NasalRX: How Endonasal Cranial Treatment Works

NasalRX is a endonasal structural treatment used by Cranial Solutions to address restriction within the nasal, facial and cranial system.

The treatment uses brief, controlled pressure applied from inside the nasal passages.

This provides a distinctive mechanical approach to structures that are difficult to influence in the same way from outside the face and skull.

Depending on the individual pattern of restriction, NasalRX may influence mechanical relationships involving the:

• vomer
• ethmoid
• sphenoid
• maxillae
• palatine bones
• zygomatic bones
• temporal bones
• wider cranial base and occipital region

The purpose is straightforward:

Identify the restriction. Apply a controlled mechanical force. Improve structural movement. Assess the change.

For some patients, the changes are subtle.

For others, treatment produces a much more definite structural release, sometimes accompanied by an audible cavitation or release through the cranial or facial articulations.

We often observe changes in cranial and facial movement following treatment, while patients may notice changes in nasal airflow, head or facial pressure, headache, facial tension and other symptoms.

The nasal passages provide an internal route into the craniofacial skeleton.

The vomer forms part of the nasal septum and extends towards the sphenoid. The ethmoid contributes to the upper nasal cavity, nasal septum and medial orbit. The maxillae and palatine bones form important parts of the nasal and facial framework.

Behind these structures lies the sphenoid, a centrally positioned bone of the cranial base with relationships to the orbits, temporal bones, occiput and dura.

This creates an interconnected mechanical system.

Rather than attempting to influence all of these structures externally, NasalRX allows controlled force to be introduced from within the nasal passages themselves.

That internal access is one of the features that makes NasalRX different from conventional external manual treatment.

It is important to understand what we mean when we describe NasalRX as cranial treatment.

This is not simply a relaxation technique or an energetic approach.

NasalRX is mechanically applied.

A controlled physical force is introduced into the nasal passage and transmitted through the surrounding nasal and craniofacial structures.

The response varies depending on where restriction is present.

Sometimes we feel a relatively small change in movement or compliance.

At other times there can be a much more definite mechanical release involving the nasal, facial or cranial structures.

An audible cavitation or release may occasionally accompany that correction.

The sound itself does not tell us exactly which articulation moved or by how much.

What matters clinically is the change we find afterwards:

Does the restricted structure move differently?

Has the relationship between surrounding structures changed?

Does the patient feel different?

The sphenoid is important, but NasalRX should not be reduced to the idea of simply “unlocking the sphenoid.”

Head and facial trauma can involve a much broader mechanical system.

We may find restriction involving the vomer, ethmoid, maxillae, palate, zygomatic region, temporal bones, occiput and cranial base.

There may also be associated restriction through the jaw and cervical spine.

For this reason, treatment is guided by the individual's pattern rather than by assuming that every patient has the same lesion.

The current injury is not always where the mechanical problem began.

Some patients have experienced previous:

• concussions
• sporting impacts
• falls
• whiplash injuries
• facial injuries
• nasal trauma
• jaw injuries

There may also have been multiple injuries accumulated over many years.

Symptoms from an earlier injury can improve without the cranial and craniofacial mechanics necessarily returning completely to their previous state.

A later injury may therefore create a new restriction, add to an existing one, or re-aggravate an older mechanical pattern.

This is why we take previous trauma and the quality of recovery from earlier injuries into account when deciding what to treat.

One of the advantages of a mechanically applied treatment is that we can compare findings before and after treatment.

Clinically, we often observe changes involving:

• movement of specific cranial and facial structures
• craniofacial symmetry and mobility
• sphenoid and cranial-base mechanics
• occipital and posterior cranial movement
• facial and scalp tension
• nasal airway space and airflow

Patients may also report changes in:

• nasal breathing
• facial or sinus pressure
• head pressure
• headache
• cranial or facial tension
• posterior scalp or base-of-skull tension
• mental clarity or brain fog
• light sensitivity
• discomfort or restriction with directional eye movement

The response is individual, and not every symptom changes in every patient.

The important point is that NasalRX gives us an opportunity to make a physical structural change and then assess the patient's response to that change.

Improved nasal airflow is one of the most consistent changes we see following NasalRX.

Some patients notice an immediate difference in a nasal passage that previously felt restricted.

They may describe the nose as:

• more open
• wider
• easier to breathe through
• more balanced from side to side
• less compressed
• requiring less effort to breathe

For patients who have been habitually mouth breathing because nasal breathing has become difficult, this can be particularly significant.

