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

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.