Network Spinal Analysis
The tenets of Network Spinal Analysis and an overview of the
Reprinted From Today's Chiropractic May/June 2003
By Donald Epstein, D.C.
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
- 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
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.
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
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
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.
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
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
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.
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
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 electromyographic
(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 stabilizing 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,
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]