Treatment of the long term after effects with cranio-sacral therapy.

So many people feel that they have never fully recovered from some infection — be it a major illness or an apparently insignificant viral infection — and they are left with a lingering sense of unwellness, or sometimes with severely debilitating symptoms. Such symptoms are frequently dismissed as inexplicable or insoluble, but they are often due to residual effects on the meninges, and relief of symptoms can often be obtained through treatment of the meninges with cranio-sacral therapy.

Meningitis is an inflammation of the meninges or membranes surrounding the brain and spinal cord, usually due to a viral or bacterial organism which invades the meninges leading to inflammation and consequent scarring of these membranes.

In its most serious and clearly recognisable form it leads to multiple symptoms most commonly affecting the head and neck (but potentially anywhere in the body) most notably headache, neck pain, nausea, vomiting and a characteristic retraction of the neck (as if the head were being forcibly pulled back by contracted tissues). In babies and children in particular meningitis can be fatal.

In the majority of cases the acute symptoms of meningitis pass within days or weeks once the infection and inflammation have subsided, or have been treated. But in many cases residual symptoms persist - sometimes mildly, sometimes severely - sometimes immediately, sometimes emerging months or even years later, and often deteriorating steadily as time goes by.

Even when only mild symptoms persist patients with a history of meningitis may say that they have never fully recovered, or never felt quite the same, since the time of the original infection. The persistent symptoms are often not regarded as being related to the meningitis and are often dismissed as malingering or stress related, perhaps primarily because no obvious explanation or solution is apparent.

Undiagnosed sub-clinical meningitis.

Most severe cases of meningitis are clearly recognisable. What is not so readily recognised is that there is a far greater number of cases in which meningitis is not identified or diagnosed and yet a milder infection and inflammation of the meninges has occurred.

Sometimes this is identified subsequently as meningism or sub-clinical meningitis, but more often it is not recognised at all. Such cases may arise from a simple cause such as a common cold, flu, an ear infection, a digestive upset, an unidentified virus, or indeed from any infection.

The initial symptoms are blurred under the more blatant symptoms of the primary infection and the persisting failure to recover is simply unexplained or dismissed as psycho-somatic.

Once again, the most common symptom pattern is persistent headache, neck pain, visual disturbances, photophobia, nausea, vagueness, poor concentration, poor memory and a general sense of malaise and unwellness. Again the symptoms may arise immediately following the primary infection, or may arise at a later date for no identified reason, or may deteriorate steadily as time goes by.

Dismissed as psycho-somatic.

The repeated dismissal of the persisting symptoms as psycho-somatic, or stress related, is in itself stressful and distressing for the patient, who initially feels certain that they are not due to stress, but with the constant repetition of such a mis-diagnosis, perhaps from many different sources, and with no identifiable physical diagnosis, may begin to doubt their own perception and even their own sanity.

Like all disease conditions this syndrome is likely to be aggravated by stress but in the majority of cases the condition can be clearly distinguished from stress related tension by its specific location, its pattern within the patient’s day to day lifestyle, its history, and other individual factors readily elicited through taking a proper ease history.

Undoubtedly a large number of people will be able to identify with the picture described above, with the discomflting and debilitating condition, the persistent and often unrelenting nature of the symptoms, the lack of proper diagnosis, the lack of response to a variety of different therapeutic approaches, the lack of an apparent solution, the frequently patronising dismissal of the condition as psychosomatic, and the generally debilitating effect on the quality of their whole life.

Fortunately there is a solution - and generally a relatively simple and quick solution, through treatment of the mininges with cranio-sacral therapy.

The meninges.

The meninges are comprised of three layers of membrane surrounding and enveloping the central nervous system. The innermost layer, the pia mater, forms a soft, closely adherent skin around the brain and spinal cord.

