by Donald Epstein, D.C. and Anthony Posa, D.C.
"Network Spinal Analysis, developed by Donald M. Epstein, D.C.,1 is an approach to health and wellness utilizing long standing chiropractic methods and employing certain principles of quantum mechanics 2, neuroanatomy, and neurophysiology, 3, 4, 5 psychoneuroimmunology 4, and changing perspectives in health care." 5, 8
It is founded on the premise that individuals free from the complex of factors precipitating from, or leading to vertebral subluxations, experience a greater range of inherent adaptability and hence, a greater sense of relative health or wellness.
INSPIRED BY D.D. PALMER
Network Spinal Analysis is inspired by D.D. Palmer's concept of tone being associated with tension on the neuroskeleton and of consciousness being associated with nerve vibration. 9 It is also consistent with Bar's model of multiple cord pressures, and the relationship of the meninges to the vertebral subluxations 10, and his model of vertebral subluxation including the element of mental impulse. At the core of its vertebral subluxation model is the categorization of vertebral subluxations into two categories: a) facilitated b) structural.
PRIORITY SYSTEM OF ADJUSTING
Once the type of subluxation has been identified, a priority system of adjusting is initiated. This sequencing of adjustments is termed the Phasing system.
The specific order of adjusting suggested by the phasing system is applied over time. The point of critical tension is sought. This refers to the site from which the adverse spinal cord tension and nerve interference is generated. The regions of facilitation and fixation are generally seen as adaptations to this region. Particular types of force applications and characteristic outcome assessments evolve over a series of Levels of Care. 11
LEVELS OF CARE
All Levels of Care utilize aspects of contemporary chiropractic techniques and share the following features:
a) Assessment of the patient's spinal and neural integrity and health through a case history which includes various lifestyle and stress history profiles, and physiologic and chiropractic examination
b) Determination of progress through periodic reassessments and questionnaires to monitor patient and practitioner outcomes
c) Modification of any Level of Care deemed to be ineffective or inappropriate to a level which more accurately parallels the changes observed in the patient This article will explore these concepts, along with the somatopsychic responses produced by the body in its self corrective process.
REACTIVE, RESPONSIVE NERVOUS SYSTEM
An objective of care is for the central nervous system to be more self reflective, increasing its capacity to detect and resolve areas of spinal tension, interference and subluxation. Through a program of care the body appears to increase its energy efficiency in achieving reduction of adverse mechanical spinal cord tension, and its associated vertebral subluxations. The clinical perspective is on the body's self-corrective, self-organizing strategies. Both the doctor and patient are striving for a more reactive, responsive nervous system which is more capable of automatically utilizing formally invasive experiences and forces in constructive self corrective fashion.
GENTLE ADJUSTMENT IS GIVEN
Corrections are made by the body's own movement, respiration and modulating tension patterns. Gentle adjustments are given to directly correct vertebral subluxations in the context of enhanced spinal and neural integrity. As the patient progresses through the Levels of Care a greater awareness of one's body, its tension patterns, its self-correcting capacity and enhanced quality of life is anticipated.
INCREASED FLEXIBILITY OF THE SPINE
"Network Care evokes spontaneous self-perpetuating contractions of the paraspinal musculature. The movements may be subtle, barely perceptible, or very obvious and may involve the arms and legs. Over a period of several months, physiological and psychological changes have been observed clinically, including increased flexibility of the spine, increased range of motion, improved mood, and sense of relaxation, self reported "wellness" and greater capacity to cope with stressful situations. These observations provide the basis for considering that Network Care involves body-mind interactions. 12
WAVE PHENOMENA DEVELOP
Two characteristic wave phenomena develop with NSA. They are the Respiratory and Somatopsychic waves, which are suggested to be an effective means of dissipating energy, from the subsystems which maintain spinal integrity." The Respiratory wave is associated with a spontaneous breathing pattern involving a deepening and rhythmic expansion of the thorax with rocking of the cranio-sacral system. This wave progresses upwards from the sacrum, the passive sub system of the spine has the opportunity to increase its motion, breaking down the negative feedback loop that may exist between the spinal integrity subsystems.
QUALITY OF LIFE IS ENHANCED
A most common consequence of this is the reduction of elimination of facilitation and spinal fixation. The somatopsychic wave progresses in a sine wave fashion, specifically moving as muscular undulations of spine. It rocks segments through their motion, often coupling individual vertebral oscillators. Patients have reported a significant enhancement of their health and quality of fife once they have experienced these wave processes.
CURRENTLY BEING EVALUATED
These waves are of such considerable interest that they are currently being evaluated at the University of Southern California, Department of Engineering in a research project titled Chaotic Modeling in Network Spinal Analysis. A population of patients receiving NSA care is being used to mathematically define the wave and its potential benefits to determine how living systems self organize.
