When patients have back pain that has been chronic and spreads across the length of the back, it is often difficult for those patients to determine its origin. For many patients with chronic pain that worsens over the years, it may seem practically impossible for a doctor to diagnose their actual condition and cause, much less for patients to have a successful self-diagnosis. This is because back pain that travels along the length of the spine is not as easily diagnosed, nor can it always be pinpointed to a previous injury or condition. Conditions of pain that are isolated to a specific portion of the back are typically due to an injury, but what should patients do if they cannot specify the event in which an injury occurred or if they have no recollected diagnosis of a back pain condition?
Unfortunately, the confusion surrounding general back pain is not only due to the inability to detect the cause, but it also reflects the early stages of research into craniosacral pain. One of the most common and least understood conditions of pain stem from the craniosacral system– a system of nerves that many don’t realize are connected to a wide variety of pain conditions. So, what is the craniosacral system? How does it relate to physically painful conditions? What are some treatment methods for the pain related to the craniosacral system?
The craniosacral system is only recently understood and its relevance to other various forms and conditions of pain have recently come to the forefront in the search for pain treatment. Other, more familiar, systems in the body– like the cardiovascular or respiratory system– have centuries of research to back up our understanding of their function and maintenance in the body. However, all of these systems, including the craniosacral system, deserve a high level of attention and study if we are to understand the primary causes and adjustment of pain. Each system plays a role in maintenance and regulation of the body on a constant basis, but the maintenance and regulation of pain is entirely dependent on the craniosacral system.
A study examining the prevalence of craniosacral pain asserts that, “[c]hronic pain disorders are the leading global cause of disability and are still increasing in prevalence. Low back and neck pain, headache and migraine considerably affect all age groups from the beginning of adolescence to middle-aged and older adults. The often limited effects and potential side effects of pharmacological treatments for chronic musculoskeletal pain conditions may be reasons why patients frequently use complementary therapies” (2020). With craniosacral difficulties leading not only to general back pain but headaches and migraines, one can begin to understand why our understanding of the craniosacral system is crucial to mitigating its painful conditions. So, what is the craniosacral system?
We can imagine the craniosacral system as a highway that extends from the base of the skull (cranio, or cranium) to the bottom vertebra of the spine (sacral, or sacrum). Simply put, the system consists of the entirety of the spine, so it should not be surprising to find a growing number of pain conditions attributable to the craniosacral system. This highway of nerves is a major part of our central nervous system (CNS) and branches out into other roads and paths of nerves that extend to our peripheral nervous system at the ends of our fingers and toes.
Every instance of pain is tied to our CNS and the CNS is how the pain we feel is communicated to our brain. If we feel pain in our hand, the CNS sends a message of pain to our brain so that we recognize the problem and seek treatment. However, even though the signals run along the craniosacral system, this does not mean that we will feel the pain travel from our hand to our spine and finally our brain. The brain recognizes the affected nerve endings, and the pain is localized to the affected areas. For this reason, we should not always assume that every pain condition is related to the craniosacral system.
One of the most basic causes of craniosacral pain is what researchers are calling “malalignment”. Malalignment in the sacral region is common among more sedentary lifestyles with a lot of sitting. If you think of the sacral bone as a three-dimensional bone being supported by tension pulling it in all directions, you can visualize that the sacrum can get turned and twisted in a variety of ways that agitate and pull or pinch nerves all around the region. Sacral torsion is a term you may hear to refer to this concept. In some cases, a torsion is so visible that you can see a corner of the sacral bone pushing out of the back, forming a lump on the low back when a patient bends over and stretches the area. If you see or feel a lump pushing out on one of the four corners of the sacral bone that would be and example of a malalignment that can cause craniosacral chronic back pain. Dr. Ghasemi Cobra and his associates explain that malalignment, “. . . in the pelvic and spinal column disturbs the balance and decreases the postural control ability. Malalignment is known as one of the main causes of back pain particularly the nonspecific chronic low back pain” (2020). Craniosacral pain is certainly what patients would refer to as “nonspecific” and as was mentioned previously, this nonspecificity leads to difficulty in diagnosing the cause. However, as Dr. Cobra and his associates conclude, malalignment may be one of the largest contributing factors to craniosacral pain.
