Cranial Facial Release for Head Pressure
Dr. James Bergtold, DC is certified in cranial facial therapy for headache and post-concussion treatment and has treated more than 5,000 patients across 25+ years of practice. He offers CFR as one option among the therapies and advanced treatments at his Naples clinic, and only when the exam supports it.
When Blocked Breathing Calls for Cranial Facial Release
Restricted breathing does not stay in your nose. When airflow through one side is limited, you mouth-breathe at night, wake up unrefreshed, and carry a dull band of pressure across the forehead and cheekbones through the day. Head pain settles behind the eyes and the jaw feels tight. Most patients who ask us about CFR have already worked through saline rinses, allergy medication and a steroid spray, and some have seen an ENT who found nothing that needed surgery.
Cranial facial release approaches that pattern mechanically rather than chemically. A small balloon is placed in a specific nasal passage and inflated for a second or two, applying a brief, controlled stretch to the bones of the face and skull and the connective tissue between them. Patients commonly report easier airflow and less facial pressure within the first visits. Research on this specific technique is limited, so Dr. Bergtold treats it as something to try and reassess, not a promise.
What Is Cranial Facial Release?
Endonasal Balloon Adjusting
Cranial facial release (CFR) is a manual technique in which a small balloon is passed into a nasal passage and briefly inflated to mobilize the bones of the face and cranium. It grew out of the older bilateral nasal specific method. CFR is a hands-on procedure, not a device or a drug, so no FDA clearance applies, and the published evidence for it remains limited.
Each inflation lasts about two seconds and repeats across different passages. Most patients feel brief pressure, not pain. The goal is freer motion at the cranial sutures and easier airflow. CFR is usually given as four visits over four consecutive days, often alongside chiropractic adjustments when the upper neck contributes.
Cranial Facial Release Treatment Areas
Head, Face and Airway
Chronic Sinus Pressure
Aims to ease fullness and improve drainage across the sinuses
Headaches and Migraines
Used with neck care when head pain keeps coming back
Restricted Nasal Breathing
Targets the nasal passages when airflow feels blocked
Post-Concussion Symptoms
Supportive care for lingering head pressure after an injury
Jaw and Facial Tension
Addresses facial bone restriction that loads the jaw joint
Snoring and Poor Sleep
May help when limited nasal airflow disturbs sleep at night
Benefits of Cranial Facial Release
Drug-Free and Brief





- 01
Drug-Free Technique
No medication, no injections and no surgical incision
- 02
Short Sessions
Each visit takes about 10 to 15 minutes with no downtime
- 03
Quick Feedback
Most patients can tell within a visit or two whether it helps
- 04
Airway Focused
Works on nasal airflow, which few manual therapies address
- 05
Defined Course
Typically four sessions, not an open-ended treatment plan
- 06
Combines With Spinal Care
Pairs with adjustments when the upper neck also drives symptoms
Cranial Facial Release vs. Alternatives
Who Is a Good Candidate for Cranial Facial Release?
Finding the Right Approach
Ideal Candidates for Cranial Facial Release
- Adults with ongoing sinus pressure or facial fullness that medication has not resolved
- Patients with headaches and migraines that also involve head or facial pressure
- People with lingering symptoms after a concussion who have been medically cleared
- Patients whose neck pain and headaches respond partly to adjustments but not fully
- Anyone who prefers a drug-free option and has realistic, short-term expectations
- Patients already receiving spinal decompression or adjustments for a related problem
Who Should Wait or Avoid Cranial Facial Release
- Recent nasal, facial or skull fracture, or recent sinus or nasal surgery
- Active sinus infection, nosebleed or an untreated infection in the nasal passages
- Bleeding disorders or current anticoagulant therapy
- Known nasal polyps, tumors, or a suspected cerebrospinal fluid leak
- Uncontrolled high blood pressure or recent stroke
- Children, unless a physician has specifically recommended it
What Happens During Cranial Facial Release
Step-by-Step Process
- 01
Exam
Dr. Bergtold takes your history, checks the neck and airway and confirms CFR is reasonable.
