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Cranial Osteopathy FAQs

Richard A. Feely, D.O., FAAO, FCA, FAAMA

Q. What is cranial osteopathy?

A. Cranial osteopathy is a sub-specialty of osteopathic manipulative medicine performed by a physician. This sub-specialty deals with subtle motions of the body through the cranial sacral mechanism. It is a gentle and powerful system, part of osteopathic medicine, that uses the patient's own inherent forces to overcome membranous, articular, ligamentous strains in the body. It is a diagnostic and treatment method for soft tissue injuries and especially cranial and sacral structures.

Q. What is the cranial rhythm?

A. It is a cyclic expansion and contraction of the membranous tissues of the body that occur 8 to 14 times per minute. It is distinct from other known pulses of the body, i.e., the heart and respiratory. It can be felt at all parts of the body by a skilled cranial osteopath.

Q. Who performs cranial osteopathy?

A. Cranial osteopathy is an osteopathic technique devised by William Garner Sutherland, D.O., originating in 1899 and popularized in the 1940s to this day. It is a technique performed by osteopathic physicians.

Q. What is cranial sacral therapy?

A. Cranial sacral therapy is the use of manual techniques performed by therapists to unwind membranous articular strains of the cranial sacral mechanism. Originally developed by William Garner Sutherland, D.O., popularized by John Upledger, D.O., and may be performed by any therapist trained in this manner.

Q. Who would benefit from cranial osteopathy?

A. Many patients with a variety of conditions would benefit from cranial osteopathy, primarily persons with soft tissue injuries with membranous articular strains to the head, torso and extremities. It is a part of the osteopathic manipulative medicine physician's armamentarium in treating the whole body from a biomechanical perspective, therefore, a patient suffering from biomechanical dysfunction causing disease such as asthma, sinusitis, ear-nose-throat problems, cerebral palsy, cranial synestosis, plageocephalgy and muscle tension headache would benefit from the use of cranial osteopathy.

Cranial osteopathy works on the basis of unwinding the membranous articular strains that are present in the body thus removing the biomechanical restrictions that prohibit fluid flow, improve circulation and restore normal homeostasis to the body part and structure.

Q. What are the contraindications to cranial osteopathy?

A. Patients with no biomechanical problems and patients with an aversion to being treated or touched.

Q. How does it feel while being treated?

A. The physician places a very light touch on your head, spine and sacrum examining the cranial rhythmic impulse and verifying the areas of the body where the impulse is restricted. The physician gently unwinds the membranous articular strains with his/her hands. When that happens, the patient may feel a slight sensation where the physician's hands are placed, otherwise, there is no sensation of pain or any other activities while he/she is performing these maneuvers on your body.

Q. What is cranial manipulation?

A. Cranial manipulation is the application of an osteopathic physician's hands to the body, palpating the cranial rhythmic impulse—also known as the primary respiratory mechanism, or third pulse of the body. The physician determines the rate and amplitude of the cranial rhythmic impulse, or lack thereof. Then, subtle pressure is applied to the body part to enhance the movement of fluid and energy to that area. After the connective tissue and the fascia (a web-like covering over all muscle and tissue) are released from tension, the cranial rhythmic impulse will have free rein and health will be restored to that body part.

Q. How does cranial manipulation work?

A. The body produces cerebrospinal fluid, which fluctuates 10 to 14 times a minute within the dura mater—the covering of the brain and spinal cord. The billions of brain cells expand and contract, which electrically and biochemically and hemodynamically cause a perceived pulse—the cranial rhythmic impulse.

Because of the articular design of the 22 bones of the skull, motion is permitted. The articular design of the sacrum (at the base of the spine) between the ilea or hip bones permits motion down the spine. Because the membranes covering the brain and spinal cord have elastin tissue and are allowed to expand and relax, the cranial rhythmic impulse can be felt. The amount of movement can be measured in millimeters and can be felt in all parts of the body by a skilled cranial osteopath.

Q. What can I expect to feel during and after a treatment?

A. During a treatment, you can expect to feel subtle pressures on the head, spinal column and tailbone. You may also feel a slight pounding of fluid under the doctor's hand. After a treatment, you may expect to feel overall general well-being, as well as relief of some or all pain.

Q. Do some patients feel cranial manipulation more strongly than others?

A. Yes. Generally speaking, the more out of balance a patient is, the more he or she will feel the cranial manipulation. Some people are also more sensitive than others.

