The aim of this study was to evaluate the effectiveness of craniosacral therapy on different features in migraine patients.
Fifty individuals with migraine were randomly divided into two groups (n = 25 per group):
- craniosacral therapy group (CTG),
- sham control group (SCG).
The interventions were carried out with the patient in the supine position. The CTG received a manual therapy treatment focused on the craniosacral region including five techniques, and the SCG received a hands-on placebo intervention. After the intervention, individuals remained supine with a neutral neck and head position for 10 min, to relax and diminish tension after treatment. The techniques were executed by the same experienced physiotherapist in both groups.
The analyzed variables were pain, migraine severity, and frequency of episodes, functional, emotional, and overall disability, medication intake, and self-reported perceived changes, at baseline, after a 4-week intervention, and at an 8-week follow-up.
After the intervention, the CTG significantly reduced pain (p = 0.01), frequency of episodes (p = 0.001), functional (p = 0.001) and overall disability (p = 0.02), and medication intake (p = 0.01), as well as led to a significantly higher self-reported perception of change (p = 0.01), when compared to SCG. The results were maintained at follow-up evaluation in all variables.
The authors concluded that a protocol based on craniosacral therapy is effective in improving pain, frequency of episodes, functional and overall disability, and medication intake in migraineurs. This protocol may be considered as a therapeutic approach in migraine patients.
Sorry, but I disagree!
And I have several reasons for it:
- The study was far too small for such strong conclusions.
- For considering any treatment as a therapeutic approach in migraine patients, we would need at least one independent replication.
- There is no plausible rationale for craniosacral therapy to work for migraine.
- The blinding of patients was not checked, and it is likely that some patients knew what group they belonged to.
- There could have been a considerable influence of the non-blinded therapists on the outcomes.
- There was a near-total absence of a placebo response in the control group.
Altogether, the findings seem far too good to be true.
The techniques were executed by the same experienced physiotherapist in both groups.
2.4.1. Craniosacral Therapy Group
35 minutes total treatment:
• 10 min Suboccipital inhibition technique.
• 5 min Frontal technique.
• 5 min Sphenoid technique.
• 10 min Fourth ventricle technique.
• 5 min Lumbosacral technique.
2.4.2. Sham Control Group
10 minutes treatment: Placebo intervention. A hands-on placebo superficial contact was performed by placing both hand palms under the occiput for 10 min, without touching the suboccipital muscles. No force, pressure, or movement was performed.
I wouldn’t call that placebo intervention a sham control for the craniosacral therapy intervention.
Wow. 20 more minutes of messing with someone’s head made that much of a change in those outcomes? That’s one heck of a placebo.
or one heck of a bad study