ART, PHILOSOPHY, AND THE SCIENCE OF IMPEDED
By: Dr. Don Glassey, M.S.W., D.C., L.M.T.
The Cerebrospinal Fluid Technique (CSFT) and Cerebrospinal Fluid Technique Massage (CSFTM) procedures combine leading edge science with the philosophical principles underlying bodywork as a healing art. The "CSFT" protocol primarily addresses freeing up impedances to cerebrospinal fluid (CSF) flow around the brain and spinal cord. The “CSFTM” procedure utilizes variations of Swedish massage strokes to affect the spinal and cranial musculature as well as the muscles that control the theoretical CSF pumping mechanisms.
The "CSFT" clinical procedure uses both low force chiropractic type techniques and variations of massage type strokes in different areas of the cerebrospinal axis. "CSFT" is a multidisciplinary protocol that includes both the aforementioned body work modalities. The hands-on protocol utilized in "CSFT" is not based on an established chiropractic technique or a specific massage procedure. However, it is related to the experience, knowledge and expertise in both healing arts of the Founder and Developer.
The "CSFT" procedure addresses all the spinal bones starting with the coccyx and up to and including the atlas vertebrae. It also includes working on the cranial bones that can be accessed externally. Additional osseous structures which directly or indirectly attach to the spine such as the pelvis and sternum may also be included in the clinical protocol.
The “CSFTM” procedure utilizes variations of the Swedish massage major categories of strokes including effleurage, petrissage, friction, and tapotement. These Swedish massage stroke variations utilized in the “CSFTM” protocol emphasize certain parameters including a precise amount of pressure, pace of the stroke, and a designated angle when applying the stroke. The aforementioned parameters are not specifically stressed in a traditional Swedish massage routine. These massage stroke guidelines are designed to free up areas of impeded CSF circulation around the cerebrospinal axis. The procedure also addresses massaging specific muscles whose action could facilitate the abovementioned CSF pumping mechanisms, as well as other paraspinal and cranial muscles.
The “CSFTM” procedure is designed primarily to affect the five layers of muscles whose action controls the movement of the vertebral column, cranial muscles as well as other muscles. These other muscles affect not only the spinal column as a whole, but also osseous structures that they directly or indirectly attach to such as the arms, scapulas, diaphragm, and ribs. The protocol addresses certain layers of the paraspinal muscles, which affect movement of large sections of the spine, such as the erector spinae group, and other deeper muscles affecting individual or multiple vertebrae such as the transversospinalis group.
Although this article will primarily focus on the scientific basis of the importance of unimpeded CSF flow and its clinical application, a philosophical foundation is an important starting point. Historically it is well documented that the philosophical foundations of bodywork are vitalistic (Saeger, J. and Kyle-Brown, D. 2007). The basic principle of vitalism states that there is an inherent or in-born intelligence that animates, motivates, heals, coordinates, and inspires living beings. (Since the body is organized in such a varied and complex manner it must be “intelligent”.) Vitalism assumes that life is self-determining and self-evolving. Healing is seen as a process of personal evolution, growth, self-development, and self-discovery. Growth and development need mutual support and that support is a feeling state, an emotion.
Feelings are just information, (just as touch is information), that needs to be listened to and not “manipulated”. When the feeling state is experienced, the body can make a physiological shift. For example, a “gut feeling” is a visceral response to one’s external environment. The feeling state then is a response to internal and external life conditions, which are “recorded” when information is received by the nervous, muscular and other systems. The memory of the information is related to the feeling at that time, and a biochemical condition correlates to the healing experience.
According to Ida Rolf, Ph.D. (Structural Integration, aka Rolfing), Janet Travell, MD (Trigger Point Therapy), John Barnes, PT (Myofascial Release), John Upledger, DO (Cranial Sacral Therapy) and others, muscular patterns are formed in psychological arrangements. The chemical of emotion intersects with the muscular patterns, and muscles respond to psychological states. Feelings and motor patterns develop together where the feelings are “fluid” born chemicals whose emotional chemistry and muscular behavior are linked.
The primary clinical objective of Cerebrospinal Fluid Technique and Massage is to free up the flow of CSF around the cerebrospinal axis comprised of the brain and spinal cord. What is cerebrospinal fluid, where is it found and why is it so important?
Cerebrospinal fluid comprises a singular continuous fluid system whose circulation is very important to the functioning of the brain itself. Far more than a “shock absorber” cushion of protection for the brain and spinal cord, the movement and flow of CSF is essential to the proper functioning of the central nervous system. Cerebrospinal fluid bathes the neurons and glial cells of the brain and spinal cord. It carries nutrients as well as removes metabolic wastes and toxic substances from the central nervous system in conjunction with the arterial (nutrients) and venous (waste and toxin removal) branches of the circulatory system.
