There are only a few places where the nervous system can be properly tuned, and these “adjusting knobs” are the bones that directly attach to the dura mater. Faulty alignment or fixations in any bone of the cranial vault or spine will over stretch, torsion, deform or drag on the dural membrane, disrupting its ability to send or receive reliable signals from musculoskeletal and visceral structures. These aberrant dural stresses frequently manifest as spasm and pain, and are often misinterpreted as muscle problems. Therapists greatly benefit from the ability to quickly distinguish between common myofascial pain syndromes and true adverse dural tension signs.