05 / Post-concussion & TBI

What Is Dural Torsion? How Twisted Brain Membranes Are Linked to Whole-Body Tension

Cranial Solutions11 September 20256 min read

Dural torsion is the abnormal twisting or stretching of the dura mater - the tough connective tissue lining that surrounds the brain and spinal cord. Biaxial testing shows dural tissue has a directional stiffness of 28 to 86 Megapascals (MPa). Because the dura attaches firmly to the sphenoid bone in the skull and continues down the spinal canal to anchor at the sacrum (tailbone), a head or neck injury that rotates the sphenoid may twist this continuous membrane. This strain is associated with neck stiffness, upper back pain, pressure headaches and restricted spinal movement.

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The Biomechanical Problem: A Continuous High-Tension Membrane System

The central nervous system sits inside a protective, fluid-filled dural sleeve called the dural sac. Rather than floating freely, the dura mater is firmly anchored at key points along the skeleton:

Upper cranial anchors: the crista galli of the ethmoid bone, the anterior and posterior clinoid processes of the sphenoid bone, and the petrous temporal ridges.
Craniocervical anchor: the ring of the foramen magnum and the upper neck vertebrae (C1-C3).
Lower pelvic anchor: the second sacral vertebra (S2) within the pelvis.

From Sphenoid Strain to Whole-Spine Tension

Step 1: Sphenoid and cranial suture restriction after trauma.
Step 2: Asymmetric dural torsion (28-86 MPa membrane strain).
Step 3: Traction carried down the spinal sleeve to the sacrum (S2).
Step 4: Restricted spinal movement, base-of-skull pain and pressure.

Because dural tissue strongly resists stretch, it behaves like a tight, continuous bedsheet. Grab one corner of a bedsheet and twist it, and diagonal lines of tension spread across the whole sheet. Similarly, when a concussion pushes the central sphenoid bone into a rotated position, it may create dural torsion that pulls from the head down towards the tailbone.

See how these drivers are assessed on our Post-Concussion Symptoms & TBI page.

Comparison: Normal Dural Alignment vs. Post-Traumatic Dural Torsion

Membrane mechanics

Symmetrical neutral alignment: Balanced tension; full compliance.
Post-traumatic dural torsion: Asymmetric twisting; high strain (28-86 MPa).

Cranial anchors

Symmetrical neutral alignment: Sphenoid clinoids and crista galli aligned.
Post-traumatic dural torsion: Sphenoid held in rotation or flexion strain.

Spinal range of motion

Symmetrical neutral alignment: Smooth bending and twisting.
Post-traumatic dural torsion: Restricted forward bending; spinal "tightness".

Nerve root traction

Symmetrical neutral alignment: Spinal nerves glide freely in dural sleeves.
Post-traumatic dural torsion: Mechanical pulling on dural nerve sheaths.

Fluid pumping wave

Symmetrical neutral alignment: Unobstructed pulsatile CSF wave to the sacrum.
Post-traumatic dural torsion: Reduced fluid movement at the craniocervical junction.

Feature	Symmetrical neutral alignment	Post-traumatic dural torsion
Membrane mechanics	Balanced tension; full compliance.	Asymmetric twisting; high strain (28-86 MPa).
Cranial anchors	Sphenoid clinoids and crista galli aligned.	Sphenoid held in rotation or flexion strain.
Spinal range of motion	Smooth bending and twisting.	Restricted forward bending; spinal "tightness".
Nerve root traction	Spinal nerves glide freely in dural sleeves.	Mechanical pulling on dural nerve sheaths.
Fluid pumping wave	Unobstructed pulsatile CSF wave to the sacrum.	Reduced fluid movement at the craniocervical junction.

The Dura as One Continuous Sheet

Top anchor

Sphenoid clinoid processes and crista galli inside the skull.

Bottom anchor

Second sacral vertebra (S2) in the pelvis.

Twist at the top may be felt along the whole spine, like tension running through a twisted bedsheet.

How Dural Torsion Is Associated With Whole-Body Symptoms

When dural torsion persists after a head or neck injury, it may set off a chain of mechanical symptoms:

Vise-Like Skull Pressure

Torsion may pull the vertical falx cerebri and horizontal tentorium cerebelli taut like a drum skin, stimulating trigeminal dural pain receptors, which is associated with ongoing pressure headaches.

Suboccipital Guarding

In response to dural strain, the small suboccipital muscles may tighten protectively, associated with ongoing base-of-skull pain.

Low Back & Pelvic Compensation

Because the spinal dura anchors at S2, cranial dural torsion may pull upward on the sacrum, which is associated with low back tightness and pelvic tilt.

Neck, back or head tension since a knock or whiplash? Read more on our Post-Concussion Symptoms & TBI page.

Supporting Movement and Fluid Dynamics

Easing dural torsion involves reducing strain at its main cranial and neck anchors:

Endonasal inflation (Nasal RX): controlled, brief inflations within key inner nasal passageways apply gentle pressure that aims to mobilise the sphenovomerine and palatal sutures, helping the dura move towards neutral symmetry.
Upper neck care: addressing C1/C2 alignment aims to reduce traction on the spinal dural sleeve at the craniocervical junction.
Supporting whole-body flexibility: easing dural membrane strain aims to support spinal flexibility and normal CSF movement. Individual results vary.

Frequently Asked Questions

What is dural torsion and how can it happen during a concussion?

Dural torsion is abnormal twisting of the dura mater, the tough membrane surrounding the brain and spinal cord. During a concussion, rapid head rotation may restrict the sphenoid bone. Because the dura anchors to the sphenoid, a rotated sphenoid may twist the dural membrane. Learn more on our Post-Concussion Symptoms & TBI page.

How can a skull injury be linked to tightness down my spine?

The dura mater is a continuous tube attached to the sphenoid bone in the skull and anchored to the sacrum (tailbone). Because dural tissue is very stiff (28-86 MPa), twisting in the head may create tension along the spinal canal.

How might endonasal inflation help with dural torsion?

Nasal RX uses gentle, brief inflations within the nasal passageways that apply outward pressure to the sphenoid and facial bones. This aims to ease restriction of the sphenoid and reduce twist on the internal dural membranes. Suitability is discussed after individual assessment.

For the full overview, visit our Post-Concussion Symptoms & TBI page.

Read the related article Can a Head Impact Lock the Bones in Your Skull?

Base-of-skull tension also features in Why Upper Neck Stiffness Accompanies Migraines

Pressure headaches can overlap with Migraines & Headaches.

Learn about our clinical approach.

Browse the published studies on our Research page.

References

01Dura Mater & Migraines Synthesis Report (2025). Biomechanical stiffness (28-86 MPa) and dural mechanics.
02Dural Attachment Points & Sutures Report (2025). Sphenoid crista galli, clinoid processes, and petrous temporal ridge anchor mechanics.
03Scientific Dural Biomechanics Data (2025). Biaxial mechanical testing, Young's modulus, and directional strain vectors.
04StatPearls: Dura Mater Anatomy (2024). Anatomical layers and dural partitions. NCBI Bookshelf / NIH.
05Zheng N, Chung BS, Li YL, et al. (2023). The relationship between myodural bridge, suboccipital musculature, and cerebrospinal fluid dynamics. Scientific Reports, 13: 18882.

Learn how our non-surgical endonasal protocol is used to evaluate suitability for conservative management, and how cranial base structural mechanics guide an individual care plan.