It also has a major influence on the body’s homeostatic pH balance of acidity/alkalinity. Recent research also suggests that CSF may be the primary factor which produces the electromagnetic environment of neurons and other cells of the central nervous system (Upledger 2000). Further current scientific research suggests that components in the CSF could act as a chelating agent removing metallic toxins from the brain and spinal cord, provide protection against free radical cell damaging oxidation, and the accumulation of non-metallic toxins. (Upledger 2000)
Respiratory physiologists currently state that carbon dioxide levels in the CSF have a more direct influence on the chemo-receptor respiratory mechanisms in the brain stem than carbon dioxide levels in the blood (Guyton 2000). Thus, carbon dioxide levels in the CSF can have a major influence on the critical acid-base balance of body homeostasis, which is partly regulated by carbon dioxide. In addition, electrolytes present in the CSF have a great influence on the body’s electromagnetic environment, which allow the central nervous system to work by the conduction of electricity. (Electrolytes are substances which when dissolved in water can conduct electricity.) Also CSF is the most conductive fluid in the body.
The abovementioned two mechanisms concerning carbon dioxide levels in the CSF, and the electrolyte elements of sodium and potassium which circulate within the “CSF”, are significantly imbalanced by impeded CSF flow (see “Clinical Analysis” section in this article).
Approximately 500 ml (about one pint) of CSF is formed per day primarily from cavities in the very center of the brain called the lateral ventricles. Spongy masses of specialized cells in the ventricles called the choroid plexus, as well as the ependyma that line the lateral ventricles, weep CSF from the blood. Also a smaller amount of CSF is formed from the ependyma of the 3rd and 4th ventricles (Guyton 2000). However, according to Bruno Chikly, M.D., one of the leading clinical experts in the lymphatic system, 15 to 30% of circulating CSF may be exchanged from lymph fluid and perhaps 70 to 85% from the choroid plexus (Chikly 2004). The total amount CSF produced per day is enough to completely replace the entire volume of CSF three to five times daily. However, the average person has about 150 ml, (less than a cupful) of CSF circulating around the brain and spinal cord at any one time. (Travis 1999)
The CSF formed in the lateral ventricles within the right and left cerebral hemispheres flows through canals into the third ventricle in the mid brain area between the right and left halves of the thalamus. It then continues through another canal into the fourth ventricle within the region of the middle and lower brain stem (pons and medulla oblongata). The fourth ventricle narrows to form the central canal of the spinal cord which extends to the level of the second lumbar vertebrae. From the fourth ventricle it is theorized that the majority of CSF may flow down through the spinal canal. A “smaller” amount then flows up through three small canals around the outer surface of the brain. (Guyton 2000)
In either pathway the CSF is now flowing between the three layers of the meninges, which are the saran wrap-like membranes covering the brain and spinal cord. CSF flows between two membranes, the pia mater, or soft mother, which is thin and adheres to the exterior surface of the brain and spinal cord, and the arachnoid mater, or spider mother, which is the middle layer of the meninges. The outer layer of these coverings is the dura mater, or tough mother, which adheres to the inner surface of the cranium, and some of the osseous cervical and sacral spinal segments. Dr. John Upledger, founder of Cranial Sacral Therapy, proposes that CSF may also circulate between the arachnoid and dura mater because CSF is absorbed through the dural envelope in the superior sagittal sinus at the top of the cranium (Upledger 1998). The sub-arachnoid space is also penetrated by the denticulate ligaments. These very small ligaments are extensions of the pia mater that attach to the spinal cord at 21 regular intervals and hold it in place. They extend from the foramen magnum, where the cord begins, to the second lumbar vertebrae where it terminates. (Gates 1980)
Although the spinal cord itself ends at the second lumbar vertebrae, it separates into numerous lumbo-sacral nerve roots which together form the cauda equina. These lumbo-sacral nerve roots are surrounded by the lumbar cistern that begins at the second lumbar vertebrae and ends at the second of five sacral segments at the conus medullaris. Strands of the pia mater form the filum terminale, and extend with some nerve fibers from the conus medullaris and attach to the posterior aspect of the first coccygeal segment. (Gates 1980)
The flowing CSF is primarily absorbed into the blood through the arachnoid villi of the superior sagittal sinus cavity at the top of the cranium, and to a lesser extent through the arachnoid granulation bodies called the pachionian granulations (Upledger 1998). However, Dr. Chikly’s scientific literature search has led him to theorize that up to 50% of the circulating CSF may actually be absorbed into the lymphatic system, as published studies have shown that a constituent of the CSF in animals drains into the cervical lymph nodes (Chikly 1999). Chikly extrapolates from this scientific data to propose the possibility that the entire spinal system absorbs CSF into the lymphatic vessels which support the central nervous system.