- 02
Setup
You recline while a small balloon is fitted to a hand bulb and lightly lubricated.
- 03
Inflation
The balloon enters one nasal passage and is inflated for about two seconds, then removed.
- 04
Sequence
The step repeats across the passages on both sides, taking 10 to 15 minutes in total.
- 05
Recovery
You sit up and breathe through each side while the eyes water off for a minute or two.
- 06
Reassessment
Dr. Bergtold rechecks breathing and pressure before deciding whether to continue the series.
Risks and Side Effects
What to Know
Common Cranial Facial Release Side Effects
The technique is uncomfortable for a few seconds at a time. Expect watering eyes, a brief burning or pressure sensation in the nose, and sneezing or a runny nose afterward. Mild facial soreness, a short-lived headache and tiredness the same evening are also reported, and these generally clear within a day.
Less Common Effects
A minor nosebleed can occur, particularly in dry conditions or in patients on blood thinners. Temporary lightheadedness is possible. Because CFR is not widely studied, the true rate of rare complications is not well established, which is one reason it is not used when there is a fracture, an infection, a bleeding disorder or a suspected cerebrospinal fluid leak.
Safety and Regulatory Status
CFR is a manual procedure, not a regulated device, so no FDA approval or clearance applies. It is not a treatment for any disease. Persistent or worsening head pain deserves a medical workup, and the National Institute of Neurological Disorders and Stroke lists the warning signs that call for prompt evaluation.
Cranial Facial Release Cost in Naples
Pricing and Payment Options
How Much Does Cranial Facial Release Cost in Naples?
Cost depends on how many sessions are recommended, whether CFR is delivered on its own or alongside adjustments and other therapies, and whether an exam or imaging is needed first. CFR is normally delivered as a short series rather than a single visit, so we quote a plan instead of a per-visit fee. Call (239) 593-6788 and our team will give you a clear number before anything is scheduled.
Insurance and Coverage
We accept Blue Cross Blue Shield, Aetna, Medicare, Medicare Advantage, UnitedHealthcare and Cigna. Coverage for cranial techniques varies a great deal between plans and many carriers treat CFR as a non-covered service, so we verify your benefits in advance and tell you what will be out of pocket before you start.
Flexible Payment Options
- CareCredit - healthcare financing with monthly payment plans, applied for online or at the front desk
- Written care plans - the series is bundled into one plan so the total is known up front
Marnie at the front desk handles benefit checks and financing questions, so cost is never a surprise partway through a series.
Why Choose Bergtold Chiropractic for Cranial Facial Release in Naples
Naples Certified CFR Provider
CFR Certified
Trained in cranial facial therapy for headache and concussion care
Exam Comes First
On-site X-ray and a full history before any technique is chosen
Honest Expectations
Clear about what the limited research on CFR does and does not show
Full Range of Options
Adjustments, laser, decompression and acoustic therapy in one clinic
25+ Years in Practice
More than 5,000 patients treated in Naples since November 2000
Rated 5.0 by Patients
A 5.0 Google rating from more than 200 Naples patient reviews
Related Treatments
Treatments that pair well with cranial facial release in Naples.
Frequently Asked Questions About Cranial Facial Release
Your Questions Answered
How much does cranial facial release cost in Naples?
There is no single price, because cost depends on how many sessions you need and whether CFR is combined with adjustments or other therapies. CFR is normally delivered as a series, so we quote the plan rather than a per-visit fee. Call (239) 593-6788 and our team will confirm the total and check your insurance benefits before anything is booked.
How long do the results of cranial facial release last?
That varies widely and is not well documented in published research. Some patients report easier breathing and less pressure that holds for months after a four session series, while others notice the benefit fading and return periodically. Dr. Bergtold reassesses after the first series and will tell you honestly if repeating it makes sense for you.
