Abstract
The application of cranial osteopathic manipulative medicine (OMM) is always controversial in the literature. Primary respiration related to the movement of spheno-basilar synchondrosis in the adult goes against the knowledge of complete ossification that occurs at this articulation after the pubertal phase. The idea that the operator's hands can communicate with the meninges is difficult to accept. The anatomy shows us that the fascial system involves the meninges and that from the microcellular point of view there are no layers that divide one tissue from another. The backing of new sciences, such as quantum physics, suggest that cranial palpation allows the osteopath to come into contact with the meninges. Recent scientific evidence shows that meningeal afferents can affect extracranial areas and that the pericranial musculature itself is able to influence these afferents. The article highlights some reflections in support of cranial osteopathy, based on scientific information that could help the osteopath to improve clinical work.
Highlights
BackgroundIn the scientific landscape, the approach with the cranial osteopathic manipulative medicine (OMM) is much debated [1]
We know that the synchondrosis between the occipital bone and the sphenoid bone, articulation underlying the concept of primary respiration and cranial bone movement, begins to ossify from 11-13 years to complete ossification at the end of puberty [4]
The ossification puts into question the manual techniques for draining the dura mater's sinus or for influencing the cerebrospinal fluid (CSF) or the lymph of the glymphatic system [8,9,10]
Summary
The approach with the cranial osteopathic manipulative medicine (OMM) is much debated [1]. By altering the dural tensional state, the secretion of some substances by fibroblasts (prostaglandins) is stimulated; from the sympathetic, parasympathetic and myelinated fibres terminations, multiple neuropeptides (noradrenaline, acetylcholine) are produced, as well as from the trigeminal meningeal terminations (calcitonin gene-related peptide - CGRP) [22,23] These substances, depending on the perceived physiological or nonphysiological stress, will influence the metabolic state of the brain and the brain's immune status, the repair capacity of the neuronal cells, as well as the nociceptive or analgesic meningeal response [22,23]. The oscillations of the cells create further alterations of mechanical tension that travel faster in the liquid tissues, creating a wet network [27] It is very probable, relying on the notions of physics that the OMM is able to enter into communication with the liquor or the cranial lymph. The question must always be neutral in order to obtain an efficient scientific response and move forward: this is the enlightenment of research
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