Cerebrospinal fluid flows between the meningeal coverings immediately underneath the spinal bones which together comprise the vertebral column. Theoretically, the flow of CSF could be impeded by slight misalignments of these bones, i.e. vertebral subluxations (a subluxation is a misalignment less than a dislocation). Since the actions of the five layers of abovementioned spinal muscles directly affect the position and movement of the spinal bones individually and in sections, it is imperative that these muscles be functioning properly in order for the CSF to flow freely. Additionally, more severe misalignments of spinal bones could increase tension on the aforementioned denticulate ligaments, and thereby impede CSF flowing within the sub-arachnoid space above the pia mater.
Although the actions of the cranial muscles do not directly affect the movement of cranial bones, the cranial bones may in fact move in response to the Primary Respiratory Mechanism (PRM) (Whedon 2009). It is theorized that the PRM is a rhythmic motion independent of the heart beat and respiration, although it can be enhanced by deep breathing. The PRM, or cranial-sacral rhythm, has been attributed to the bending of cranial bones and a subtle motion between the bones. Living bone, unlike dry, dead bone, is flexible like plastic, and hypothetically could expand and contract at the fibrous sutures between the cranial bones allowing small amounts of movement (Whedon 1997). Since the CSF also flows directly underneath the cranial bones, any misalignments of these bones hypothetically could impede CSF flow within the cranial vault. Therefore, it is essential that the cranial muscles are functioning properly in order for the CSF to flow freely, as well as the muscles that control movement of the cranium.
It is theorized that the cerebrospinal fluid flowing around the brain and spinal cord is facilitated primarily by the action of two coordinated pumping mechanisms. The cranial pumping mechanism occurs at the spheno-basilar junction where the sphenoid bone articulates with the basilar portion of the occiput bone. The sphenoid bone is in the center of the skull and articulates with many cranial bones.
The abovementioned theoretical physiological pumping mechanism would suggest that upon inspiration, as the nasal conchae fill up with air, pressure is applied on the anterior portion of the sphenoid bone, and the sphenoidal sinus where it articulates with the basilar portion of the sphenoid bone. This pressure could cause the spheno-basilar junction to move slightly posterior and inferior. On expiration, the spheno-basilar articulation relaxes as the pressure created by the inhaled air is exhaled. This release of pressure could cause the spheno-basilar junction to move slightly anterior and superior. This “to and fro” movement of the spheno-basilar junction could pump CSF down through the spinal canal towards the second sacral segment, and may also assist flow up and around the cranium.
The other major pumping mechanism which could theoretically facilitate CSF flow is the sacrum. The physiology would suggest that when upon inspiration as the diaphragm contracts down it could result in a series of muscle contractions in the thoraco-abdominal region causing the sacrum to “pump”. Physiologically as the following muscles contract inferiorly, it could cause the sacrum to extend up upon inspiration where the narrow sacral apex goes anterior and the broad sacral base goes posterior. The rectus abdominis, internal oblique, transverse abdominis, quadratus lumborum, and serratus posterior inferior contracting inferiorly in a synergistic manner could cause the diaphragm to contract down upon inspiration. These aforementioned muscles could hypothetically assist the sacral pump along with the actions of the iliocostalis and longissimus relays of the erector spinae group, and the inferior most portions of the multifidus muscles of the transversospinalis group, which also contract inferiorly.
Upon expiration the diaphragm relaxes upward also affecting a series of muscle contractions in the same region which theoretically could complete the “pumping” (up and down movement) of the sacrum. The following muscles contract superiorly which could cause the sacrum to flex down upon expiration where the apex goes posterior and the base goes anterior. And the iliopsoas, external oblique, and serratus posterior inferior contract superior synergistically causing the diaphragm relax. In order for the CSF to flow freely facilitated by the pumping mechanism theory, it is important that the abovementioned muscles, which may contribute to the pumping mechanisms, be functioning properly as well.
The aforementioned Primary Respiratory Mechanism or cranial-sacral rhythm could also contribute to a synchronous movement of the cranial-sacral pumping mechanism by way of the dural attachments at the foramen magnum (basilar portion of the occiput bone) and second sacral segment. It is suggested that the extension and flexion (upward and downward movement) of the sacrum could contribute to a synchronistic flexion and extension of the spheno-basilar junction in the cranium where in flexion the junction rises and in extension the junction falls. The cartilaginous articulation of these two bones (sphenoid and basilar portion of the occiput) allow for the bones to move slightly up and away from each other on flexion, and toward each other on extension.
Additionally, it is hypothesized that the articular pillars of the individual spinal bones could move in a piston-like motion initiated by the sacral pump to facilitate CSF flow in the spinal canal. The sub-arachnoid space is penetrated by the denticulate ligaments which are extensions of the pia mater from C-1 to L-2. These very small ligaments attach to the spinal cord acting like guide wires on a bridge holding the cord in place, and also maintain proper tension. The dentate ligaments could contract in response to the “up and down” movement of the vertebral articular pillars, and also facilitate CSF flow within the spinal canal.