Does cranial facial release hurt?
It is briefly uncomfortable rather than painful for most people. Each balloon inflation lasts about two seconds and typically causes pressure behind the nose, watering eyes and an urge to sneeze. The sensation stops as soon as the balloon deflates. Patients who find the first inflation intolerable can stop at any point, and we will not push through it.
When will I notice a change after cranial facial release?
Most patients who respond notice something during or shortly after the first session, usually easier airflow through one or both nostrils. Any further change tends to build across the four visit series. If nothing has shifted after the first two visits, that is useful information and we will look at a different approach instead of continuing.
How often do I need cranial facial release?
CFR is typically delivered as four sessions over four consecutive days rather than as ongoing weekly care. Some patients repeat the series months later if symptoms return, especially seasonally. It is not designed as an indefinite treatment plan, and Dr. Bergtold will not keep scheduling sessions when they are not producing a change.
What is the difference between cranial facial release and a chiropractic adjustment?
A chiropractic adjustment applies force to spinal joints, usually in the neck or back. Cranial facial release works inside the nasal passages with a small balloon to mobilize the bones of the face and skull. They address different structures and are often used together when head pain has both a neck component and a facial pressure component.
Is there scientific evidence that cranial facial release works?
The published evidence for CFR specifically is limited to case reports and small case series, not large randomized trials. Broader research supports manual therapy for cervicogenic headache and migraine, which informs the rationale, but those studies did not test CFR. We tell patients that plainly so the decision is made with accurate information.
Can cranial facial release fix a deviated septum?
No. A deviated septum is a structural difference in the cartilage and bone dividing the nasal passages, and correcting it requires surgery. CFR may make breathing feel easier by mobilizing surrounding structures, but it does not straighten the septum. If your ENT has identified a septal deviation, that evaluation should guide your decision.
Can cranial facial release help after a concussion?
Some patients with lingering post-concussion pressure and head pain report improvement, and Dr. Bergtold holds certification in cranial facial therapy for post-concussion treatment. Evidence remains limited. Anyone with a recent head injury needs medical clearance first, and CFR is offered as supportive care alongside, not instead of, medical follow-up.
Can children get cranial facial release?
We do not offer CFR to children at this clinic unless a physician has specifically recommended it. The technique is uncomfortable and the evidence in pediatric patients is thin. Children with neck or posture-related complaints are better served by our pediatric chiropractic care, which uses gentle, low-force techniques.
Should I see an ENT before trying cranial facial release?
If you have never had your symptoms evaluated, yes. Chronic congestion, facial pain and pressure can stem from infection, polyps, allergies or structural problems that need medical treatment. Dr. Bergtold will refer you when the findings point that way. CFR is most appropriate once serious causes have been ruled out and other care has not resolved things.
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References
Cranial facial release itself has not been tested in large trials. The studies below cover manual therapy for headache and the safety profile of chiropractic care, which is the broader context for this technique rather than evidence for CFR specifically.
- Núñez-Cabaleiro et al., Headache. (2022). Effectiveness of manual therapy in the treatment of cervicogenic headache: A systematic review. PMID: 35294051.
- Lu et al., Pain Res Manag. (2024). Myofascial Release for the Treatment of Tension-Type, Cervicogenic Headache or Migraine: A Systematic Review and Meta-Analysis. PMID: 38585645.
- Onan et al., J Integr Neurosci. (2023). The Efficacy of Physical Therapy and Rehabilitation Approaches in Chronic Migraine: A Systematic Review and Meta-Analysis. PMID: 37735140.
- Gouveia et al., Spine (Phila Pa 1976). (2009). Safety of chiropractic interventions: a systematic review. PMID: 19444054.
- National Center for Complementary and Integrative Health. (2025). Manual therapies vary in how thoroughly they have been studied, and patients should discuss any complementary approach with their healthcare provider.