The middle layer, the arachnoid mater, carries a network of blood vessels to supply the brain and spinal cord. The outermost layer is the dora mater, or dural membrane, a watertight sheath which contains and encloses cerebro-spinal fluid, a fluid which surrounds and bathes the central nervous system, providing nutrition and drainage for the central nervous system and creating the medium within which the central nervous system grows, develops, and functions.

This dural membrane attaches to all the bones of the cranium forming an inner lining (or periosteum) for the cranial bones. It also attaches to the sacrum and coccyx and to the 2nd and 3rd cervical vertebrae, C2 and C3. Apart from these firm bony attachments the dural membrane in its normal healthy state is freely mobile, able to float in response to moveinents of the body (thus accommodating the normal bending and twisting of the spinal column), and also in response to fluctuations of cerebro-spinal fluid within the membrane.

Scarring of the meninges impinges upon nerves.

In meningitis, meningism or sub-clinical meningitis, inflammation of the mininges leads to scarring and sclerosis (or hardening) of the membranes, which in turn creates tightness and restricted mobility within the membrane.

Due to its bony attachments, any tension or restriction to the dural membrane is likely to exert pulls on the various bones to which it attaches, leading to possible misalignments and compressions of the bones which may in turn impinge upon nerves and restrict arterial supply, venous drainage, lymphatic flow or cerebro-spinal fluid flow.

In view of its attachments these compressive effects will be most significantly felt in the upper cervical regions where the dura attaches to the occiput and to the 2nd and 3rd cervical vertebrae (hence also the forceful retraction of the neck in acute meningitis).

Consequent impingement of nerves and blood vessels in this region would particularly affect: the vagus nerve Cr X

- causing nausea, headache, sickness, and visceral disturbances; the accessory nerve Cr XI - causing contraction of the sterno-mastoid and trapezius muscles; the cervical nerves - causing pain and tension from the occiput-atlas joint at the back of the head to the cervical musculature; the jugular vein - causing restricted venous drainage from the brain, with consequent congestive headaches, vagueness and haziness; the vertebral artery - causing reduced arterial supply to the brain, with consequent poor concentration, vagueness, dizziness and headaches.

Also, nerves to all parts of the body must penetrate the dural membrane as they enter or leave the spinal cord. Tensions or contractions in the dural membrane can therefore constrict the nerves as they penetrate the membrane bilaterally throughout its length.

This constriction is likely to have a particularly significant effect in the localised area affected by inflammation, causing localised symptoms and symptoms along the pathway of the affected nerves. However, the effects will not be limited to local symptoms, particularly if the inflammation is severe, for the following reasons:

Firstly, the membrane system is a reciprocal tension membrane system, indicating that tension anywhere in the membrane will be reflected reciprocally to all other parts of the membrane system. So any contraction anywhere in the dural membrane will cause abnormal pulls and tensions throughout the meninges, potentially impinging upon nerve outlets anywhere in the system. with consequent effects both locally and in the structures supplied by the affected nerves. This will particularly activate any previous weaknesses or lesioned areas.

This may affect not only spinal nerves but also cranial nerves emerging through the dura within the cranium. So for example, the optic, ophthalmic, trochlear and abducent nerves which supply the eyes (along with the sympathetic and parasympathetic nerves responsible for dilation and constriction of the pupils and focusing of the eyes) might all be affected with consequent disturbances of vision, photophobia and poor focusing.

Or there might be impingement of the vagus nerve, which supplies most of the viscera in the thorax and abdomen including the heart, lungs and most of the digestive system, and which is commonly associated with nausea, headache and sickness.

Generalised tightness in the head.

Secondly, contraction anywhere in the membrane causing decreased flexibility, may lead to a generalised tightening of the membranous sheath around the brain and spinal cord, thereby interfering with central nervous system function (a feeling of tightness and contraction within the head is often described by patients with this condition).

Thirdly, hardening or sclerosis of the membrane may cause disturbances of cerebro-spinal fluid flow, locally or generally, and since cerebro-spinal fluid provides nutrition and drainage to sustain the central nervous system, this may have deleterious effects on central nervous system function.