Q. How long are the treatments?

A. Cranial manipulative treatments typically take 10 to 30 minutes.

Q. How frequently should I get a treatment?

A. Depending on your condition, treatment may be recommended once or twice a week on an outpatient basis. As your condition improves, treatments should taper to twice a month, then once a month, and finally to three or four times a year for preventive maintenance.

Q. Are there any after-treatment restrictions?

A. It is not good to do heavy exercise, consume alcohol, eat a heavy meal or engage in sexual activity within 12 hours after a treatment.

Q. What is the duration of the relief? Can it be permanent?

A. The duration of relief can be from hours to days, and generally increases with successive treatments. Pain relief can be permanent.

Q. What should I bring with me to my first appointment?

A. You should bring any x-rays, MRIs, MRAs, CT scans and PET scans with you on your first cranial manipulation visit. Also remember to bring any laboratory and neurodiagnostic studies, such as EEGs, EMGs and NCV-SSEPs.

Q. What age range benefits most from cranial manipulation?

A. The younger the patient, the more benefits he or she receives from cranial manipulation. The best results are found in patients in the first six months of life, followed by age six months to two years, age two to six, and age seven to 18. With each successive decade, a patient will usually need longer and more frequent treatments to achieve the desired results.

Q. Which illnesses respond best to cranial manipulation?

A. Cranial manipulation is very effective in treating any mechanical trauma to the head or tailbone. Birth trauma responds the quickest and most completely to this form of treatment.

Q. What is Dr. Feely's success rate with cranial manipulation?

A. Most patients are greatly improved or cured within six to eight visits.

Q. Is there a clearinghouse for osteopaths who practice cranial manipulation?

A. Yes. The Cranial Academy can give you a list of competency-tested cranial osteopaths in your area. For physician referrals, send a self-addressed, stamped business-size envelope ($0.55 postage) to:

The Cranial Academy
8202 Clearvista Parkway, #9-D
Indianapolis, IN 46256

Please include the city and state for which you are requesting referrals.

The Cranial Academy will also fulfill requests for physician referrals by e-mail or fax for a $10 charge; Visa and MasterCard are accepted. Requests are fulfilled within 24 hours.

To request a referral by e-mail, contact:
Fax referral requests to: 317/594-9299

Q. Can any osteopath perform cranial manipulation?

A. Yes. Any licensed osteopath is able to perform manipulation, including cranial osteopathic manipulation. But all osteopaths are not highly skilled in this specialized form of treatment. Contact the Cranial Academy at the address above for a referral to an osteopath who is skilled in cranial manipulation.

Q. Are there specialists within osteopathic medicine?

A. Yes, there are osteopathic specialists in all recognized medical specialties, from obstetrics, neurosurgery and cardiology to family practice. Most DOs are family practitioners. A few, like Dr. Feely, specialize in osteopathic manipulation.

Q. Can there be a change in the body's reaction to prescription drugs while undergoing this treatment?

A. Yes. When a person is under the influence of a narcotic, cranial osteopathic manipulation often takes longer, more frequent treatments.

Q. Does Dr. Feely work in conjunction with MDs to balance a patient's prescription drugs and overall treatment?

A. Yes. Dr. Feely recognizes the importance of all of your health care providers understanding your treatment regimen, as well as being aware of any and all prescription medications you may be taking. If you need additional medication or changes in your medication, Dr. Feely will be happy to speak with your physician or prescribe it himself.

Q. Is it realistic to expect to be prescription drug-free after successful treatment?

A. Not all patients will have total relief with osteopathic manipulation. Some patients may need to continue a few prescription drugs. However, most patients will decrease their amount of medicine dependency, as well as the need for painkillers and other frequently used drugs such as migraine medications.

Q. What is the price range for cranial osteopathic manipulation treatments?

A. Dr. Feely normally performs cranial osteopathic manipulation in conjunction with total body osteopathic manipulation treatments. For price information, please contact our office manager, Farida Charania, at 312-266-8565.

Q. Is a referral from an MD necessary for cranial osteopathic manipulation?

A. No.

Q. Does medical insurance cover osteopathic manipulation?

A. Yes, most medical insurance covers osteopathic manipulative treatment when the claim form is properly coded and the insurance company applies the proper definition to those codes, and does not self-impose any restrictions on manipulation. Some insurance plans allow only about $1,000 of treatment per calendar year; other plans do not pay for an office visit and osteopathic manipulation performed on the same day.

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