Network Spinal Analysis
The tenets of Network Spinal Analysis and an overview of the
Epstein models
By Donald Epstein, D.C.
Network Spinal Analysis (NSA) is an evidenced-based approach to wellness and
body awareness.1 Gentle precise force applications
to the spine cue the brain to promote new wellness strategies. Two unique healing
waves develop with this work. They are associated with spontaneous reorganization,
redistribution and release of spinal tension.2
NSA is applied through a series of four levels of care. The application of NSA
combines the practitioner’s clinical assessment of refinements in self-regulation
of spinal cord tension patterns, unique “self-organizing” spinal sensory
motor strategies within the recipient of care, with the patients’ self-assessments
of personal wellness and changes in life style.
Greater awareness of “self” and conscious awakening of the relationships
between the body, mind, emotion and expression of the human spirit are realized
through NSA care. Doctors of chiropractic also use NSA as an application for
the identification and self-regulation of vertebral subluxation patterns, spinal
tension and autonomic defense posture and accompanying osseous structural changes.
NSA is currently taught exclusively to chiropractors and chiropractic students,
and is presented in relationship to chiropractic practice and subluxation-based
care. Practitioners are taught to implement NSA in their practices consistent
with the guidelines established by the Council on Chiropractic Practice (and
the cannon of ethics of the Association for Network Care). The Epstein models
are soon to be offered through the curriculum of a certificate program of Wellness
Education and Outcomes Assessment offered by Florida Atlantic University in
Boca Raton.
The Epstein models upon which NSA is based are as follows:
- The Epstein Model
of Somatic Awareness:
Cognitive awareness of body structures, including the spine, is an essential
component of healing and wellness. Cognitive somatic and spinal awareness,
with the ability to verbalize the experience, suggests utilization of higher
cortical centers. The inability to perceive, process and verbalize body sensations,
emotions, and tension patterns limits the range of one’s adaptive responses.
This promotes the body-mind disconnection that can create and sustain spinal
distortions and vertebral subluxation. Care is taken to establish and refine
capacities, strategies and pathways that promote and nurture a wider range
of auto-regulatory and self-empowering responses and choices. It is proposed
that the body cannot self regulate adaptation to a situation if the neural
pathways that promote observation of the area and choice in response are inhibited.
- The Epstein Model
of Spinal and Neural Integrity:
Panjabi3 and Epstein4
have proposed stability sub-systems that regulate the dynamic state of spinal
and neural integrity. These proposed systems must be able to rapidly share
energy and information with one another. Spinal and neural integrity as an
expression of spinal and neural wellness is associated with instantaneous
modifications of perception and adaptive responses to the changing environment.
Clinical assessments are used to evaluate the body’s ability to establish
and nurture mechanisms to reorganize the relationship between the subsystems
and the environment.
Passive Subsystem
This system is composed of the vertebrae, ligaments and spinal discs. Palpation
for compliance of these segments determines if tension is being stored within
this system. If tension is present this suggests that the small inter-segmental
muscles of the spine are acting in defense, as the individual is locked in
protective physiology and lack of safety. The flexibility of the passive system
can be enhanced, and tension released, through the NSA respiratory wave initiating
rhythmic oscillations of the vertebral segments entrained with the mechanisms
of breathing. This results in vertebral segments and neurologic afferent pathways
offsetting defense physiology with pathways of safety and ease. In addition,
active para-spinal muscle tension can build and then release tension through
spontaneous stretching or motion of the musculature of the spine or extremities.
When this occurs the vertebral segments move through a greater range of motion
and tension is released. Moreover, a greater range of motion of vertebral
segments and elimination of defense physiology is achieved.
Active Subsystem
This system is composed of the spinal muscles and tendons, especially the
long muscles of the spine. Tension in the spinal long muscles is in relationship
to adaptation to stress including emotional tension. The entrainment of spinal/respiratory
movements that occur during NSA care can reset adaptive responses. Spontaneous
movement through stretching, or through the somatopsychic wave5,
may also redistribute tension and facilitation patterns within the musculature.
Neural Control Subsystem
This system is composed of the spinal cord, nerve roots and peripheral nerves.
The attachment of the meninges to the vertebral segments is also included.
The concept of Adverse Mechanical Cord Tension (AMCT), introduced by Alf Breig6,
is associated with lengthening in flexion/extension or lateral bending of
the cord. Relating to this concept, NSA considers five spinal cord tension
patterns or “phases.” NSA care is evaluated according to these five
phases. For example, heel tension, resistance to flexion/extension of the
Achilles tendon is suggestive of adverse mechanical cord tension that is also
believed to be indicative of a facilitated subluxation of a flexion/extension
nature. Eversion stress, resistance of the Achilles tendon to lateral bending
motion, is suggestive of AMCT/facilitated subluxation related to aberrations
in lateral bending of the spine.