The import of unimpeded CSF flow to proper body functioning is promoted by the following aspects and expressions of human anatomy and physiology. It is proposed that the act of walking could assist the theorized sacral pumping mechanism by the rolling motion of the hips causing an “up and down” movement of the sacrum. Mastication could also facilitate CSF flow because the atlas vertebrae moves slightly “up and down” when chewing. Slips of the dura mater, which adhere to the medial aspect of the atlas transverse processes, could also contribute to CSF flow up into the cranium when chewing. The sucking reflex also causes a movement of the atlas vertebrae similar to the abovementioned physiology, and could also facilitate CSF flow in infants in the same anatomical area.
It is proposed that impeded CSF flow causes a stasis or “pooling” of CSF that occurs within the menigeal covering of the brain and spinal cord. It is hypothesized that impeded CSF could be caused by a vertebral subluxation, defined, according to chiropractic theory, as a misalignment less than a dislocation, or a subluxation of a cranial bone as suggested by osteopathic theory. These aforementioned cerebrospinal osseous subluxations could be related to a lack of recovery by the homeostatic mechanisms of the body to a cumulative combination of physical stress and/or mechanical trauma, mental-emotional, and chemical stress.
It is suggested that the abovementioned overload of stress could accumulate in the central supporting structure of the body, the cerebrospinal axis comprised of the cranium and spinal column. Ida Rolf, Ph.D. (Structural Integration, aka, Rolfing), John Upledger, DO (Cranial Sacral Therapy), Janet Travell, MD (Trigger Point Therapy), John Barnes, P.T. (Myofascial Release) and others have described the physiological effect of the aforementioned types of stress on the muscle and connective tissue systems, which support and move the axial and appendicular skeleton. It is theorized that the cumulative effect of tension, taut fibers, and spastic contractions of these supportive soft tissues, could together comprise contributing conditions resulting in subluxations of spinal and cranial bones.
The chiropractic and osteopathic subluxation theories suggest that the first structure the subluxated cranial and/or a spinal bone would come into contact with is the outermost layer of the meninges, the dura mater. The semi-permeable dural membrane is continuous with the inside of the vertebral canal (endosteum) and cranium (outer periosteal layer), and also directly adheres to these bones at a number of attachment sites including the foramen magnum, atlas/axis and third cervical vertebrae (Gray’s Anatomy, 15th Edition, 1995). It is proposed that when the bones of the axial skeleton subluxate even slightly, the dural membrane could be compromised, which hypothetically causes a stasis or “pooling” of the CSF flowing underneath the subluxated spinal and/or cranial bone.
It is proposed that this stasis or “pooling” of the CSF could increase the hydrostatic pressure in that area causing the force and/or weight of the CSF to press against the meningeal membranes (dura and pia mater) within which the CSF flows. It is theorized that this creates a condition whereby through the physical process of filtration (requiring no energy), fluid and solutes, such as sodium and potassium within the CSF, are pushed through the semi-permeable meningeal membranes (inner dural layer and pia), in the area of increased hydrostatic pressure related to the aforementioned osseous subluxations.
It is further theorized that the abovementioned electrolytes of positively charged sodium and potassium molecules flowing within the CSF could then decrease in number in the area of CSF stasis. However, since potassium molecules are twice the molecular weight of sodium, it is primarily the heavier potassium molecules which would be effected. This could potentially also disturb the electrolyte balance within the CSF, which could effect the overall electromagnetic environment of the nervous system, and impair its physiology.
It has been observed clinically (Glassey 2006) that the physiological condition described above can be evaluated through manual palpation on the skin surface over the area of CSF stasis. The analysis is for a change in the coefficient of friction over the involved area. It is proposed that this phenomena is caused by an increase in the overall negative charge on the skin surface related primarily to fewer positively charged potassium molecules in the area of impeded CSF flow, i.e., a decrease in positively charged potassium molecules could cause an increase in the overall negative charge in that area. Extrapolating from a principle of physics, when there is an increase in the negative charge on any surface it potentially changes the coefficient of friction over that area.
This change in the coefficient of friction can be clinically detected by manual palpation of the fingertips, where Meissner’s corpuscles, which sense “fine” touch, are concentrated. It is palpated as a tactile sensation of a “drag” or resistance on the skin’s surface. It is proposed that impeded CSF flow can be clinically analyzed by a change in the coefficient of friction on the skin surface over the area of impedance. The trained practitioner analyzes for the presence of a “drag” or resistance on the skin surface through manual palpation. This tactile discrimination could also enable the practitioner to clinically determine when the CSF impedance has been corrected in that area.
