Be Wary of NeuroCranial Restructuring (NCR)
Stephen Barrett, M.D.
NeuroCranial Restructuring (NCR) is said to involve manipulation of the sphenoid bone, which is between the facial bones and the front of the skull . It is said to be an improved form of Bilateral Nasal Specific (BNS) developed by Dean Howell, N.D., a naturopath who is licensed in the state of Washington. His curriculum vitae indicates that he studied nutritional therapies and iridology with James D'Adamo, N.D., D.C., radionics with Galen Hieronymus, Ph.D., and BNS with J. Richard Stober, D.C., N.D. For many years, Howell's Web site has stated:
NeuroCranial Restructuring is the newest and most powerful therapy in physical medicine. NCR is a cumulative treatment process involving controlled release of the connective tissue tension to unwind the body and return it toward its original design. NCR utilizes careful analysis of the body's proprioception (patterns of balance) to determine the precise areas of the skull needing to be unlocked during each day's treatment. . . .
After receiving a form of deep muscle massage and external cranial manipulation, the patient is analyzed to determine the cranial treatment pattern for the day. Then the patient is positioned on a treatment table with one or two therapists helping to hold him/her in a very specific position. The skull is finally released by the action of small, inflatable endonasal balloons that are inserted through the nostril and inflated briefly into the throat. The inflation feels like getting water up the nose and rarely requires five seconds to complete. . . .
Frequently these treatments, such as Bilateral Nasal Specific therapy, gave relief of symptoms and some long-term results while using a generalized pattern of treatment. Many of the results, however, were temporary and the treatment was frequently painful.
With the specific treatment pattern found with NCR's careful analysis and the new addition of specific body positioning, the entire skeletal structure can be permanently changed. . . . This unlocking of the connective tissues' residual tensions combines with precise movements of the cranial bones to allow the structural systems of the body to move incrementally and cumulatively towards the body's original design.
NCR creates a permanent structural release for the changes triggered by traumatic events of a body's life. Birth trauma, accidents and falls, sports injuries, medical procedures, severe emotional and biochemical traumas are just some of the causes of musculoskeletal damage that are released with NCR .
Howell claims the conditions amenable to NCR include: "Alzheimer's; anxiety and nervousness; arthritis, bursitis, rheumatism; attention deficit disorder, dyslexia, hyperactivity and other learning disabilities; autism; cerebral palsy; concussion and other head injuries; depression, obsessive-compulsive disorder; Down's Syndrome; dystonia; ear infection and deafness; glaucoma, double vision and other vision problems; headaches, head pressure, migraines; insomnia; low energy, fibromyalgia, chronic fatigue; muscle spasms, neck and shoulder pain; organ functioning; orthodontic stress and bruxism; osteoporosis; Parkinson's disease and tremors; phobias; poor concentration and focus; relationship difficulties; sciatica, kyphosis (hunchback), lordosis (swayback), scoliosis (spiral spine), military spine & other back problems; seizures; sinusitis, sleep apnea, snoring, other breathing and sinus disorders; strokes; tinnitus; TMD, TMJ (mouth, head and jaw pains); vertigo and other balance problems; whiplash syndrome; wrinkles (NCR replaces a face lift)." 
Howell also states:
Starting with the birthing process, your head has received a series of traumas that impair the functioning of your entire nervous system. Falls, car accidents, sports injuries, fevers, infections as well as other physical and emotional traumas can all cause your head to move and lock into undesirable shapes and positions. We have found that the structural priority of the body is cranial stability, so your spine and muscles will assume whatever position necessary (however painful) to adequately support your head.
To achieve your most functional stability, then, your head —and through it your spine and entire nervous system—must be returned to its optimal shape and position. Side effects of NCR treatment include increased energy, happiness, inner peace, mental acuity, pleasant interpersonal relationships, youthful appearance, facial symmetry and beauty .
Howell practices, teaches, and offers "certification" in NCR. His basic course, which costs $10,000. includes 40 hours of instruction over a 7-day period . In June, 2009, Howell's NCR Med site listed 21 "certified" practitioners in the United States, of whom 7 were chiropractors and 9 were naturopaths. Fees I have seen quoted on the Web have ranged from $500 to $900 for the initial 4-session "treatment sequence" and $450 to $600 for subsequent sequences.
Irrational and Unsafe
There is no published scientific evidence or logical reason to believe that NCR is effective for treating any of the conditions for which it is recommended. There is no reason to believe that the sphenoid bone can be safely manipulated or that moving it would provide health benefits. In addition, although few complications have been reported, there is good reason to believe that it can be harmful.
In 1983, during treatment with Bilateral Nasal Specific (a variant in which a finger cot is used as the balloon), a Canadian baby was asphyxiated after the finger cot slipped off the syringe on which it was mounted and lodged in the child's windpipe. The practitioner was found guilty of manslaughter, fined $1,000, and ordered to stop using BNS .
A case has reported of a 51-year-old woman who sustained fractures in two sectors of her nasal septum (the bone between the nostrils) during an NCR treatment in which balloons were inflated inside her nostrils. During the procedure, the patient heard a crunching sound and experienced severe midface pain accompanied by nosebleed. Surgery was required to reposition her nasal septum. The authors noted that if the balloons had been placed more deeply into the nose, disastrous complications could have occurred .
The Texas Board of Chiropractic Examiners has concluded that Nasal Specific Treatment is within chiropractic's scope as defined by state law. In 2001, the board stated:
Nasal Specific Treatment appears to be a correction of the cranial bones and, as such, appears to meet the criteria of being within the scope of practice of a Texas licensed chiropractor.
Please be advised that Occupations Code, 201.502 states that it is ground for refusing, revoking, or suspending a license for "failure to use proper diligence in the practice of chiropractic." In other words, the Board expects a licensee to be properly trained in any technique that the licensee uses on a patient. .
The board did not specify how one can get "proper training" in an improper procedure.
- Frequently asked questions. Caring Medical & Rehabilitation Services Web site, accessed July 12, 2003.
- Howell D. What is NeuroCranial Reastructing? Dr. Dean Howell Web site, accessed June 12, 2009.
- Howell D. NeuroCranial Restructuring Doctor Training Certification. Dr. Dean Howell Web site, accessed June 12, 2009.
- Howell D. Physicians training class overview. NCR Med site, accessed April 24, 2003.
- Lowell J. Bilateral nasal specific. NCAHF Newsletter 8(1):2, 1985.
- Davis GE and others. A complication from Neurocranial Restructuring: Nasal septum fracture. Archives of Otolaryngology Head and Neck Surgery 129:472-474, 2003.
- Scope of practice regarding Nasal Specific and Nasal Lavage. Texas Board of Chiropractic Examiners, Jan 15, 2001.
This article was revised on June 12, 2009..