The body is an instrument, the mind its function, the witness and reward of its operation.
-George Santayana
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CranioSacral Therapy (CST) : Chronic Pain and CranioSacral Therapy
“CranioSacral Therapy has proven to be a powerful complement to massage therapy in addressing chronic pain. While massage can effectively address abnormal somatic (body) patterns through the musculoskeletal system, CST approaches somatic disturbances through the craniosacral, fascial and central nervous systems.
Chronic pain can range from mild tissue irritation to intense suffering and disability affecting an individual's entire body, psyche and life. What's more, the perception of pain often persists long after the injured tissue has healed. This can cause compensatory patterns that continue to maintain the sensation of pain, eventually leading to abnormal somatic and visceral [organ] changes that frequently mask the primary cause of the chronic pain.
CST can be used to identify and help the body change core patterns contributing to chronic pain. It also effectively addresses its associated symptoms, such as musculoskeletal imbalance, trigger points, myofascial dysfunction, chronic fatigue, immune system dysfunction, autonomic nervous system dysfunction, elevated heart rate, high blood pressure, endocrine system dysfunction, stress, anxiety, hypothalamic dysfunction and sleep difficulties.
Chronic pain has a multitude of causes, including congenital disorders, spinal disorders, musculo-skeletal imbalance, compensatory patterns, surgery, scar tissue, disease processes, trauma, infection, overuse, disuse and misuse. “The common denominator of conditions that cause chronic pain is irritation of the nociceptive (pain cell) endings, axons, or processing circuits causing abnormal activity that is interpreted as pain.”
Recent research points to central nervous system adaptation as a common contributor to chronic pain. Body tissue often responds to pain through habitual muscle tension, postural distortion, diminished tissue mobility, thickening and congestion of the fascia, decreased blood flow to painful areas, a build-up of metabolic waste products, adverse strain on the peripheral, central and autonomic nervous system tissues, and an overall sense of fatigue.
Can you recall a time you experienced a paper cut or were pricked by a thorn? Remember how sensitive your finger was to touch or perhaps to the slightest movement? The pain receptors in the area became easily stimulated, even with slight pressure. Yet, in a few days, the sensitivity decreased.
With chronic pain, the sensitivity does not decrease. Entire areas of the body might stay in a state of overwhelming sensitivity and pain. Nervous system tissue reacting in this way is referred to as being “facilitated,” which means the pain cells and pain pathways are overly reactive. It's as though a magnifying glass is amplifying a vast and abnormal amount of sensory information into the area. This can then cause abnormal changes in the structure and function of the tissue innervated by the area of the affected spinal cord neurons, thus maintaining the sensation of chronic pain.
The facilitated sensory input might even cascade into other regions of the spinal cord and brain. The overflow of signals can irritate brain regions, leading to the ongoing perception of pain and the symptoms that often accompany chronic pain. Disturbance of the sympathetic division of the autonomic nervous system (sympathetics) often will lead to widespread bodily dysfunction. The sympathetic turmoil also contributes to chronic pain. “The sympathetics control the caliber of most of the vessels of the body. When the sympathetics are hyperirritable in a given area, in a given segment or in a peripheral distribution, there is a tendency for either exaggerated vasoconstriction or vasodilation [constriction or dilation of blood vessels]. This contributes to chaos and the perpetuation of pathology. When you control the blood supply to a given area, you control its life; you control its capacity for recovery, its capacity to survive and maintain its integrity as a tissue.”
The vascular stress caused by sympathetic nervous system imbalance can lead to more tissue aggravation and pain signalling. Also, “the sympathetic nervous system is an important participant in the maintenance of splinting.” Splinting is one way the body tries to avoid feeling pain - by rigidly contracting the muscles so minimal movement will occur. In these many ways, the unbridled responsive region(s) of the central and autonomic nervous systems might maintain the feeling of pain.
Normal tissue mobility is essential for this healing process, which is critical in addressing chronic pain. Enhanced mobility can help normalise vascular flow, decrease metabolic waste build-up, aid normal neural structure and function, de-facilitate affected spinal cord and brain areas, decrease adaptive body patterns that might be maintaining chronic-pain signals, and normalise autonomic nervous system function, thus decreasing abnormal strain on the associated somatic and visceral structures.
All this can help the body decrease the enormous strain chronic pain places on it, and help free the body from related suffering. In this highly individualised way, CST might enhance the body's ability to naturally correct the imbalance and dysfunction that might be contributing to painful patterns. CST can assist the body in changing abnormal tissue-strain patterns residing in the depths of the brain and spinal cord, throughout the musculoskeletal system, and in the body as a whole. CST also can be used in combination with massage and other manual therapies as an effective treatment for chronic pain conditions.
Reference: Tad Wanveer, LMT, CST-D; guest author for John Upledger, DO, OMM
Dr Upledger asked Tad Wanveer, LMT, CST-D, to share his insights on CST
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