It is further theorized that when the condition of “stasis” or “pooling” is corrected, the hydrostatic pressure returns to “normal”, and potassium molecules no longer filter through the meningeal membranes in that area. The increase in the negative charge caused by a decrease in positively charged potassium molecules, and the “drag” or resistance on the skin surface, related to the change in the coefficient of friction, are no longer present when the impedance to CSF flow in that area is corrected. The practitioner analyzes the aforementioned change as the absence of a “drag” or resistance on the skin surface over the area of CSF impedance, which was formerly present.
A similar physiological “phenomenon” is described by Osteopath, Dr. Robert Fulford, in his book Dr. Fulford’s Touch of Life. (Andrew Weil, M.D., devoted almost an entire chapter to Dr. Fulford in his number one “New York Times” bestseller Spontaneous Healing). Dr Fulford states in his book that when a patients “life force” wasn’t flowing in an area of the body, he felt a “drag” on the skin surface over the spot. He also claimed that the “life force” is created by a field of electromagnetic energy enveloping and surrounding the body (Fulford 1996). This electromagnetic energy field could be produced by the movement of electrolytes in the CSF. Conversely, impedance to CSF flow could have produced the “drag” on the skin surface described by Dr. Fulford, related to a change in the coefficient of friction in the abovementioned theory.
Chiropractor and chiropractic researcher, I.N. Toftness, DC also described a similar phenomenon of a tactile resistance on the skin surface over a vertebrae, which he determined through a chiropractic analysis was subluxated. He stated that the “drag” ceased upon correction of the subluxation by a chiropractic adjustment. In his research with a Microwave Radiometer instrument, Dr. Toftness reported that the body emitted an extremely high frequency of microwave radiation, (a harmonic at 69.5 GHz or million Hertz while the human body “normally” emits a range of about 8 to 28 Hz), over areas where he detected vertebral subluxations. Dr. Toftness theorized that this extremely high frequency was related to “disturbed” nervous tissue (Toftness 1976). Neurological deficit or “disturbed” nervous tissue could be connected to impeded CSF flow in the central nervous system. It is hypothesized that an electrolyte imbalance associated with impeded CSF flow could impair neuron conductivity, effecting the axoplasmic flow, and could result in neurological deficit.
The following physiological theory is proposed as a possible explanation of the relationship between vertebral subluxations and “disturbed” nervous tissue, neurological deficit, or disturbance in the CNS. Vertebral subluxations could potentially disrupt nerve signal transmissions (neurological deficit) in myelinated nerve trunks immediately distal to the spinal nerve roots emanating between vertebrae. The axon is the central core of the nerve fiber, which conducts the action potential along the nerve. The axoplasm is a viscous intracellular fluid inside the axon (not unlike the blood plasma in arteries). Electrical currents flow both outside the myelin sheath covering the nerve in surrounding extracellular fluid, as well as through the axoplasm along the nodes of Ranvier. The action potential is conducted from node to node along the nerve fibers, by salutatory conduction, i.e. proceeding by “leaps” rather than gradual transmission. (Guyton 2000)
Conduction of the nerve impulse in myelinated nerve fiber is accomplished almost entirely by ion conduction through voltage gated sodium channels with very little contribution from the potassium channels. Salutatory conduction requires little metabolism for establishing Na+ and K+ concentration differences across the nerve membrane to generate a series of nerve impulses.
Membrane depolarization and polarization (electrical conduction) to generate the action potential nerve impulse is dependent upon the concentrate on Na+ ions crossing the permeable nerve membrane. At the end of the action potential the nerve membrane becomes permeable to K+, which creates hyper- polarization, and then disappears allowing the generation of a new action potential. (Guyton 2000)
It is suggested that the imbalance in the electrolytes of Na+ and K+ in the primary pathway of CSF flow, just proximal to the aforementioned spinal nerve roots, could interfere with the abovementioned mechanism of action potential nerve conductivity. Although there is no current scientific research evidence for peripheral CSF flow distal to the intervertebral foramina, (IVF), it has been reported by Upledger that CSF may flow out the dural sleeves as far as IVF.
Dr. Upledger participated in research at Michigan State University conducted by Irvin M. Korr, Ph.D, physiologist in the Biomechanics Department. Radioactive tracers were injected into the lateral ventricles of guinea pigs and radioactivity was found throughout the length of the spinal cord, the dural tube, and out the dural sleeves as far as the IVF (Upledger 1998). It is proposed that compression of the anterior and posterior spinal nerve roots could be caused by a vertebral subluxation. The compression could increase the hydrostatic pressure on the CSF surrounding the nerve roots and imbalance the concentration of sodium and potassium. This, in turn, could impair the conduction of nerve impulses distal to the nerve roots, by imbalancing the concentration of Na+ and K+ crossing the nerve membrane which generate a series of nerve impulses. Since membrane polarization (electrical conduction) and hyper-polarization are dependent upon concentration of sodium and potassium ions respectively, the electrical current through the axoplasm could be altered, which could result in neurological deficit or disturbance.
