Craniopathy is the study of the musculoskeletal system of the skull and its relationship to cerebrospinal fluid (CSF) flow in the brain and cord. The basic theory behind craniopathy is called the craniosacral primary respiratory rhythm. According to this theory there is a fundamental rhythm comprised of combined neurological, cardiorespiratory and musculoskeletal waves. It further maintains that CSF movement in the brain and cord is affected by and driven by these waves. Current research, especially phase contrast upright MR angiograms such as those being done by Dr. Noam Alperin of the University of Florida continue to confirm these long held craniopathic claims.

Craniopathy endeavors to reduce mechanical strains of the skull, especially its base, which is the most important joint area in the skull. Although the joints of the cranial vault, called sutures, close with advancing age the forces acting on those joints continue throughout life. The sutures speak volumes about fluid mechainics in the brain and skull, called cranial hydrodynamics, which I discuss thoroughly in my book. In contrast to the membranous bones, the base the skull, which is made of cartilagenous bone is supposed to continue to remain active and move in concert with the upper cervical spine throughout life. Craniopathy uses a multitude of corrective procedures applied to the facial bones, the bones of the cranial vault and the bones of the base. It also uses specific circulatory techniques designed to drain the skull, such as fourth ventricle bulb compression technique to create a pressure gradient, as well as stuffed sinuses. All of the circulatory techniques are interesting in light of the latest research into CCSVI. Cranial hydrodynamics are extremely easy to feel, as well as affect in infants, babies and young children because their skulls are still open.

Craniopathic correction of the occiput and base of the skull is very similar to upper cervial chiropractic except that the corrective procedures are performed for the most part with the patient supine; that is, face up. Some corrective contacts apply light sustained pressure to the transverse process or posterior arch of the first cervical vertebral called atlas, similar to upper certain methods currently used for upper cervical correction. Sometimes the mastoid bones are also used, which some upper cervical have likewise employed in the past. Additionally sphenobasilar and occipital corrective forces are also used in a similar way, as well as stairsteps and figure eights. Whereas, some upper cervical practioners use sound waves to apply force, craniopaths apply strain and counterstrain positions along with natural and enhanced respiratory rhythm and forces.

Having been trained in both, my opinion is that there are very few truly qualified craniopaths when it comes to serious neurological conditions. In contrast to upper cervical correction which is based on precision x-ray analysis of the strain, analysis of the strain in craniopathy is based mostly on the feel of the treating physician, which is very subjective. The strains are also categorized according to unique terms that are hard to substantiate using today’s technology or even visual inspection. Terms such as sphenobasilar side bending and torsion strains, or temporal bulges for example may be true but hard to prove. Physical anthropological studies would have to be done to determine the validy of such claims. The other problem is most practitioners analyze the strain with patient lying down. In contrast to most craniopaths, because of my background in applied kinesiology I always used specific postural analysis based on plumb lines, pelvic and shoulder levels as well as depth of curve analysis according to AK protocols put forth by Dr. David Walther.

Nonetheless, despite its drawbacks, when performed by qualified experts, especially when combined with specific correction of the pelvis at the opposite end of the nervous and musculoskeletal system, which can be extremely helpful in reducing traction tension from a tethered cord or a pressure conus type condition the use of Dr. DeJarnette’s sacrooccipital blocking technique used with proper respiratory enhancment, is an excellent option in the hands of highly seasoned and skilled practioner with set pre and post objectives and goals. It is a perfect compliment to upper cervical care. Unfortunately, upper cervical practioners don’t use or even consider anything other than the upper cervical spine.

Because of the lack of skilled practioners, I would recommend for now, however, that patients with serious neurological types of problems considering chiropractic care, to find a highly qualified upper cervical practioner who have a better certification and clinical protocols, rather than taking a chance on the uncertainty of craniopathy and questionalble analysis of unclear strains. Upper cervical care has a proven track record and excellent science and research to back it up. Craniopathy does not and there far too many variables, too many unqualified practioners and highly subjective analysis.

In my opinion, craniopathy should belong in the domain of upper cervical care corrective courses since it includes the upper cervical spine and the base of the skull. It also offers a seasoned skilled practioner of specific upper cervical a wide array of additional tecniques to treat unusual and complicated case associated with genetic and other malformations, such as upper cervical fusion and other craniocervical anomolies, that current methods, might not be as effective on. Craniopathy is also great for day old infants strained at birth, and senior senior citizens with issues that might preclude upper cervical care as an options or when x-rays are not practical or available. It also compliments care for certain types of facial issues, such as TMJ and sinus problems to name a few.

The practice of combining craniopathy with specific upper cervical methods, such as high quality sacrooccipital technique further reduces the mechanical strains of the axial skeleton, brain and cord from both ends.