Wellness and Network Spinal
Analysis Newly Positioned
By Donald Epstein, DC
Network Spinal Analysis (NSA) has evolved over
the post 20 years and most recently has been influential in
expanding and articulating the wellness paradigm. NSA is an
evidenced-based approach to wellness and body awareness. Gentle
precise force applications to the spine cue the brain to create
new wellness promoting strategies. Two unique healing waves
develop with this work. They are associated with spontaneous
re-organization, re-distribution and release of spinal tension.
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 and muscular structural
NSA is currently taught exclusively to chiropractors and chiropractic
students, in relationship to chiropractic practice and subluxation-based
care. It is applied through a series of four levels of care.
This application 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 and the patients' self-assessments of
personal wellness and changes in lifestyle. Practitioners are
taught to practice consistent with the Council on Chiropractic
Practice (CCP) guidelines and the canon of ethics of the Association
for Network Care. However, there are other elements within the
"Epstein Models" that NSA rests upon that supersede
traditional chiropractic thought. The Models are soon to be
offered through the curriculum of a certificate program of "Wellness
Education and Outcomes Assessment" offered by the Florida
Atlantic University in Boca Raton.
Following are the Epstein Models upon
which NSA is based.
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 subluxations.
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.
Spinal and Neural Integrity. There
are stability sub-systems that regulate the dynamic state
known as spinal and neural integrity. These 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 modification
of perception and adaptive responses to a changing environment.
Clinical assessments and interventions must establish, or
nurture mechanisms and processes to reorganize these subsystems'
relationships with one another and the environment. The emotional
subsystem is believed to control the sensory and motor sensitivity
(gain) at every spinal level and participates with the passive,
active and neural control subsystems in modifying spinal and
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 or her 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 or she is on the
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
Subluxations. Two classes of vertebral subluxations exist,
each having different etiology and responding to a different
force application. The structural (Class A) subluxation is
a segmental distortion associated with a compromise of the
intervertebral structures . This is most commonly produced
by a localized physical trauma or is adaptive to spinal cord
The Class B or facilitated subluxation is associated with
lack of recovery from emotional, mental or chemical stress
and is associated with a state of adverse mechanical spinal
cord tension and "multiple cord tensions." This
is a product of stress physiology and attendant stress posture,
and is best addressed through a gentle touch as an oscillatory
impulse at or in the vicinity of the vertebral/dural relationships
in the cervical and sacral-coccygeal spine.
The application and integration of these four models is consistent
with both traditional chiropractic objectives and practice,
and academic wisdom. However, if any of these models are applied
in the absence of the Epstein Model of vertebral subluxation,
the contribution of NSA to the chiropractic objective is negated.
This arises because NSA may also be applied as a form of wellness
education, without any representation of diagnosing, treating,
attending to, remedying, correcting, preventing, or advising
in relationship to any condition - including subluxation,
malady or symptom.
In order for an individual to practice NSA within the context
described, it will require at least three and one-half years
of post-graduate study, including a distance learning certificate
in the program mentioned. These individuals will not be taught
to identify or adjust subluxations, nor will they practice
chiropractic or any health restorative or maintenance discipline.
In the meantime, 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 subluxations. It also provides
for the development of new sensory motor strategies to assist
in spinal and neural integrity. This is practiced in relationship
to the identification, classification and force application
to correct and promote patient self-regulation of vertebral
NSA will continue to provide wellness care that expands beyond
what has been considered usual and customary as a ceiling
to care. When NSA wellnss care is instituted, the NSA chiropractor
is encouraged to inform the patient or practice member that
wellness care is beyond the scope of traditional chiropractic.
Practitioners are advised not to bill any third party for
pure wellness care, or services not in relationship to the