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Craniosacral Therapy for Migraine

Craniosacral (or cranial sacral) therapy feels the most like witchcraft of any of the migraine treatments I’ve tried. Despite being performed by a massage therapist, CST is nothing like typical massage. Instead, the massage therapist holds your head or rests their hands on parts of your face, then makes almost imperceptible pulsating movements. They run their fingers lightly through your hair, softly stroke your face, and gently tug on your ears. At the end of the session, they cradle your sacrum and maybe run their hands over your feet. The touch is so light that it feels like it couldn’t possibly make a difference. Yet every alternative health care provider seems to recommend it as a migraine treatment and even some conventional providers suggest it.

Providers say CST works by manipulating the bones of the skull and the dura mater (the membrane just below the skull) in a way that relieves cerebrospinal fluid pressure or arterial pressure1. However, many people question whether the bones and dura mater are as flexible as this would require and a recent systematic review of literature showed no evidence for CST’s efficacy2. My quack meter would have me dismissing CST completely if not for the well-regarded headache specialist who told me she believes CST is effective because it relieves the nerve fibers within the sutures of the skull.

Since I’ve been feeling frustrated and thwarted recently in my attempts at migraine treatment, I was receptive when my therapist/naturopath raved about a local craniosacral therapist’s success in treating migraine. The massage therapist was willing to give me a big discount if I came in three times a week out and her office is three minutes from my house. Knowing I wouldn’t be out too much money or time if I tried it for a few weeks and that the sessions would at least be relaxing, I went for it.

I didn’t expect results, not only because the research supporting CST is meager, but because I tried it six or seven years ago with no change to the migraines. I was pleasantly surprised when I left the first session with my pain one notch lower on a 0-10 pain scale than it was when I arrived and it didn’t escalate again that day. Sessions two and three produced similar results, even on the day I’d had a migraine that was gearing up to be a bad one. Unfortunately, I stopped seeing an improvement after third session. I’m not sure if this is because the therapist worked for 45 minutes the first three sessions and only 30 minutes each of the next four, or if my body simply stopped responding to the treatment.

The jury is still out. I’m hopeful that CST will at least provide some relief in acute migraine attacks, even if doesn’t ultimately prove to be a helpful preventive. I’d love to hear from readers who have experience with CST. Does it reduce the intensity or frequency of your migraine attacks? Is it helpful as a preventive therapy or mostly as an abortive?

This article represents the opinions, thoughts, and experiences of the author; none of this content has been paid for by any advertiser. The team does not recommend or endorse any products or treatments discussed herein. Learn more about how we maintain editorial integrity here.

  1. "How does CranioSacral Therapy Work?” The Upledger Institute.
  2. Ernst, Edzard (2012). "Craniosacral therapy: A systematic review of the clinical evidence". Focus on Alternative and Complementary Therapies 17 (4): 197–201. doi:10.1111/j.2042-7166.2012.01174.x


  • ClaudiaPutnam
    1 year ago

    I disagree that a CST professional must be Upledger trained. There are a couple of different schools and philosophies. I do agree that a CS therapist should have received an advanced, multi-year course of training. I am a certified biodynamic craniosacral therapist who went through a rigorous two-year immersion course with lots of hands-on coaching, including 200 practice hours. You can get some levels of Upledger certifications in much shorter periods of time. Biodynamic and Upledger approachers start in different places (Upledger is more mechanical, working on you from the outside, while biodynamic trusts your innate tendency toward health, and works with more subtle processes arising within your body), but both meet in the same place. I don’t think I’ve ever had a session from any type of CST that has ever felt the same, and most of them have been pretty great. A BCST would NOT push on your body with “light pulses,” or would only very rarely do so. We sometimes, with permission, will rock the body to and fro, but this is a grosser manipulation, not involving the bones of the cranium. In general, we wait for the natural rhythm of the cerebral spinal fluid to manifest itself and then work with the patterns that arise until the appropriate shifts occur. Typically, with acute migraine, you look for the pattern of inflammation, help alleviate pressure, and help clear the passages that drain fluids from the brain. As for clearing chronic migraine, there are strategies for calming the nervous system over time. Since no one yet knows what the migraine mechanism is, including me–I get a lot of them myself–figuring out what each individual’s path to fewer headaches will be is…. well, tailored to the individual. I too see near immediate remediation with acute headaches in my clients and have ongoing curiosity about prevention/reduction of chronic headaches. I suspect that that those of us with low thresholds and lots of triggers will have to buckle down on diet. 🙁 I do believe that treatments over time will result in a calmer nervous system overall and I can’t see how this wouldn’t benefit migraine sufferers. Personally, I keep my rates much lower than average–they’re what I myself could afford. Those who pay for three sessions up front get a steep discount. Alternatively, if you pay singly for 3 visits, and then elect to keep coming, ongoing visits after that are also discounted. The hope is that people will be able to afford the care that helps them detune their nervous systems in this ridiculously overstimulating and triggering world.