ADDRESSED THROUGH THE PHASING SYSTEM
The concept of adverse mechanical cord tension is introduced in relationship to the facilitated subluxation. This is consistent with Alf Breig, M.D.'s model of elongation of the spinal cord in the planes of flexion-extension and lateral bending with pathophysiologic consequences 14. The facilitated subluxation is addressed prior to the correction of the structural (inter-segmental) distortion. The facilitated subluxation is consistent with concepts of multiple cord tensions and is theorized to be in relationship to dural tension. The occiput through sixth cervical, sacrum and coccyx subluxations are addressed through the Phasing system. It is the vertebral meningeal attachment that is of considerable concern as aberrant mechanics at these levels are often in relationship to a more generalized facilitation of the central nervous system and the musculature.
It is commonly observed that a contact taken on one end of the spine can initiate changes at a remote part that visit. For example a specific sacral "notch" contact taken medially may immediately influence the thoracic musculature to dissipate tension, develop a full and deep full spinal respiration, and rock a specific cervical segment through its precise range of motion as predicted by the chosen adjustment.
As spinal segments synchronize their motion, or oscillate, improvements may be seen in spinal hypertonicity, vertebral alignment, posture, and indicators for vertebral subluxation.
Evaluation of parameters such as extremity tension seen as resistance to flexion-extension or lateral bending of the heels, impaired movement of spinal segments in association with respiration, paraspinal musculature hypertonicity, and postural adaptations are a few of the indicators suggesting such a disturbance. 15
Spinal and Neural Integrity is associated with the ability of four sub systems to remain highly reactive to change, and able to share energy and information between one another. These sub systems include the Passive (vertebrae, ligaments, discs), Active (spinal muscles and tendons) and Control (Nervous system) of Panjabi. Epstein suggests the meninges as a part of the Control system including adverse mechanical cord tension within this system.
LOSS OF SPINAL AND NEURAL INTEGRITY
In addition, Epstein adds a fourth Emotional Subsystem. This subsystem is composed of the composite of tissue tension and a restriction within its range of oscillation or movement. When tissues of the spine including the connective tissue can not move through its full range of motion or oscillate effectively this is associated with a loss of spinal and neural integrity.
When the spinal tissues can more freely oscillate and or release their tension, then there is a dissipation of tension from the emotional sub system significantly enhancing spinal and neural integrity 16. This may be accompanied by a cathartic expression of emotion, or by large paraspinal muscle movement, and an enhanced respiration. Reduction of the effects of vertebral subluxation are a common consequence.
SPARKED ACADEMIC INTEREST
As adverse mechanical cord tension is resolved through the application of NSA, coordination of spinal oscillators occur. This means that individual segments will entrain their rocking in a synchronous fashion. The entrainment of coupled oscillators is a prominent topic in current neurophysiologic research as it applies to spontaneous pattern generation. This progressive spontaneous entrainment of spinal oscillators has sparked the interest of a variety of academic researchers.
No specific structural adjustments are initiated until the individual segments are rocking through their own range of motion with the appropriately entrained segment.
In Level One of care, the spinal structures learn how to dissipate tension and reduce chronic facilitation. In Level Two of care, the body develops two entrained spinal oscillators with a resulting correction of chronic vertebral subluxations. In Level Three the patient is even more participatory in the corrective process as the body learns through the use of positioning and long lever arm maneuvers to spontaneously self correct the transitory subluxations in the absence of chronic distortion.
Progressive coupling of oscillators tends to amplify the signal exchanged between them, suggesting a more self-attentive nervous system. The more frequency entrained oscillators there are within a system the more difficult it is to interrupt by external stimuli, and the more stable the relationship between the two synchronized elements (vertebrae) may become.
STATE OF READINESS
NSA does not adjust the segments of maximum fixation, discomfort or pain. It suggests adjustments once the central nervous system appears to have a better awareness of the segment, and can initiate its gentle rocking through its motion with respiration. This must be accompanied by a state of readiness of the spine in assisting the body to correct the subluxation. With progression through subsequent Levels of Care the body increases its ability to recognize tension, distortion and subluxation patterns and generate subtle movements, and respirations to spontaneously self correct.
PRODUCE VERTEBRAL CORRECT10N
It is common for audible releases to occur as articulations release their distortion in response to gentle contact adjustments distal to the contact. Eventually utilizing subtle long lever arm maneuvers such as positioning die arm or leg body's a precisely will initiate the own self corrective waves to produce vertebral correction including a noticeable articular release.
VERTEBRAL SUBLUXATIONS ARE RESOLVED
It has been suggested that the inability of the cortex to effectively, perceive a stressor results in a limbic and spinal response recirculating the energy which was not fully experienced. Adverse mechanical spinal cord tension is proposed by Epstein to be a mechanism for storing the energy often in relationship to vertebral subluxations. As the central nervous system becomes more refined in its ability to be aware of tension and energy patterns from which it has been segregated, the facilitation patterns reduce, and spinal compensations including vertebral subluxations are resolved.