Fourthly, restriction of the membrane may lead to impingement on blood vessels - either directly on the vessels themselves, or indirectly through its effect on nerves which supply blood vessels - thereby restricting arterial supply, venous drainage and lymphatic flow to affected parts of the body with consequent deterioration in function.

This sclerosis or hardening of the membrane if untreated is likely to increase with time, since the reduced mobility and reduced local fluid flow - arterial, venous, lymphatic and cerebrospinal - will prevent proper nutrition to the area and lead to continuing expansion of the fibrosed area around a local fibrosed focus. It is for this reason that the patient’s symptoms deteriorate as time goes by, or perhaps only appear some time after the initial episode.

The cranio-sacral system.

The dural membrane forms a vital integral part of the cranio-sacral system. The cranio-sacral system consists of the dural membrane, with its associated structures - the bones of the cranium and sacrum, the cerebro-spinal fluid and the fascia which emanates to all parts of the body from its connections to the dora at the spinal cord.

All these structures pulsate together in a symmetrical rhythmic motion known as the cranial rhythm. Any disturbance of function within any of these structures can be palpated by the experienced cranio-sacral therapist as a disturbance to this symmetrical rhythmic motion, and the exact location of the restriction can be identified. For example, inflammation of the meninges in the upper cervical region on the right would create a focal point of restriction towards which the cranio-sacral motion would pull. Distarbance of function can be diagnosed and treated through the cranio-sacral system

Disturbances of function anywhere in the body (not just within the cranio-sacral system) are reflected through the fascial and dural pathways into the cranio-sacral system. Similarly, distortions within the cranio-sacral system reflect out through the dora and fascia to influence and affect all parts of the body.

Consequently, the cranio-sacral practitioner can, by tuning into the asymmetries and distortions of the cranio-sacral system, make a detailed diagnosis of the whole body, and by correcting imbalances can restore proper functioning to all parts of the body thereby treating a very wide variety of conditions.

The cranio-sacral system is extremely subtle. Its movements can only be palpated with a correspondingly subtle touch. When more forceful or heavy handed therapies are applied the cranio-sacral system simply puts up its defences and shuts them out.

Having tuned in to the subtle movements of the cranio-sacral system through this exceptionally gentle contact, the cranio-sacral practitioner can then influence and release the affected restrictions by gently rebalancing the subtle twists, pulls and asymmetries reflected through the system.

Exceptionally gentle and subtle.

In the case of the meningeal effects with which we are concerned here, treatment would involve firstly, in accordance with the principles of cranio-sacral therapy, following the pulls exhibited by the membranes, to a point of slacking off when the restricted tissues would be able to unhook and release themselves; and secondly, applying the gentlest of traction to the affected area of membrane in order to stimulate a process of release and opening out.

One very valuable technique which might be used in these circumstances is the technique for the release of tension within the falx cerebri (and consequently tensions throughout the reciprocal tension membrane system).

With the patient lying on his or her back, the practitioner places one hand under the occiput with the fingers extending caudally under the neck; the other hand is placed over the frontal bone, the fingers extending towards the face (taking care not to cover or discomfort the eyes)

As the practitioner tunes in, various subtle pulls and twists will manifest, some of which may be superficial and transient, others more profound and persistent. If the practitioner allows his hands to be very gently drawn into these subtle patterns, he will eventually find himself drawn to a barrier or point of resistance.

If he waits patiently at that barrier, the resistance will eventually unlock, dissolve, and slacken off, allowing the cranium to return to a more easeful, freely mobile, fluent, and symmetrical state.

Another technique that would be particularly suitable in the treatment of these meningeal effects is dural tube traction from the occiput.

Having first ensured that the cranial base is released by various means, the practitioner places his or her hands so that the occiput is resting lightly onto the fingers, with the tips of the fingers projecting slightly beyond the base of the occiput.

