Massage & Bodywork

MAY | JUNE 2016

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sham protocol was equal to that in the craniosacral treatment. The main outcome measure used to assess change in neck pain was the visual analog scale, which asked about pain over the past week on a 0–100 scale, with 100 being the worst amount of pain. Secondary outcome measures included anxiety, body awareness, depression, functional disability, health-related quality of life, pain acceptance, pain on movement, pressure pain sensitivity, safety, stress perception, the patient's global impression of improvement, and well- being. THE RESULTS The results demonstrated the group receiving craniosacral therapy had a signifi cantly greater decrease in pain compared to the sham group at week 8 and at week 20. The craniosacral group changed from an average pain score of 64 (out of 100) at baseline to a score of 32 at week 8 and 32 at week 20. In comparison, the sham group changed from an average pain score of 64 at baseline to 54 at week 8 and 49 at week 20. The difference between the groups at week 8 was 21 points, favoring craniosacral treatment. At week 20, the group difference was 17 points, again favoring craniosacral treatment. Viewed in a different manner, at week 8, 74 percent of those treated with craniosacral therapy showed at least a minimal clinically important difference in pain intensity (at least 20 percent pain reduction), whereas only 41 percent of the sham patients experienced this. In terms of substantial clinical improvement (at least 50 percent pain reduction) at week 8, the craniosacral group demonstrated improvement in 44 percent of the subjects, whereas only 15 percent of the subjects in the sham group demonstrated improvement. At week 20, the craniosacral group reached 78 percent with minimal clinically important difference and 48 percent with substantial clinical improvement. There were no adverse events during this clinical trial. Compared to the sham group, the group receiving craniosacral treatment also had signifi cant changes at weeks 8 and 20 in terms of functional disability, pain on movement, physical quality of life, and the patient's global impression of improvement. Body awareness and pressure pain sensitivity were signifi cantly improved only at week 8, and anxiety was signifi cantly improved only at week 20. As with any clinical trial, there are study limitations. First, we do not know if the treatments rendered by the clinicians are similar to treatments by craniosacral therapists in the fi eld, especially because clinicians have different levels of skill and because this form of care is so individualized to the patient. Second, the neck pain was nonspecifi c, without an actual diagnosis, so we cannot truly defi ne what type of neck pain responds best to this form of care. Finally, a longer follow-up would C h e c k o u t A B M P 's l a t e s t n e w s a n d b l o g p o s t s . Av a i l a b l e a t w w w. a b m p . c o m . 51 The results demonstrated the group receiving craniosacral therapy had a significantly greater decrease in pain compared to the sham group at week 8 and at week 20. SOMATIC RESE ARCH be benefi cial to determine the continued effects of this treatment on neck pain over time. Overall, this study demonstrates craniosacral treatment may be benefi cial for people with neck pain. Be sure to work with your clients and other members of their health-care team to determine what treatment is right for them. Notes 1. Steven P. Cohen, "Epidemiology, Diagnosis, and Treatment of Neck Pain," Mayo Clinic Proceedings 90, no. 2 (February 2015): 284–99, doi:10.1016/j. mayocp.2014.09.008. 2. H. Haller et al., "Craniosacral Therapy for the Treatment of Chronic Neck Pain: A Randomized Sham-Controlled Trial," The Clinical Journal of Pain (September 3, 2015). Jerrilyn Cambron, DC, PhD, MPH, LMT, is an educator at the National University of Health Sciences and president of the Massage Therapy Foundation. Contact her at jcambron@nuhs.edu.

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