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Dr. Terrie Lewine, Philadelphia, PA 215-928-8898

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 states.

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.

Epstein Models

Following are the Epstein Models upon which NSA is based.

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 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 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 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-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 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 tension patterns.

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 subluxations.

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 vertebral subluxation.