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Gentle Approaches for Arthritis

by Jonathan Lawrence(more info)

listed in craniosacral therapy, originally published in issue 170 - May 2010

Arthritis is a term that literally means 'joint inflammation'. Technically, any joint pain is therefore arthritis.

From a pathological point of view there are two broad categories of arthritis: osteoarthritis which is wear and tear usually affecting single joints, and systemic arthritic conditions such as rheumatoid arthritis, which results from a disease process that affects many joints and includes effects in other tissues.

The author giving treatment

Craniosacral and positional release techniques have a part to play in the control and management of the conditions, and along with acupuncture, herbal and homeopathic approaches may help to minimize the need for conventional painkillers and their side effects. In the case of rheumatoid arthritis, corticosteroids are widely used.

Osteoarthritis, also known in the spine as spondylitis, is a condition present in all adults, especially in later life. Many people have this problem without being aware of it. In severe cases, pain and disability can result. This is most obvious in the hips and knees, where replacement surgery can restore mobility and reduce pain and in the back.

What is not always remembered, however is that bones and joints have the ability to repair and regenerate to some extent. Bones have two types of cell that control the density and shape of the tissue. Osteoblasts form bone and osteoclasts remove bone mineral constantly, working to regenerate and remodel the bone and joints in response to the stresses placed on them.

One of the causes of osteoarthritis is when local tissues are subject to trauma. This may be major trauma which results from an accident, or micro trauma which can be caused by repetitive movements or poor posture. This causes inflammation, which in turn creates scar tissue. Scar tissue may reduce the blood supply to the joints. As blood takes nutrients to the joints and removes waste products and toxins, the ability to self-heal diminishes. Over a long period of time, often many years, arthritis sets in.

It stands to reason therefore if you can increase the local blood supply and stimulate the joints, the arthritic process may slow and in some cases a degree of regeneration occurs.

Craniosacral and positional release techniques can deal with inherent tensions caused by tissue memory, causing local tension. With the hands resting lightly laterally and medially across the offending joint, a tension in the soft tissues especially the fascia can draw the hands to a binding point where in a short space of time a release will be felt. The effect of this is to increase mobility and allow the vascular component of the joint to operate more effectively, reducing inflammation and promoting repair.

One of the very first patients I treated 25 years ago, was a hockey player in his late forties who lent me his knee to practise on. At that stage, x rays had shown that the joint surfaces were worn and uneven; there was the characteristic crepitus (creaking sound) when the joint was moved, and there was extensive pain on the ligaments around the knee.

Treatment as outlined above reduced the pain and allowed him to continue playing his beloved hockey for a few more years. I met up with him again last year, many years after we had moved to the West Country. He had continued having regular treatment, and although the arthritis had worsened, he hadn't needed a replacement knee as would have been expected from the initial findings.

A frail elderly lady in her 90s consulted me 6 years ago with extensive wear in her shoulder joints and neck. She had done a heroic amount of physical work in the past. Using the combination of treatments outlined above on a monthly basis, her range of movement in the joints has improved significantly, and her pain has diminished.

Client stretching leg treatment

From a holistic perspective there are likely to be mechanical factors resulting from compensating for the pain and disability caused by the condition. In the case of the patient with the knee problem, there will be mechanical strains through the other leg joints on the same side such as the ankle and knee.

The joints on the other leg will have to take more weight in order to minimize discomfort. Similarly the pelvic and spinal joints will be forced to compensate for this imbalance, loading them unevenly.

In addition, osteoarthritis can develop or be exacerbated by existing mechanical imbalances that further load the affected joint. Therefore it is always vital to make sure that the body is in the optimum mechanical state, that is the bones and soft tissues are mobile and free. This can be achieved using the techniques described.

Rheumatoid arthritis (RA) has phases when the disease is more active than others. During the inflammatory phase, direct treatment of the affected joints can aggravate the symptoms. A technique called a 4CV (compression of the 4th ventricle) can be helpful. This simple technique can be taught to the patient, or administered by a partner.

The very gentle compression applied to the base of the skull, ensuring that pressure over the adjacent sutures is avoided, causes the CRI (Cranio Rhythmic Impulse) to shutdown, creating a number of stillpoints. The stillpoint usually lasts for a fraction of a second during which fluid exchange increases throughout the body. This point is often characterized by the patient taking a deep breath, sighing or deeply relaxing. The effect of this appears to reduce inflammation if repeated regularly.

The efficacy of this technique is thought to be achieved as the result of the slight pressure on the fourth ventricle, one of the cerebrospinal fluid chambers in the brain. The floor of the fourth ventricle is associated with a number of brain structures that regulate basic life processes.

If 4CVs are administered little and often there is a gentle incremental effect which seems to have a beneficial effect on patients with RA.

Prevention however, is better than cure. In our culture we do not recognize that a problem exists until we get symptoms appearing. I see many patients who, I believe would have had fewer problems if they had been seen before the symptoms had developed.

Arthritis takes many years to develop, so it would make sense for patients to have regular check ups, or seek an opinion after an accident, a period of heavy work or a whiplash.

Further Reading

Hamblen D Simpson H. Adams's Outline of Orthopaedics. Churchill Livingstone. ISBN-13: 978-0-7020-3061-1. 2009.
Magoun H. Osteopathy in the Cranial Field. The Cranial Academy. Belen. Library of Congress Cat no 76-11297. 1976.
John E. Upledger, Jon D. Vredevoogd. Craniosacral Therapy. Eastland Press. Seattle. ISBN 0-939616-01-7. 1983.
John E. Upledger. Craniosacral Therapy II Beyond the Dura. Eastland Press. Seattle. ISBN 0-939616-05-x. 1987.

Further Information

Turning Point Training runs courses in the Craniosacral and positional release techniques as described above, Tel: 01769 579079 or 


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About Jonathan Lawrence

Jonathan Lawrence BA DO Cert Ed, following 4 years teaching Environmental Science, trained at the European School of Osteopathy graduating in 1985. Jonathan has been practising Osteopathy in private practice for 25 years, treating patients of all ages – from babies to the elderly. Having lectured to audiences ranging from small technique classes to presenting at the 2008 Advancing Osteopathy Conference, he established Turning Point Training in order to bring high quality and affordable professional courses in Craniosacral and positional release techniques to practitioners trained in conventional or complementary medicine. He may be contacted on Tel: 01769 579004;  

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