Positive Health Online

Cerebrospinal fluid (CSF) bathes the brain and central nervous system. It is fundamental to the ideas behind Craniosacral Therapy.

William Garner Sutherland, osteopath and student of the founder of osteopathy, A.T. Still, developed the concepts and practice underlying Cranial Osteopathy. He came to call CSF ‘liquid light’ in recognition of the extraordinary qualities of this substance.

Craniosacral practitioners have identified a number of rhythms related to CSF flow. These have come to be known as cranio-rhythmic impulses (CRI) or the involuntary motion (IVM). These range from about 8-14 times per minute to the mid and long tides which are much slower. Of interest is that the fastest rhythm is similar if not the same as the Traube-Hering-Mayer oscillation[1] in conventional physiology which is thought to be the result of entrainment of other body rhythm including breathing and heart rate.

These ideas which may have seemed so far-fetched, from a contemporary point of view are now being reinforced by some recent scientific findings.

Fig 1 The Role of CSF in Facilitating Use of Energy in the Body[2]

Current knowledge shows that 5L per day of CSF is produced. It turns over 3-4 times per day. Extra cellular matrix (ECM) proteins in CSF allow it to be characterised as a liquid matrix.  It is continuous with ECM of brain and interstitial fluid.

Fig 2 Production of CSF in the ventricles

CSF is key in determining the systemic PH balance of the body.  In addition, CSF also Transports Nutrients and Hormones to CNS, plays a role in regulating circadian rhythms, provides guiding cues for cell migration and Instructs stem cells to proliferate or differentiate.

It also helps to regulate, Ionic balance, eliminates waste and provides buoyancy and shock absorption to protect the brain.

Photoreceptors in the CSF fluid chambers echo Sutherland’s characterisation of it as Liquid Light  and Yogananda calls CSF “The Bridge between Spirit and Light.”

CSF is absorbed through the large veins in the brain known as the venous sinuses, the arachnoid villi of the innermost layer of the meninges, the cervical and mucosal lymphatics, the perineural spaces of the peripheral nervous system and through contact with interstitial fluid and capillaries.

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Fig 3 Venous sinuses of the brain [3]

CSF can become stagnant this can be caused by:

• Lack of voluntary motion
• Poor involuntary motion (CRI)
• Toxicity
• Overstretching of the dura
• Spondylitic change with osteophyte development

The relatively recent discovery of the Glymphatic system (GS) in the brain in 2013 has lent credence to the physiological underpinning of CST as a prime factor in health. Up to that point it was thought conventionally that there was mechanism for the drainage of lymph from the brain.[2]

The GS is a network of tunnel-like perivascular spaces that promotes directional, bulk fluid movement through the brain. The increase of glymphatic function during sleep correlates with the prevalence of NREM. Currently 90% of the function of the GS is thought occur during sleep.

Fig 4: Perivascular spaces in the brain opening up to facilitate GS function [4]

Altered states of consciousness may increase function of the GS Including during CST treatment which are characterised by Still Points when the craniosacral rhythm stops during treatment. After the still point the perceived quality of the CRI improves.

Caption: Fig 5 CST Treatment of the Occipital Bone

Here are a couple of typical examples of the benefits of CST in practice.

Peter, 71 came to see me following a concussion 3 months previously. He had no recollection of the incident. He had been walking on uneven ground close to a building site where he was conducting a survey. He was found unconscious and woke up in hospital. He had suffered head injuries to the posterior and superior aspect of the cranium. In addition, there was bruising to the right side of the pelvis. MRI scans showed damage to the cerebral cortex. More recent scans showed scarring in those areas.

It became apparent that cognitive function was impaired, especially to short term memory and the recollection of names. Being resourceful, Peter noted everything he needed to remember down and developed mnemonic strategies for recall.

In addition, he was experiencing mild paraesthesia in his legs and, most prominent on the right and in the right foot.

Following a private consultation with a neurologist he was given a pessimistic prognosis with the story that there will some permanent loss of cognition and his age would indicate that this could be progressive.

He was informed that the paraesthesia was likely due to brain injury and that it may improve in time.

On examination of the cranium, I noted a characteristic pattern of shock in the system. This is expressed as a rigidity or withdrawal of the tissues on palpation. In addition, the sacrum and lumbar spine was restricted. There was a functional scoliosis associated with this as well.

Following the first treatment, Peter noticed improved mood and slight improvement in memory as well as more refreshing sleep. He also reported seeing vivid colours during the treatment, a not uncommon experience and may be related to Zaparetta’s observations.[1]

Fortunately, the memory improved rapidly. In addition to the cranial treatment, I prescribed remedies to help heal the injury. A homeopathic combination for inflammation and a couple of remedy combinations that address brain injury.

Although the picture has not resolved there is sufficient improvement in the symptom picture as to enable almost normal function. Memory is better to the extent that he can resume his career and the paraesthesia has resolved. In addition, the low back discomfort and restriction has gone and the scoliotic pattern resolved.

By supporting the self-healing benefits of CST the combination of the encouragement of better motion within the cranium and the increased function of the GS in treatment encourages the homeostatic tendency towards health.

Anna, 37 suffers with vertigo, migraines and low back pain. She had bacterial meningitis at 11 years of age and had suffered with intermittent vertigo ever since. She currently resolves this with the Epley manoeuvre, although this does not always work.

The migraines started in late teens and is often triggered following neck pains. The headaches are debilitating usually requiring bed rest in a darkened room for a day.

On examination, the right ilium of the pelvis was anterior on the right creating a tilt upwards and forwards.

The cranium was characterized by a torsion of the Reciprocal Tension Membrane (RTM) formed by the infolding of the cranial meninges. The effect of this is to create areas of tension and slackness within the cranium which is understood to affect the vascularity of the tissues and nerve function. In this case the cause was most likely to have been scarring from the meningitis. This in my clinical experience can predispose to symptoms presented in this case.

Torsion of the RTM is often associated with migraines, vertigo and due to the disturbance of the dural attachments in the cranium and upper cervical can create a functional scoliotic pattern. In this case that pattern was a major factor in creating imbalance in the pelvis.

The first session addressed the torsional pattern in the cranium and through manipulation of the ilium the imbalance at the base was addressed as well.

Her low back symptoms resolved very quicky but tended to come back a little between treatments. As would be expected, with the presence of scar tissue in the meninges would mean resolution of the head symptoms would take longer.

Treatment is still ongoing but most of the migraine and vertigo symptoms are significantly better and more stable.

This example shows how derangements of the CS system can throw up  a number of symptoms that do not appear to be linked. Treating the primary cause will benefit the patients in terms of comfort and quality of life.

References

1. http://www.tensegrityinbiology.co.uk/publications/traube-hering-mayer-waves/
2. https://thewayfwrd.com/podcasts/ep-71-cerebral-spinal-fluid-the-bridge-between-spirit-and-matter-featuring-dr-mauro-zappaterra
3. https://commons.wikimedia.org/w/index.php?curid=79731841
4. https://en.wikipedia.org/wiki/Glymphatic_system
5. https://www.cell.com/current-biology/fulltext/S0960-9822(21)01130-1