  • Robert108
    2 years ago

    Kerri, My name is Robert. I practice a type of bodywork called Tibetan Cranial. The work has over 3,000 yeas of history. I have had great results when working with people who experience Migraine Headaches. Tibetan Cranial works to create balance by reading and interpreting pulse points on the head. By accessing and assessing patterns of held tension we work to create space and continuity in the functioning of the various cranial bones.

    A client of mine who has had Migraine Headaches for over 40 yeas, experienced tremendous relief after just one session.

  • Rose
    5 years ago

    Hi Kerrie, I’m 54 years old and have experienced migraines my entire life (at least since age 8 or so). I have tried absolutely everything. At this point, I have managed to reduce the frequency and intensity of migraines (except when the barometric pressure changes, then all bets are off!) The single most helpful treatment I have ever experienced is CST. I agree with one of the other posters who mentioned the importance of having a Upledger trained specialist with experience. Anyone can say they do CST, but it takes great skill to actually work effectively. How it works is far less important to me than that fact that the pain is relieved. While quite effective for a painful headache in the moment, it also had the effect of lowering my overall arousal level. Light, noise, etc. had less intense effect. Over time, I had fewer migraines with less intensity. As I experienced it, my body “remembered” what it was like to not feel over aroused by pain and my entire nervous system was soothed. As with everything else related to migraine, no one treatment is “the” answer. But I urge other migraine suffers to check it out.

  • Dawn Costa
    6 years ago

    Hi Kerrie. I tried CST because initially I received a coupon for a holistic healing center. I suffer from chronic migraines and at that point was open to any treatment. I really tried to not be skeptical after the first treatment. My CST therapist had very little hands on time other than the back of my head. She claimed to be able to feel my blood flow. I didn’t notice any change in pain level. I really gave it a try even continuing for several sessions at $120 per session. After about 5 sessions I just couldn’t justify the cost. However, some therapies work for others and this just didn’t work for me. It definitely is controversial and I understand why. It’s hard to understand how just light touching is going to ease the severe pain of the migraine. Thank you for your story because I really thought maybe I was the only one it didn’t work for or that I was missing something. Still keeping my fingers crossed that I find the right therapy to help with the pain as I’ve tried everything!

  • Lisa A
    6 years ago

    I am a huge proponent of CST. I have been suffering from frequent debilitating migraines for 3 years now since my spinal meningitis and shingles. For the past 2 years I have sought out alternative management in addition to my migraine meds. I take CST and acupuncture. I was very skeptical of both but what a huge difference it has made in my healing process. I receive treatments now once every 2 weeks or so but originally it was a twice a week. My sessions are both at least an hour if not more. Sometimes they are separate treatments and sometimes I receive both at the same time. My two practitioners are AMAZING and work together. That being said, I wouldn’t go to just ANY massage therapist who says she ” does CST”. Practitioners should be advanced trained by the Upledger institute. This is not ” voodoo” but it requires specialized training. For me, I know I would not be functioning as well as I am today. My pain in my head overall has been greatly reduced as well as my frequency of migraines. However I tried several times to abort without meds and hoping the treatment would work alone but no such luck. It is an adjunct to my regimen. However both acupuncture and CST let me feel relaxed and more emotionally stable. My CST practitioner is so informative and has taught me so much that someday I hope to further my education with this. Fortunately when I am in a ” bad way” I can get a treatment quickly which is key. I have even learned to perform CST on myself and find my still point. So, bottom line, if you are blessed to have a knowledgeable practitioner, you will most likely find relief. It is not a quick fix and must be continued over time. The healing process is a slow one and migraine disease is unique and complicated. Good luck!

  • theresadz
    6 years ago

    I haven’t tried extended therapy for migraine but I have tried it for TMJ and it has helped that immensely. I would think that maybe the longer sessions were helping more than the shorter sessions. I know that when my friend was massaging me the shorter sessions never worked as well.

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