An additional clinical indicator related to the correction of an area of impeded CSF flow involves the same abovementioned physiological theory. An increase in hydrostatic pressure in an area of CSF stasis or “pooling” related to impeded circulation could also have a similar effect on oxygen and carbon dioxide levels in the CSF. Since the molecular weight of carbon dioxide molecules is one and one-half that of oxygen molecules, more of the heavier carbon dioxide molecules could “filter” through the semi-permeable meningeal membranes then oxygen molecules. This could result in a decrease in carbon dioxide molecules circulating in the CSF in the area of impedance (stasis). This decrease in carbon dioxide levels in the CSF could cause an increase in pH (a more alkaline condition) in the aforementioned acid-base balance in the CSF specifically, and the body in general.
This increase in pH could affect the homeostatic chemo-receptors which control respiration in the brain stem. The physiological response to the abovementioned increase in pH, due to a decrease in the carbon dioxide levels in the CSF, could be a slight decrease in the amount of oxygen taken in by the body through inspiration to maintain an alkaline body pH. Hypothetically, the respiratory control mechanisms in the brain stem would register a decrease in carbon dioxide levels related solely to impeded CSF flow. (Again, respiratory physiologists currently state that carbon dioxide and oxygen levels in the CSF are more influential than in the blood in regulating respiration.) However, this is a “false” reading of the overall carbon dioxide/oxygen concentration in the CSF and subsequent acid/base balance. “False” because the imbalance is created by a “abnormal” condition of impeded CSF flow, rather than a “normal” physiological change in overall carbon dioxide/oxygen levels, i.e., acid/base balance.
When the impeded CSF flow is corrected, the stasis or “pooling” in the area of impedance would be eliminated, and the increase in hydrostatic pressure would no longer be present. And carbon dioxide molecules would no longer filter through the semi-permeable meningeal membrane in the area of impeded CSF flow. Consequently, carbon dioxide levels in the CSF return to a “normal” level, i.e. a level not related to the “abnormal” condition of impeded CSF flow. The respiratory control mechanisms in the brain stem would register this change as an overall increase in carbon dioxide levels in the CSF, i.e. a more acidic condition. The physiological response would be to increase the intake of oxygen through respiration, which would increase pH, and restore acid/base balance in the CSF.
The abovementioned theoretical physiological phenomenon has been observed clinically by the immediate response of a spontaneous diaphragmatic breath as the body increases oxygen intake through inhalation. It is suggested that the correction of impeded CSF circulation can be clinically observed as an immediate spontaneous diaphragmatic breath each time an area of impeded CSF flow is corrected. (Glassey 2006)
Another possible clinical indicator of the correction of impeded CSF flow is detected by the manual palpation of a physiological “cavitation”. A cavitation is defined as the formation of a partial vacuum in a liquid (CSF) as the result of the separation (dispersion) of its parts (Merriam-Webster 2005). It is proposed that when a spinal bone subluxates initially, it misaligns in a posterior direction due to the angle of the articular facets between the vertebrae (Burns 1980). Similarly, it is suggested that the initial direction of a cranial bone subluxation is medially towards the brain, due to the parallel articulations of the sutures between the bones of the cranium.
In both cases, (vertebral and cranial), this could create a “depression-like” osseous encroachment on the dural membrane directly underneath (cranial) or within the bone (vertebral). This “depression-like” impingement could hypothetically cause an increase in the hydrostatic pressure in that area. When the impedance to CSF flow is corrected, it could create a “cavitation” type effect as the impeded CSF disperses when the increase in hydrostatic pressure is released. Clinically, it has been found that the physiological “cavitation” can be tactilely detected as a “pop, click, or clunk” sensation palpated directly over the subluxated spinal bone or over subluxated cranial bone sutures. When the increase in hydrostatic pressure is no longer present, the aforementioned “depression” in the dural membrane is released. It is suggested that a partial vacuum is formed in the circulating CSF as the liquid (CSF) disperses evenly into that previously subluxated area, i.e. the CSF “cavitates”.
It is proposed that secondarily to the initial direction in which the vertebral or cranial bone subluxate, as described above, the bones could also potentially misalign very slightly in a rotational direction (Burns 1980). This would result in a slight torquing of the dural membrane beneath (cranial) or within (vertebral) the bone, and could cause a “twisting” or “kinking” of the dural sheath in the misaligned area. This “twisting” or “kinking” hypothetically could cause an increase in hydrostatic pressure in that area. When this type of impedance to CSF flow is corrected (released) it could also create a “cavitation” which can be detected by a trained practitioner. Clinically, it has been found that this type of “cavitation” can be tactilely detected as a series of “pops or clicks” as the “twist or kink” in the dural membrane “unwinds”.