The physicians go on to suggest that “[m]alalignment in the pelvic and spinal column regions exists in 90–80% of the adult population. Malalignment leads to asymmetry in bones and joints in pelvis, trunk, and limbs and affects the muscles and lower limbs and disturbs the balance and decreases the postural control ability. It is known as an early and significant cause or an exacerbating factor in 50–60% of people suffering from back pain particularly the nonspecific chronic low back pain (NSCLBP) which is the most common form of low back pain”. With most of the adult population suffering from malalignment of the spinal column, is it any wonder that patients experience indecipherable back pain? Is it any wonder that research into craniosacral pain has increased exponentially?
Along with malalignment leading to the imbalance and asymmetry of other bones, joints, and limbs, it will typically lead to other conditions related to craniosacral pain. These conditions include and are certainly not limited to fibromyalgia, migraines, multiple sclerosis, insomnia, and general neck pain. While these are the most common conditions related to the craniosacral system, the list is seemingly endless. As was previously mentioned, and because we are learning more about the craniosacral system every day, many will falsely attribute their pain or medical condition to the craniosacral system when their condition requires treatment which is entirely unrelated. This is why craniosacral treatment should focus on the affected area between the base of the skull and the base of the spine.
A quick note on malalignemnt and chronic craniosacral back pain. Many non-physician providers will attempt to treat craniosacral back pain with spinal adjustments such as chiropractic adjustments and special stretching and massage. These techniques should help for sure but in most cases these are temporary relief. Many patients suffering from these conditions describe having to seek these treatments continually. One patients described it as an endless cycle of chiropractic visits with no other option but to keep coming in and the results don’t always last very long. Stretches and massage help also, but these are similar scenarios of temporary relief and the requirement for patients to come in forever. Is it any wonder that these service providers are quick do diagnose craniosacral pain as the problem, because the only current treatment is an ongoing cycle of adjustments and massage. Patients may be fine with this for a while, but ultimately, they will want some sort of relief that lasts.
When pain travels along the spine like this, and splits off into various parts of the body, it can seem almost impossible to find a treatment that can both target and mitigate the pain. Neuragenex has developed the field of Neurofunctional Pain Management as a treatment for chronic pain conditions of all kinds. Neurofunctional Pain Management is a treatment protocol that utilized external high pulse electrical stimulation and specialized hydration therapy to relieve pain and retore health to a point where patients can get back to an active lifestyle and be motivated to engage in healthier lifestyles and activities, which will magnify the patients quality of life. Patients with craniosacral pain can be treated across the entire spine top to bottom using high pulse electrical stimulation. This treatment creates a sustained depolarization effect that relieves pain for a prolonged period of time. Nutritional hydration therapy helps retore health and reduce inflammation that may be exacerbating the pain condition. Also, it’s perfectly fine to continue to receive adjustments and massages from non-physician providers while going through a course of treatment with Neuragenex. The mission of Neuragenex is to relieve pain, restore health, and magnify quality of life without drugs, surgery, or invasive procedures. Our vision is to be the fist though, first choice, and fist step in the journey of chronic pain relief.
Ghasemi, C., Amiri, A., Sarrafzadeh, J., Dadgoo, M., & Maroufi, N. (2020). Comparison of the effects of craniosacral therapy, muscle energy technique, and sensorimotor training on non-specific chronic low back pain. Anaesthesia, Pain & Intensive Care, 24(5), 532-543.
Haller, H., Lauche, R., Sundberg, T., Dobos, G., & Cramer, H. (2020). Craniosacral therapy for chronic pain: a systematic review and meta-analysis of randomized controlled trials. BMC musculoskeletal disorders, 21(1), 1-14.