Adverse mechanical cord tension is proposed to be associated with stress physiology
and is believed to be expressed by the individual as a defense posture. It
is suggested that the spinal cord tension patterns and attending vertebral
subluxation(s) are the mechanisms through which the defense processes are
retained in the body and disconnected from the brain’s reassessment of
the adverse mechanical cord tension.
It is proposed that the presence of AMCT and vertebral subluxation is associated
with a loss of critical self-perception and self-regulatory processes due
to dissociation of higher brain centers.
The Emotional Subsystem
This subsystem is proposed to be associated with a range of motion (rhythmic
oscillation) and tension within any tissue of the body, including the elements
of the passive and active neural control subsystems. A relationship is suggested
between range of motion of vertebral segments and emotions. That is, within
the range of motion of spinal segments there is a corresponding range of expression
of emotions through these segments. The emotional motor system (Holstedge)7
is reported to influence the sensory and motor gain (threshold of excitability)
at every spinal level. The ability or inability to perceive, process and verbalize
a body sense or emotion is believed to be linked to the emotional motor system.
Although the chiropractor utilizing NSA does not assess the emotional subsystem
directly, he/she considers its implication in spinal and neural integrity.
- Wellness:
The concepts of wellness and illness exist on a continuum.
One’s position along the wellness-illness continuum represents the realm
through which one experiences his body, circumstances, symptoms, sense of
self, relationships and the world in general.
Neither wellness nor illness exist in a direct relationship with pathology
or lack thereof. Wellness-illness is a function of one’s internal experience,
and not one’s circumstance. Therefore, an individual may exhibit various
stages of pathology, remission or health regardless of where he/she is on
the wellness-illness scale.
Wellness and illness include domains such as: physical, mental and emotional
state, and social well-being. They are based upon one’s subjective experience
of self and one’s health beliefs. It is possible to objectify these domains
through specific survey instruments that ask the individual to report their
perceptions.
- Vertebral Subluxation:
Two classes of vertebral subluxations exist (described below), each having
different etiology and responding to a different force application.8
The structural (Class A) subluxation is a segmental distortion associated
with a compromise of the inter-vertebral structures within the foramen. This
is most commonly produced by a localized physical trauma or is adaptive to
spinal cord tension patterns.
The facilitated (Class B) subluxation is associated with lack of recovery
from emotional, mental or chemical stress and is believed to be associated
with a state of adverse mechanical spinal cord tension. This clinical finding
is believed to be a product of stress physiology and attendant stress posture,
and is best addressed through a gentle touch at or in the vicinity of the
vertebral/dural attachments in the cervical and sacral-coccygeal spine.
Rather than viewing the vertebral subluxation as the single cause of ill health,
it is instead viewed as an integral link in the process of body-mind disconnection
and a physical consequence of defense physiology and postural changes.
It is suggested that the brain can learn to recognize such distortions and
develop mechanisms to self-regulate restoration to normal function. The spinal
contacts applied in NSA are used to the brain to self-regulate to normal the
mechanisms that produced and perpetuated the subluxation(s) while promoting
new spinal and neural pathways and strategies of self organization to offset
future episodes of vertebral subluxation.
- The Spinal Gateway
When vertebrae distort as a consequence of defense posture, at least one of
the vertebral articulations is in relationship to the stress experienced at
the time. Within the concept of NSA, a force is not applied to a segment that
is a product of defense posture. That is, within the NSA phasing system, a
segment that invites contact and is believed to be associated with a peaceful
state is selected for contact. The “spinal gateway” is such an area.
No force in NSA is applied to the region of tension, facilitation or fixation.
Although an adjustment applied there may correct the vertebral distortion,
it will not allow for rapid progression thought the NSA Levels of Care (see
page 26 for details) and the emerging properties available with NSA.
Within the method of Network Spinal Analysis, I have introduced the concept
of the “spinal gateway.”8 This is viewed as an interface between
the dimensions of energy, consciousness and physical tissue. The spinal gateway
serves as a nexus or hub for interaction between the sub systems that establish
and maintain spinal and neural stability and integrity. Spinal gateways are
located on, or adjacent to the spinal segments having physical vertebral-dural
attachments. Application of a light force or touch to a spinal gateway assists
the body-mind to shift from a dominant state of stress physiology (which is
expressed as defense posture) to a state of greater adaptive self-assessment
and organization. Precise and gentle touch contacts at these Spinal Gateways
assist the brain to connect more effectively with the spine and body. As a
consequence, the individual develops new strategies for living and healing.