Then simply thinking the occiput away from the vertebral column will provide sufficient stimulus to initiate a very slight subtle traction which will very gently stretch the dural membrane as it passes from its attachments around the foramen magnum at the base of the skull, through the vertebral canal clown to the sacrum and coccyx.

The experienced cranio-sacral therapist can direct the therapeutic effect as required, focusing the attention on appropriate areas of resistance and monitoring the response and release of the cranio-sacral system.

This traction is so gentle and subtle that by the standards of any other therapy it would not be considered as traction at all. Anything more forceful will again only lead to resistance from the body. Only by approaching the membranes in this exceptionally gentle way, with a subtlety and sensitivity that must be developed by the practitioner through regular and consistent practice, will the cranio-sacral system respond.

Using this approach is very effective, often rapid and dramatic. Countless examples would be possible but a few brief case histories will demonstrate the point.

  • A young man aged 26 suffered from constant persistent headache emanating from the base of the skull on the right hand side, radiating up over the head to the right eye, also spreading down into the neck, sometimes accompanies by nausea and migraine attacks. The headache had been with him every day for over a year. He awoke with it every morning and it tended to become more severe as the day progressed.
    He was leading a pressurised life (which he enjoyed) but the symptoms showed no relationship to the fluctuations of pressure or relaxation in his life.
    He had contracted viral meningitis 15 years previously at the age of 11 since when he had suffered migraine attacks and blurred vision.
    Cranio-sacral diagnosis immediately identified the affected area of the meninges. After one treatment he reported virtually complete relief from symptoms with just slight headache occasionally.
    Two further treatments removed the residual symptoms and he was able to continue his pressuriscd but enjoyable lifestyle to its full extent.
  • A girl of 13 suffered from persistent headache, nausea, neck pain, dizzy spells, intense pain behind the right eye and in the right temple, tiredness, poor concentration, poor memory, reduced mental function, fatigue and a general feeling of being constantly unwell and unable to carry on a normal life. Her condition had arisen from a viral infection nine months previously.
    She had been off school for a term and a half. When she did try to go to school she invariably returned halfway through the day unable to carry on.
    She had previously been a bright and intelligent girl; it was now being suggested that she would have to stay clown a year at school because she was so far behind.
    Numerous medical tests over several months had revealed nothing. Acupuncture treatment had not helped. Some suggestion of psychosomatic causes and malingering had been suggested but nothing about her personality was consistent with such a suggestion and it was not seriously considered.
    ME or post-viral syndrome was considered to be the most probable diagnosis (another common dumping ground for undiagnosed conditions) but again, a detailed analysis showed that the symptoms were not consistent with this theory. There had been no suggestion or indication of meningitis at any tune.
    Cranio-sacral diagnosis immediately revealed a marked and severe restriction of the meninges. with severe distortion of the symmetry of the membranes through the head, focusing around the upper cervical and occipital regions on the right hand side, radiating down into the neck and projecting down through the dural membranes to the sacrurn.
    After one treatment she went back to school, and instead of returning halfway through the day as usual, she phoned her mother at the end of the day to say she was going round to a friend for tea - the first time she had done this for months. Her life returned to normal immediately and her symptoms were completely eliminated after five further treatments.
    She did not have to stay down a year and excelled in her class at the end of year exams. She subsequently passed all her 0 levels with flying colours whilst simultaneously pursuing a highly active and demanding plethora of other pursuits. in all of which she excelled. A complete recovery was clearly evident.

Cases of unresolved after-effects of meningitis, meningism, and undiagnosed sub-clinical meningitis are common. The failure to identify, diagnose, and treat them leads to a great deal of unnecessary suffering which can readily be alleviated by effective cranio-sacral therapy.

It is to be hoped that with the increasing awareness of craniu-sacral therapy most of these cases can be identified for what they really are, and treated appropriately with cranio-sacral therapy.

Last, but in no way least, the results of the technique speak for themselves - as they always have.

Reproduced from The International Journal of Alternative & Complementary Medicine, September 1992.