title: Cranial osteopathy: its fate seems clear.
abstract: BACKGROUND
  According to the original model of cranial osteopathy, intrinsic rhythmic movements of the human brain cause rhythmic fluctuations of cerebrospinal fluid and specific relational changes among dural membranes, cranial bones, and the sacrum. Practitioners believe they can palpably modify parameters of this mechanism to a patient's health advantage.
  
  
  CONCLUSIONS
  This treatment regime lacks a biologically plausible mechanism, shows no diagnostic reliability, and offers little hope that any direct clinical effect will ever be shown. In spite of almost uniformly negative research findings, "cranial" methods remain popular with many practitioners and patients.
  
  
  CONCLUSIONS
  Until outcome studies show that these techniques produce a direct and positive clinical effect, they should be dropped from all academic curricula; insurance companies should stop paying for them; and patients should invest their time, money, and health elsewhere.
authors.affiliation: Department of Anatomy, College of Osteopathic Medicine, University of New England, Biddeford, ME 04005, USA. shartman@une.edu
authors.forename: Steve E
authors.initials: SE
authors.lastname: Hartman