For example, if one puts a weighted pressure (spinal or cranial bone) on the lining (dural membrane) of a “fire hose” in a specific area there will be an increase in the hydrostatic pressure, and an area of “stasis” or “pooling” in the water (CSF) flowing through the hose. If the pressure is removed (subluxation is corrected) it will create a partial vacuum in the area of stasis of pooling, and the water will then separate or disperse, i.e. a cavitation occurs. By the same analogy, if one twists the “fire hose” in a specific area, there would also be an increase in the hydrostatic pressure, and an area of stasis or pooling in the water (CSF) flowing through the hose. If the pressure is removed, it will again create a partial vacuum in the area of stasis or pooling, and the water (CSF) will also disperse, i.e. a cavitation occurs.
It has been observed that the correction of an area of impeded CSF flow presents the following objective clinical indicators. First, it can be palpated by the “cavitation” that occurs as the impedance is corrected. Secondly, there will be a change in resistance on the skin surface over the area of impedance. Lastly, an immediate observable diaphragmatic breath is an additional sign that the impedance to CSF flow has been corrected. It is theorized that impeded CSF flow is a physiological condition caused by vertebral and cranial subluxations, which produces objective clinical indicators. These clinical indicators allow the trained practitioner to detect the presence and location of areas of impedance to CSF flow, and provide a method of evaluating or post-checking for the correction of the areas of CSF impedance. (Glassey 2006)
Current Scientific Research
John Upledger, DO, OMM, founder of Cranial Sacral Therapy, presciently wrote an article entitled “The Expanding Role of Cerebrospinal Fluid in Health and Disease” (Upledger 2000). Recent research into the anatomy and physiology of cerebrospinal fluid supports the proposition that CSF is the key component in many of life’s biological processes or said another way- “the fluid of life”.
An article in Science News entitled “More than the Brain’s Drain” proposed a much larger role and significance of CSF, far beyond the function in the title of the article. The article reported that CSF flow carries important signals for sleep, appetite and sex, all essential biological processes. The aforementioned article surveyed and reviewed recent scientific research on CSF. It cited evidence that CSF may actually comprise a river of information within the central nervous system. (Travis 1999)
The abovementioned theory, that components in the CSF form a communication system within the central nervous system, is further supported by Candace Pert, Ph.D. As a psychoimmunoneurologist, she states that CSF is one of the major pathways for transport of neuropeptides, which also includes extracellular fluid and the blood. Dr. Pert states in her book that neuropeptides act as messenger molecules regulating practically all of life processes. She states that neuropeptides are also concentrated in the limbic system - the seat of the emotions. In fact, all the structures of the limbic system including the amygdala, hippocampus, hypothalamus, pituitary gland and parts of the basal ganglia area bathed in CSF. Dr. Pert calls neuropeptides the “Molecules of Emotion” in her ground breaking book by the same title. (Pert 1997)
The abovementioned Science News article provides research documentation that molecules circulating in the CSF can penetrate the brain, and theorizes that some areas of the brain may release substances into the CSF. It proposes that cerebrospinal fluid may also protect against oxidation in the CNS. The article reports that the free radical scavenging and in-direct anti-oxidant hormone melatonin, could be secreted directly into the CSF by the pineal gland because the brain cells’ melatonin targets are located close to the third ventricle reservoir of cerebrospinal fluid. (Travis 1999)
Perhaps the most potentially significant related research findings, which provide research information that may be connected to the biochemical composition of and CSF physiology, were described in the Proceedings of the Natural Academy of Science USA. In an article entitled, “Magnetite Biomineralization in the Human Brain” Joseph Kirshvink, et al., from California Institute of Technology, reported that their research found a minimum of 5 million single-domain magnetite crystals (Fe3 O4) per gram in human brain tissue. It was further reported that over 100 million of these ferromagnetic mineral magnetite (Fe3 O4) crystals per gram were found in the dura mater and pia mater. (Kirshvink 1992)
The abovementioned scientific research could have a direct correlation to recent studies that have shown both Parkinson’s and Alzheimer’s disease may by induced by toxic build-up of heavy metals, within the basal ganglia in the case of Parkinson’s, and in the cortical and sub-cortical regions of the brain in the case of Alzheimer’s disease (Upledger 2000). The Kirshvink, et. al., research could also lend credibility to Upledger’s claim that cerebrospinal fluid contains low-molecular weight chelating agents that remove metal atoms from the interstitial spaces of the brain and spinal cord, as well as from neurons and glial cell membranes (Upledger 2000). The California Institute of Technology investigation may also provide research correlations that constituents in the CSF protect the CNS against oxidation, and the toxic accumulation of non-metallic toxins. (Upledger 2000)
Kirshvink, et al., state that ferromagnetic mineral magnetite (Fe3 O4) crystals are formed biochemically by many living organisms within Kingdom Animalia. They report that human tissues possess similar crystals of biogenic magnetite because their research found a minimum estimate of between 5 and 100 million single-domain crystals per gram in the tissues of the human brain and dura and pia mater. The average values for the meninges (pia and dura mater) in this study were nearly 20 times higher than in the human brain tissue itself. (Kirshvink 1992)
The results of this study (Kirshvink et, al.) concluded that the consistency of their magnetic property data from piece to piece of brain tissue and meninges suggests that the observed moments were not produced by occasional contamination (toxic) from the environment, but were “in situ” ferromagnetic materials that were naturally distributed in a tissue characteristic fashion. They also reported that differences between tissues from the normal brains they studied versus those suspected or confirmed to be Alzheimer’s disease cases were negligible. And that areas of the brain previously reported in other studies to have high iron content, including the dentate nucleus, the basal ganglia and areas of the mid-brain, had no greater content of magnetic particles than did the cerebellum or cerebral cortex. (Kirshvink 1992)
After extracting cerebrospinal fluid in a medical lumbar puncture procedure, CSF appears luminescent upon observation. This luminescent quality of CSF could be related to its being crystalline in nature. It is proposed that the mineral magnetite (Fe3O4) crystals reported in the brain tissue and dura and pia maters by Kirshvink, et, al., occur naturally as part of the chemical composition of cerebrospinal fluid. It is further suggested that the aforementioned chelating and anti-oxidant properties of CSF could also be related to the circulating Fe3O4 crystals within it.