Improved nasal airflow may make it easier to return to nasal breathing and potentially improve the wider mechanics of respiration.

The nasal structures do not sit independently from the rest of the skull.

Mechanical relationships extend through the facial skeleton towards the sphenoid and cranial base and into relationships involving the temporal bones, occiput and dura.

This is one reason a treatment applied internally through the nasal passages can sometimes be followed by changes well beyond the nose itself.

Clinically, we often observe changes in wider cranial and facial movement following NasalRX.

The treatment is therefore not simply about opening a nasal airway.

It is about using the nasal passages as an internal mechanical access point into the craniofacial system.

The dura is the tough connective tissue membrane surrounding the brain and continuing around the spinal cord.

It has important anatomical attachments and relationships throughout the cranial base.

Because the sphenoid, temporal bones and occiput participate in this region, changes in cranial-base mechanics are relevant to the physical environment in which the dura functions.

Our clinical rationale is therefore not that NasalRX directly “treats the dura.”

Rather, by changing restriction within the surrounding cranial and facial structures, we aim to improve the mechanical environment associated with the dura and cranial base.

The brain exists within a dynamic fluid environment involving arterial blood flow, venous drainage, cerebrospinal fluid, meningeal lymphatic pathways and the glymphatic system.

CSF movement is influenced by physiological forces including cardiovascular pulsation and respiration.

Cranial osteopathy has also long recognised a rhythmic cranial mechanism and proposed that cranial movement is functionally related to CSF and fluid dynamics.

At Cranial Solutions, our clinical model is that cranial mobility may be another mechanical component within this wider dynamic environment.

This is one reason improving cranial and craniofacial restriction is particularly interesting.

However, we do not currently have direct physiological measurements demonstrating that NasalRX increases CSF flow, increases glymphatic clearance or directly changes cerebral blood flow.

Those remain important areas for future research.

NasalRX can be particularly relevant following concussion or head trauma because the forces involved do not act on the brain in isolation.

They also pass through the skull, face, cranial base and cervical spine.

In some patients we find persistent mechanical restriction following the injury.

In others, the latest concussion appears to have re-aggravated restriction associated with previous injuries.

This is why our post-concussion assessment looks beyond neurological symptoms alone and considers whether cranial, facial, nasal, jaw or cervical restriction may still be contributing to the patient's overall presentation.

NasalRX may then form one part of an integrated treatment approach alongside cervical care and, where appropriate, other concussion rehabilitation.

The same structural approach can be relevant to people who have not experienced a recent concussion.

Depending on the individual's findings, NasalRX may be considered where there is significant nasal or craniofacial restriction associated with problems such as:

• nasal obstruction
• sinus or facial pressure
• mouth breathing
• headache
• migraine
• cranial or facial tension
• jaw/TMJ problems
• previous facial or head trauma

The decision to use NasalRX is based on the patient's history, examination and mechanical findings rather than on a diagnosis alone.

NasalRX uses a small inflatable device introduced into the nasal passage and briefly expanded in a controlled manner.

The treatment produces pressure within the nasal passage and transmits force into the surrounding structures.

The exact approach can vary according to the restriction being addressed.

Patients commonly describe a strong but brief sensation of internal pressure.

When a structural release occurs, it may be felt or occasionally heard.

Afterwards, we assess the mechanical response and ask the patient about any immediate changes they have noticed. These findings guide how we adjust treatment using advanced biomechanics to resolve any remaining mechanical restrictions. Depending on the findings, treatment may involve internal joint alignment through controlled inflation, external manual soft-tissue work and joint repositioning, or a combination of these approaches.

A typical initial course of NasalRX consists of six treatments, usually performed once or twice per week.

Some patients respond more quickly than others.

Where progress is slower but treatment is producing useful changes, a further four to six treatments may be recommended.

The decision to continue is response-dependent rather than automatic.

Treatment frequency and the overall number of sessions can also vary according to the individual's presentation, previous injuries and degree of mechanical restriction.

We are interested in both structural and symptomatic change.

Depending on why the patient is being treated, we typically will observe gradual reduction in intensity of symptoms over the course of procedure sessions - but often significant change occurs from the first or second treatment.

NasalRX provides Cranial Solutions with a distinctive way of working mechanically with the nasal, facial and cranial system from an internal access point.

For the right patient, it may form part of treatment for persistent craniofacial restriction, nasal breathing problems, headache, facial pressure or symptoms following concussion and head trauma.