Cranial Manipulation and Head Pain

By Darryl Curl

Dr. Woolery writes: "Wow! I had planned to wait until I finished your book before I wrote you but the chapter on posture and head pain blew me away ... so I am writing you immediately." Dr. Woolery goes on to write about upper cervical technique and his experience with it. Of interest is his affirmation of the reflex disturbance of upper cervical function and posture. It appears that Paul Chek's chapter we discussed last month was right on target for him. Let's see if we can make it two in a row and look at another chapter of keen interest to chiropractors.

Herein are excerpted (with permission) many clinical gems contained in Dr. Jack Ebner's excellent and very thorough chapter, "An Overview of Cranial Manipulation." Dr. Ebner discusses the basis of cranial manipulation in the relief of headache.

"Cranial manipulation has been controversial within the manipulative arts since the mid-1930s when it first appeared along parallel lines of development in both the chiropractic and osteopathic professions. Misperceived and misunderstood, cranial techniques have been relegated to esoteric status and are rarely if ever included in the required curricula of any chiropractic college. Deemed irrational by those who perceive the cranium as a fused whole, cranial manipulation has been widely classified as an intuitive technique with no basis in scientific knowledge.

"Interestingly, objective studies in recent years have supported the findings of the early pioneers in the cranial field. Practitioners of cranial therapeutics are achieving results in various cases where conventional treatments were ineffectual.

"Several chiropractic colleges now offer postgraduate courses in cranial therapy. Cranial techniques also make up an important basis for several of the most commonly practiced systems techniques in chiropractic (including sacro-occipital technique, applied kinesiology, and activator technique).

"Sutherland's work is the basis for osteopathic cranial manipulation. Several tests on the topic of cranial manipulation have appeared in the last few years. And chiropractic, osteopathic and dental journals have published more articles relating to the field craniopathy in the last five years than in the entire history of the field.

Dr. Ebner goes on to explain cranial techniques:

"The temporosphenoidal corkscrew is a classical musculosutural countertorsion technique and acts over the articulation between the frontal, temporal, sphenoidal, and parietal bones. It also acts directly over the belies of the temporalis muscles. The temporalis muscle crosses over four cranial bones and inserts into the coronoid process of the mandible. It is involved in almost all biting problems. It is one of the main connections between jaw problems and headaches, especially temporal headaches.

"The effect of this technique may be to (a) remove structural stress from the cranial bowl, (b) mobilize rotation of the temporal bone, and (c) stretch the temporalis muscle, thereby relaxing tension over underlying articulations.

"Heels of the hands or metacarpal area are used as a contact over the greater wings of the sphenoid or over the temporal bone. A countertorquing pressure is maintained by both hands. Light pressure may be used. Countertorsional mobility may be motion palpated, and any restrictions may be corrected with this adjustment. Temporosphenoidal corkscrew may be performed in both directions as a general mobilization procedure for the cranials.

With each article, I encourage you to write the questions you may have, commentaries on patient care, or thoughts to share with your colleagues, to me at the following address. Please include a stamped, self-addressed envelope.

Darryl Curl, DDS, DC
2330 Golden West Lane
Norco, CA 91760