

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|March 28, 2024
PubMed
Summary
This summary is machine-generated.

Craniosacral therapy (CST) shows no significant clinical benefits for musculoskeletal or non-musculoskeletal conditions. Evidence from randomized controlled trials indicates CST is ineffective for pain, disability, and various health issues.

Keywords:
complementary therapiesmeta-analysisosteopathysystematic review

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Area of Science:

  • Integrative Medicine
  • Evidence-Based Practice
  • Clinical Effectiveness Research

Background:

  • Craniosacral therapy (CST) is a complementary therapy with purported benefits for various health conditions.
  • Existing evidence on CST's clinical effectiveness remains inconclusive, necessitating rigorous evaluation.

Purpose of the Study:

  • To systematically evaluate the clinical effectiveness of craniosacral therapy (CST) across a range of musculoskeletal and non-musculoskeletal conditions.
  • To synthesize findings from high-quality randomized controlled trials (RCTs) to determine the efficacy of CST.

Main Methods:

  • A comprehensive literature search was conducted across major databases (PubMed, PEDro, Cochrane, Web of Science, OML) for RCTs on CST effectiveness.
  • Risk of bias was assessed using the PEDro scale and Cochrane Risk of Bias 2 tool; evidence certainty was determined using GRADEpro.
  • Quantitative synthesis was performed using RevMan 5.4 software with random effect models.

Main Results:

  • Fifteen RCTs were included for qualitative synthesis, and seven for quantitative synthesis.
  • CST demonstrated no statistically significant or clinically relevant improvements in pain or disability for conditions like headache, neck pain, low back pain, pelvic girdle pain, and fibromyalgia.
  • CST was found ineffective for non-musculoskeletal conditions including infant colic, preterm infants, cerebral palsy, and visual function deficits.

Conclusions:

  • The synthesized evidence indicates that craniosacral therapy offers no demonstrable benefits for the assessed musculoskeletal or non-musculoskeletal conditions.
  • While two RCTs suggested benefits in children, these findings were attributed to serious study flaws, rendering them likely false positives.
  • Current evidence does not support the use of CST as an effective treatment for the evaluated conditions.