While cranial osteopathy and craniosacral therapy are often used interchangeably, even by medical professionals, they are separate therapies with common origins.

Significantly, cranial osteopathy is a medical treatment applied by licensed osteopathic physicians, while craniosacral therapy requires little or no medical background. Certification in craniosacral therapy could be obtained through a one-day training course. In other words, cranial osteopaths have trained as osteopaths, and then gone on to further study the cranial concept of osteopathy. By comparison, craniosacral therapists are usually not osteopaths but have varied backgrounds.

Both cranial osteopathy and craniosacral therapy originated in the work of Dr. William Garner Sutherland, an early 20th-century osteopathic physician.

In the 1940s, Dr. Sutherland determined that cranial sutures, although fused in adults, have their own mobility in relation to the skull. Through study, research, and manipulation, Dr. Sutherland concluded that the cranial bones, sacrum, dural membranes, and cerebrospinal fluid function as interrelated units, which he referred to as the body's primary respiratory mechanism. The goal of cranial osteopathy is to restore the cranial rhythmic impulse to a normal rate.

Cranial therapy has its origins in Dr. John Upledger, an osteopathic physician, who developed his own approach to Dr. Sutherland's work and began teaching it to non-osteopaths. He gave his approach the name craniosacral therapy in order to differentiate it from cranial osteopathy.

At the time, and perhaps still today, many osteopaths were unhappy with Dr. Upledger for openly teaching what they considered to be osteopathic methods to non-osteopaths, with only a fraction of the training.

In a sense, craniosacral therapy might be considered as simpler form of cranial osteopathy but, since the former is not performed by osteopaths, it cannot be properly termed osteopathy.

Both therapies recognize the importance of movement in facilitating and sustaining life. When a body, or an area of the body, is stagnant or restricted from moving, then disease can result.

Both approaches affect the cranium, spinal cord, sacrum, and coccyx, although cranial osteopaths work more specifically with the bones and sutures of the skull, while craniosacral therapists work deeper on the membranes and cerebrospinal fluid surrounding the brain and spinal cord. Cranial osteopathy focuses more on the underlying structural imbalances in the cranial bones, while craniosacral therapy involves the application of almost imperceptible pressures.

A key principle of cranial osteopathy is the primary respiratory rhythm, and this is the focus of the cranial osteopath's assessment of the central nervous system, the cranial bones, sacrum, cranial and spinal dura, and the cerebrospinal fluid within. The idea is that changes in bone position can lead to subtle changes in the shape of the skull and a restriction to the flow of cerebrospinal fluid.

When they are in proper alignment, the bones of the skull fit together like puzzle pieces. However, the impact of birth trauma, illness, direct force trauma, concussions, or other injuries to an area of the skull can lead to slight shifts in the alignment of the bones, as well as alterations to the flow of cerebrospinal fluid. This can lead to physical symptoms, such as pain, dizziness, chronic headaches, and others.

The self-regulatory mechanisms of the body always attempt to restore the body to a point of health or balance. Cranial osteopaths seek to identify any areas of restriction and use their hands to carefully and gently free up restrictions in the movements of cranial bones and associated soft tissues in order to stimulate the flow of cerebrospinal fluid.

The Osteopathic Cranial Academy is an international membership organization that provides training in cranial osteopathy to qualified healthcare practitioners, including doctors of osteopathy, medical doctors, and dentists. The Academy awards a Certificate of Proficiency to members who have completed postgraduate studies in cranial osteopathy.

Cranial osteopathy can be used in conjunction with other medical, dental, osteopathic, and chiropractic treatments.

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