Ferric, Fe III or Fe3+ contains iron in its plus-three oxidation state. Mineral magnetite is a black isomer mineral of the spinal group that is an oxide of iron. It is hypothesized that the magnetic quality of Fe3 gives it the ability to attract metals. The O4 oxide component is a binary compound of oxygen with a more electro-positive element as a group, which could give it the capacity to act as an anti-oxidant. (Merriam-Webster 2005) It is theorized that Fe304 occurs naturally as a biochemical component in the CSF, and functions as a chelating agent removing metal atoms from the interstitial areas of the brain and spinal cord. Since CSF is the interstitial fluid of the brain and spinal cord it is the natural medium to provide these important functions for the CNS (Guyton 2000). It is further theorized that ferromagnetic mineral magnetite (Fe3O4) could also have anti-oxidant properties enabling it to neutralize negatively charged free radical electrons due to the more electropositive quality of an oxide compound.
It is proposed that the differences reported by Kirshvink, et. al., of the presence of over five million single-domain magnetite (Fe3O4) crystal per gram of human brain tissue, and over 100 million of the same type of crystal per gram in the pia mater and dura mater, could be related to impeded CSF flow around the brain. It is suggested that the abovementioned increase in hydrostatic pressure in the CSF caused by subluxated cranial bones could filter the naturally occurring low molecular weight Fe3O4 crystals in the CSF, first into the dura and pia mater, and secondly into the brain tissue itself. This would theoretically account for the research data reported by Kirshvink et.al., that found 20 times the number of single-domain magnetite (Fe3O4) crystals in the dura mater and pia mater as opposed to the brain tissue itself.
Although Kirshvink et. al. reported that the normal brain tissue and suspected or confirmed Alzheimer’s disease cases contained approximately the same number of Fe3O4 crystals, this would not discount a theorized correlation of Fe3O4 concentrations with senile dementia and/or Alzheimer’s disease. In the abovementioned Science News article it was reported that in a January 24, 1998 Lancet article, Edward Rubenstein of Stanford University noted that with age the brain’s choroid plexus calcifies. It is hypothesized that a build-up of Fe3O4 crystals, due to the aforementioned theoretical mechanism of increased hydrostatic pressure caused by long-term subluxated cranial bones above the lateral ventricles, could result in calcification of the choroid plexus. This also could explain the dramatic decline in the production of CSF from the choroid plexus associated with aging suggested by Rubenstein.
Rubenstein proposes that changes in CSF physiology may also contribute to dementia in some elderly people (Travis 1999). In many elderly people cerebellar function deteriorates in terms of motor, balance, memory, hearing association and many other areas. These decreases in function could hypothetically also be related to decreased CSF production caused by calcification of the choroid plexus. Decreased CSF production could cause an electrolyte imbalance within the CNS affecting nerve conductivity, and possibly be a factor in the abovementioned physiological dysfunctions related to aging.
In conclusion, the recent research cited above, combined with the research correlations hypothesized, strongly suggest that, in fact, CSF may be found to be the single most important fluid in the body’s physiology. This proposal most certainly lends much credibility to the cogent statements made about cerebrospinal fluid by two masters of major healing arts of the 20th century. A.T. Still, the founder of Osteopathy, and Dr. Randolph Stone, the founder of Polarity Therapy, made the following observations about cerebrospinal fluid. A.T. Still referred to CSF as "the great river of life", (Sutherland 1990), and Dr. Stone called CSF “the liquid medium for the Breath of Life.” (Stone 1986)
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