By Caroline Barrow CST-D MCSS
What the Science Says – And What I’ve Seen In Practice
It’s hard to address this question unbiasedly as, having worked with it for over 25 years, I’ve seen so many times when it has (often seemingly miraculously), as well as times when it ‘hasn’t’ – although that in itself brings up a whole other set of questions: what did happen, what didn’t, what was expected, what does ‘work’ even mean?
Let’s assume that ‘it worked’, for now, means some kind of change that the recipient would say was helpful to their body-mind-spirit wellness.
Which, as a question, make ‘does it actually work’ even more nuanced and therefore interesting…
What the sceptics say, and why they have a point
The sharpest critique of CST concerns whether practitioners can reliably agree on what they’re feeling when they palpate – especially when they palpate the craniosacral rhythm. Several studies have tested this, and the results were not flattering! It turns out that we practitioners don’t always agree.
But we’re all feeling something. A subtle rhythm that’s been hard to isolate. Current science suggests that it might be to do with an inherent movement of blood vessels called vasomotion, overlain with influence from the autonomic nervous system. There are different rhythms created through this mechanism and many other body rhythms too. (In fact we are all very rhythmic beings it turns out!) So are we all feeling the same thing? Maybe not. Does it mean we’re not feeling something, the observation of which might help the person (the rhythms are still coming from the person’s own body after)? No, I would argue not.
And even more, this measure is not testing whether patients get better, which is arguably a more important question.
What the outcome research does say
There’s not a lot but…
There are published studies showing significant improvements in pain, anxiety, sleep, and quality of life following CST. Also in fibromyalgia, chronic neck pain and in general chronic pain populations. Some of this research has come from independent university groups with no connection to the training providers (eg the Upledger Institute), some has come from our alumni.
Is it a mountain of evidence? Not published in this way, no. Systematic reviews tend to conclude ‘promising, but more rigorous trials needed’, which is, of course, what they say about most of complementary medicine. But ‘not yet proven beyond doubt’ is a different verdict from proving that it ‘doesn’t work’.
The direction of findings does seem to be consistent…
Why serious scientists are paying more attention
Something has shifted in the last twenty years that’s genuinely exciting, and it has nothing to do with CST specifically.
Fascia research has transformed how mainstream science thinks about connective tissue. Researchers at Harvard and elsewhere have shown that the fascial web – the connective tissue that runs through literally everything in the body – is a dynamic, mechanosensitive signalling system. Touch it, even lightly, and you trigger neurological responses. The idea that gentle manual work on connective tissue could produce measurable biological change is no longer considered fringe – it has a mechanism.
And then there’s the work around trauma, the neuroscience of how safe, attuned, listening, respectful touch settles the nervous system in ways that create genuine conditions for healing. That research is now taken seriously in treatment and mainstream psychology and psychotherapy.
None of this specifically validates CST. But it does mean the theoretical landscape has shifted considerably since the 1990s. The question about whether or not it works can begin to take in different parts of our systems that it might be affecting.
What I’ve seen in my own practice
I’ll give you a few examples.
Early in my career, when I first learned to treat the sphenoid, the butterfly-shaped bone in the centre of our skull that articulates with almost every other in the cranium and face, I volunteered to be the demo in class. When I got off the table, my eyesight had changed. My eyes were clearer and felt as though they were working together in a way they hadn’t been before.
I treated a client once who came in with tunnel vision, double vision, and headaches. He’d seen a few consultants but he medical profession had no answer for him. The following week he came back and told me assuredly that nothing had changed: he still had headaches. I checked my notes from the previous session. “You had tunnel vision,” I said, “and double vision.” He stopped. “Oh,” he said. “I don’t have that any more.” He appeared to have forgotten that that was what had brought him and not noticed it had gone. (This is actually quite common – that people forget the issues they came with as soon as they are gone!)
And then there’s a colleague of mine, a committed sceptic, I would say, who’d had headaches four or five days a week, every week, bad enough to require medication just to keep functioning. He mentioned almost in passing that he’d taken a proper tumble during a fast downhill run (…the wisdom of that being a whole other conversation!) I persuaded him onto the table. After working with various cranial structures (I wish I could remember exactly what happened), the headaches stopped. Not reduced, but went completely.
What still surprises me are chronic fatigue-type presentations. Clients often struggle to move again after staying in one position for too long, so lying still(ish) for an hour is sometimes anticipated to be a challenge. But they often get up with a flexibility and energy they weren’t expecting. CST seems to reach something in their system that helps their body recalibrate in some way. I’m still curious about that, but have seen it happen many times.
Of course, none of that is research, it’s clinical observation. But in my and many of my colleague’s practices, its referrals that keep us in business, so something is happening!
What CST can’t do
It can’t cure everything. Also, sometimes, healing is not the same as curing either.
Obviously, there are conditions that need other interventions, other specialists. There are often times when CST is part of someone’s journey, not the whole of it. What it can do is work with the craniosacral system – cranial and facial bones, the dural membranes – as well as the fascial connections throughout the body, supporting pathways for nerves, blood and other fluid flow, and create conditions for the body’s own healing mechanisms to step back in.
What it also does, reliably, for almost everyone who comes is shift something. Something softens. People find they respond to the world a little more gently; they let go of things, sometimes physically, sometimes emotionally, often both at once. This can be even harder to study, but in 25 years, I’ve seen it too consistently to dismiss it.
The research hasn’t caught up with all of it yet… but it’s getting there.
Written by Caroline Barrow CST-D MCSS
Director of Upledger Institute UK | CranioSacral Therapy Instructor | 30+ Years as a hands-on therapist | Founder of College of Body Science 25+ years developing courses and teaching anatomy, physiology and pathology for complementary practitioners | Passionate about and committed to bringing CST to the world’s awareness and helping people find their own inner wisdom.