NSA continues to expand the application of wellness care and outcomes assessments
for the chiropractic profession. This involves clinical application for the
correction and self-regulation of vertebral subluxation(s). It also provides
for the development of new sensory motor strategies to assist in spinal and
neural integrity.
As chiropractic, the care is in relationship to both the practitioner’s
clinical health and spinal assessments and the patient or practice member’s
self-assessment of their experience of advancements in spinal and neural integrity
and wellness.
Research
An active research program investigating various parameters of NSA was initiated
nearly a decade ago and will continue into the future. Early on, a commitment
was made to foster the research program through major universities using the
expertise of senior researchers. Subsequently, the program has developed through
study at the University of California in Irvine and the University of Southern
California, and is commencing at Florida Atlantic University.
Following standard protocol for the establishment of an evidence base for emerging
methodologies, the program first involved publication of a descriptive paper
representing the clinical approach. This was followed by a retrospective study
to ascertain if anecdotal reports could be substantiated. Results of the retrospective
study indicated statistically significant health and quality of life benefits
reported by over 2,800 recipients of care. The outcomes of the study led to
further refinement of Network Chiropractic to the levels of care now practiced
in NSA. A longitudinal study investigating the benefits of care related to the
refined approach has been completed and is awaiting final analysis prior to
publication. However, preliminary results indicate similar benefits as reported
through the retrospective study.
An important spin-off of the retrospective study has been the establishment
of a health and quality of life questionnaire that is oriented towards “well”
populations as opposed to other questionnaires that focus primarily on sick
populations. This questionnaire has application to all health-related disciplines,
not just NSA.
While a major thrust of NSA research is to investigate its clinical impact,
research into other aspects of NSA is also necessary. The unique somatopsychic
wave accompanying NSA care is intriguing. Study has been undertaken to ascertain
the nature of this wave phenomenon by analyzing the surface electromyogrphic
(sEMG) signals during the different levels of care. Study has thus far revealed
a high level of predictability between signals received and the different levels
of care. Results indicate that as recipients progress through the NSA levels
of care, the associated somatopsychic wave increases in organization.
Investigation into all aspects of NSA will continue as results, both anecdotal
and evidence based, suggest a wide range of implications into areas as diverse
as neurophysiology, psychothearpy, systems analysis of non-linear systems, behavioral
modification and bioculturalism.
As NSA continues to be investigated in these different arenas, the models underpinning
NSA will certainly be enhanced. This is expected to provide a yet deeper understanding
of the expression of the innate wisdom found within all living systems.
1. Epstein, D. The Theoretical Basis and Clinical Application
of Network Spinal Analysis (2001, Longmont, Colorado, Innate Intelligence, Inc.)
2. Bohacek, S and Jonckheere, E: Chaotic Modeling
in Network Spinal Analysis: Nonlinear Canonical Correlation with Alternating
Conditional Expectation (ACE): A Preliminary Report. Journal for Vertebral Subluxation
Research 1998; 2 (4) 188-195
3. Panjabi M. The stabalizing system of the spine,
Part I. function, dysfunction, adaptation, and enhancement. Journal of Spinal
Disorders 1992; 5(4): 383-389.
4. Epstein, D. The Theoretical Basis and Clinical
Application of Network Spinal Analysis (2001, Longmont, Colorado, Innate Intelligence,
Inc.)
5. The somatopsychic wave is a spinal wave that develops
unique to Network Care, and which is associated with a reduction of spinal tension,
various spinal re-organizational states and patient reports of enhanced wellness.
As care progresses, this wave undergoes visible refinement which can be mathematically
mapped and has been the topic of academic studies and articles.
6. Breig A. Adverse Mechanical Tension in the
Central Nervous System. (1978; Stockholm, Sweden: Almqvist & Wiksell Int.;
New York: John Wiley & Sons) 39-41, 45, 96, 116, 121-123, 129-130, 155
7. Holstege G. The Emotional Motor System. European
Journal of Morphology 1992; 30 (1): 67-69.
8. Epstein, D, Network Spinal Analysis: A System
of Health Care Delivery Within the Subluxation-Based Chiropractic Model Journal
for Vertebral Subluxation Research 1996; 1 (1) 51-59
[Editor’s note: “Spinal Gateway” is a termed trademarked to
Donald Epstein]
Provide your feedback on this
article.
© Copyright 2003 Today's Chiropractic