LARGEST STUDY OF HEALTH AND WELLNESS OUTCOMES
Network Care has been studied through the Department of Anatomy and Neurobiology, Department of Otolaryngology-Head and Neck Surgery, College of Medicine, Department of Sociology, at the University of California, Irvine. 17. This was the largest epidemiological study of chiropractic patients to date. It was also the largest study of health, and wellness outcomes for a chiropractic population. It was amongst the largest studies of any population for self reported evaluations of health and well being. It also established the initial validity of a health and wellness and quality of life instrument for a non-medical discipline.
BENEFITS ARE EVIDENT
The study included 2,818 patients from 156 participating offices of members of the Association for Network Chiropractic. "The evidence of improved health in the four domains (physical state, mental/emotional state, stress evaluation, life enjoyment) over-all quality of life from a standardized index, and the "wellness coefficient" suggests that Network Care is associated with significant benefits. These benefits are evident from as early as 1-3 months under care, and appear to show continuing clinical improvements in the duration of care intervals studied, with no indication of a maximum clinical benefit." This indicates that for the population studied clinical benefits accrued over time, with no ceiling. These findings are being further evaluated through longitudinal studies of current populations under care in combination with investigation of the neurophysiological mechanism underlying its effects.
POSITIVE CHANGES IN OVERALL HEALTH
The study concludes with "These initial findings show that Network Care is associated with significant improvement in all indicators of health evaluated, and demonstrate a strong association between Network Care and self reported, positive changes in overall health/wellness."
LEADING EDGE OF BODY-MIND DISCIPLINES
In summary, the self-recognition of the presence of an impediment to one's health with the ability to self-correct the offending pathophysiology is a high ideal for any form of health care. NSA combines a vitalistic, holistic system of precise outcome assessments for spinal and neural integrity and improvements in health and quality of life.
Although some research projects have been performed within our profession, few have specifically documented the long-term health and wellness benefits of chiropractic, as a non-medical discipline. The research to date, along with the ambitious projects underway, and a scholarly textbook in preparation is helping to position NSA at the leading edge of the body-mind disciplines. A base of enthusiastic support from the academic community in the fields of neuroanatomy, neurobiology, sociology, immunology, biochemistry, psychology, radiology, engineering, physics, endocrinology and mathematics has developed.
"Within the boundaries of the study design, these findings provide substantial evidence that Network Care should be included among those practices with established health benefits".18
1. Epstein, D., The Association for Network Chiropractic, 444 Main Street, Longmont. Colorado 80501
2. Prigogine L., Order out of Chaos. New York: Bantam Books, 1994:226-290
3. Breig A., Adverse mechanical tension in the central nervous system. New York: John Wiley & Sons, 1978
4. Sunderland S., Meningeal neural relations in the intervertebral foramen. J. Neurosurgery 1992; 40:756-761
5. Pert CB. Neuropeptides, the emotions and bodymind. Noetic Sciences Review, 1987; 2:13-18 (Black PH., Psychoneuroimmunology: brain and immunity: Scientific American 1995 (Dec.): 16-25
6. McGinnis L., Alternative therapies. Cancer 1991;67:1788-92 Kenny FW, The consumer's view of health. J Adv Nurs 1992; 1992;17(7):829-34 Palmer, DD., The Chiropractor Beacon Light Press, Los Angeles, Calif. 1914, 1969 edition 17-21
7. Boone, WR., Dobson, GJ., A Proposed Vertebral Subluxation Model Reflecting Traditional Concepts and Recent Advances in Health and Science. Journal of Vertebral Subluxation Research Aug. 1977, 1 (1) 19-21
8. Epstein, D., Network Spinal Analysis: A system of Health Care Delivery Within the Subluxation Based Chiropractic Model, Journal of Vertebral Subluxation Research, August 1997 1(]) 53-56
9. Blanks, RH, Schuster, T, Dobson, M., A Retrospective Assessment of Network Care Using a Survey of Self-Rated Health, Wellness and Quality of Life., Journal of Vertebral Subluxation Research 1 (4) 15-
10. Epstein, D., Theoretical Basis and Clinical Application of Network Spinal Analysis (NSA), September 1996, VIII. Innate Intelligence, Inc. p 9
11. Breig A., Adverse mechanical tension in the central nervous system, New York: John Wiley & Sons, 1978
12. Epstein, D., Network Spinal Analysis: A system of Health Care Delivery Within the Subluxation-Based Chiropractic Model, Journal of Vertebral Subluxation Research, August 1997 1(1) 53-56
13. Epstein, D., Theoretical Basis- and Clinical Application of Network Spinal Analysis (NSA), September 1996, VIII Innate Intelligence, Inc. p 9-10
14. Blanks, RH, Schuster, T, Dobson, M. A Respective Assessment of Network Care Using a Survey of Self-Rated Health, Wellness and Quality of Life. Journal of Vertebral Subluxation Research 1(4) 15-30
15. ibid p.28