你腦脊髓液的顱薦椎療法(顱薦椎平衡治療, CST) (by 黃冠維物理治療師)
當你有受傷後的後遺症、睡眠問題、疲勞問題、找不到原因的疼痛、頭痛、神經性疼痛、筋膜痛等問題，醫生或物理治療師可能會建議你去做顱薦椎療法 ( Craniosacral Therapy, CST )。
顱薦椎療法是一種很特殊的物理治療中的徒手治療，很輕柔，治療的過程患者會表示有點像氣功，或是沒什麼感覺。但治療後卻能夠改善症狀。
黃冠維物理治療師今天來跟大家講講什麼是顱薦椎療法。
顱薦系統
顱薦椎療法顧名思義就是利用徒手的方式去影響你的顱薦系統。顱薦系統包括一些骨頭，和骨頭裡面的東西。
骨頭：顱骨(你的頭部骨頭)、脊椎、薦椎(薦骨，脊椎尾端的地方)。
骨頭裡面的東東：中樞神經系統、腦袋、脊髓、腦脊髓液、一些膜。
腦脊髓液 & 顱薦椎治療(顱薦椎平衡治療)
在這個顱薦系統裡，你的腦和脊髓被一套硬膜組成的半封閉式液壓系統所包覆著，這套系統裡充滿著腦脊髓液。
腦脊髓液是一種純生理鹽水，在腦脊髓外圍、腦室、導水管、脊髓中央等地方流來流去。腦脊髓液可以幫你做緩衝，避免腦震盪、還可以運送營養、運送廢物、調解腦壓。真是好棒棒的東西呢！
所謂的顱薦椎療法，就是有一派醫療人員認為，利用徒手治療的方式，幫助腦脊髓液循環，或許能夠幫助中樞神經系統的放鬆，也能夠促使身體的一些筋膜放鬆。
顱薦椎系統裡的腦脊髓液運送有自己的一套頻率，大約是一分鐘 6 到 10 次左右，和呼吸、心跳都不一樣，這個頻率又叫作頭薦骨韻律。
專長顱薦椎療法的醫生或物理治療師可以藉由觸診顱薦骨頻率來評估病人。除了評估腦脊髓液的脈動外，也會評估身體的筋膜張力包括腳踝、足背、大腿前側、髂前上脊、肋骨、肩膀、顱骨這些地方。
「所以腦脊髓液和筋膜張力有關係？」你問道。
沒錯，研究與執行顱薦椎療法的醫生、物理治療師認為，筋膜這樣遍佈全身的結締組織，可以評估其不正常張力，來幫助治療者獲得資訊找出問題的源頭在哪裡。
放鬆筋膜、藉此影響腦脊髓液的流動，腦脊髓液的流動改變了，會再影響中樞神經系統，來達到身體的平衡。
顱薦椎療法如何幫助你？
相較於動來動去的其他徒手治療或是運動治療，顱薦椎平衡治療相較之下還蠻靜態的，病患甚至可能睡著。
整個療法最重要的事情之一，就是顱薦系統、筋膜系統的放鬆。為了達到這個目的，通常執行顱薦椎療法的治療空間會佈置得讓人能夠感到舒適、安心的感覺。
治療者會請病患以輕鬆的心情來接受治療，治療師也會在執行前後傾聽病患的感受，必且做記錄。
物理治療師會以雙手非常輕柔的去放鬆你的頭顱、脊椎、薦椎，幫助腦脊髓液的流動、促進廢物代謝。有多輕呢？大概是 5 公克，意思是一點點的力道改變，就有可能造成不同的身體感受，但也有可能是在一段時間之後改變，所以治療者和病患保持溝通是非常重要的事。輕柔的手法也特別適合怕痛的病人。
顱薦椎療法使顱骨更有彈性、鬆弛，影響大腦與脊椎神經的薄膜，讓腦脊膜與脊髓神經的緊繃得到釋放。最後得到神經系統的環境優化，讓身體達到平衡。
治療過程依照不同病患會有不同感受，有人會覺得睡了一場好覺、有人會感受到自己的氣在跑、有人會說沒有什麼特別感覺，這些都是很正常的。
「所以大概做幾次治療可以改善我的狀況呢？」
這其實是個很多人想問，但是沒有一定答案的大哉問。一般來說，治療前物理治療師應該要和病患溝通病情、討論療程。所以答案是「要看你的身體狀況以及治療師的判斷。」
一般來說，如果你適合顱薦椎治療，隨著治療次數，身體的疼痛應該會隨時間縮短、症狀強度降低等等。
通常顱薦椎療法會搭配其他治療同時進行，所以你可以依照需求同時進行其他物理治療、或是醫生的治療，並不會有什麼衝突。
什麼樣的人適合顱薦椎療法？
- 受傷後的後遺症
- 晚上不好睡，東翻西滾都睡不著
- 明明睡很久，但是還是都很累
- 自覺壓力山大
- 無原因疼痛
- 各種緊繃、疼痛症狀反覆發生
- 長期情緒低落
- 長期頭痛
- 沒原因生病
- 神經性疼痛
- 筋膜痛、筋膜緊繃、其他筋膜問題
- 很怕痛的
什麼樣的人不適合顱薦椎療法？
- 急性第一頸椎骨折
- 顱內壓不穩定
- 急性中風
- 急性動脈瘤
- 延髓突出
- 急性腦內出血
- 腦瘤
- 硬膜管上有任何的破洞
- 急性腦外傷
有以上情形的話，真的要多注意。
合作撰寫：好痛痛 (粉絲頁連結)、黃冠維物理治療師 (專欄連結) (粉絲頁連結)
好痛痛復健科、骨科、物理治療、運動訓練搜尋器
註：
顱薦系統圖片，大圖好痛痛手繪，小圖來自 Mysid CC by SA 3.0 授權
註：本部落格文章是以科普、衛教為出發點，不代表任何人的生理狀況。每個人的身體皆不相同，有任何疑問請詢問自己的醫師、物理治療師、專業教練。
好想試試看喔！（失眠一直困擾著我）
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