Specific lists of injuries,conditions, disorders, treatment and research, this page includes;  Upper arm pain, Trapped nerve  in the neck and arm, Carpal Tunnel syndrome, is Surgery Effective at Treating Carpal Tunnel? Tennis Elbow, Golfers Elbow, Bicep Tendonitis, Fractures of both bones in the forearm, Scaphoid Fractures, Colles Fracture, Torus fracture, (“buckle” fracture), Metaphyseal fracture, Greenstick fracture, Galeazzi fracture, Monteggia fracture, Growth plate fracture, (physeal fracture), Wrist Sprains  injuries and strained muscles,  Arm Diseases, Heart Problems, Cold laser also known as Low level laser therapy, this includes low level laser research for healing,  ligament,and bone repair.

A research review published in The Lancet, for Cold/ Low Level Laser treatment for neck pain.  Research and the successful management of “Repetitive stress injury” or “Carpal tunnel syndrome” by a new treatment modality- application of Cold/ low level lasers,  for Tendonitis , Burstis, Fractures, conditions and disorders, and  pain relief and accelerating the  healing process.

The human arm has many uses, so when an arm hurts, productivity is affected and concern arises. When you have pain in the arm, the reasons can be varied.  Some may be obvious, while others are hidden.  Most often, arm pain is caused by injuries or falls. Continued stress can also injure arms, causing upper arm and wrist pain. Arm pain can be a symptom of a more serious problem such as a heart attack. Whenever you experience arm pain it’s vital to get immediate medical attention.

Injuries and Strained Muscles

Pain caused by arm injuries is usually in the lower arm. Any trauma or injury involving the arm can cause pain. Common examples include sprains and fractures, which are the most visible arm injuries. Overusing your arm, resulting in strained muscles, is one of the most common causes of arm pain. For example, excessive swimming, throwing, swinging such as in tennis and other repetitive activities, usually involved with sports, can result in arm pain.

Trapped or Pinched Nerves in the Neck

Pinched nerves in the neck cause numbness, weakness and pain in arms or hands. Neck pain due to muscle strain can cause stiffness and aches spreading to the upper arm. If you experience shooting pain spreading to the hand and fingers, you may have a pinched nerve. When this occurs in both arms and hands the pain is more severe. Pinched nerves can be the result of joint irritation, swelling or injuries.

Causes of Upper Arm Pain

Because the upper arm has plenty of muscles, it’s harder to injure it. However, one condition causing upper arm pain is bicipital tendonitis, involving a torn or frayed tendon near the shoulder. This triggers pain in the upper arm biceps. Lifting heavy weights can cause upper arm pain because it inflames shoulder tendons. Other causes of upper arm pain may include diabetes, a chemical burn, heartburn, brachial plexus injury, peripheral neuropathy or upper arm injury.

Heart Problems 

There is a strong link with tingling feelings or pain in the left arm and the possibility of either angina or a heart attack. Angina describes chest pain that’s related to the heart. This symptom is found more in males than in females. It’s rare that left arm pain is the only sign. If you do have pain in the left arm, it’s important to be diagnosed and treated as soon as possible.

Diseases

Diseases affecting other body organs can cause arm pain. A few examples include arthritis or peripheral vascular disease. Degrees of arm pain may range from mild to severe. In some cases the pain can even be life-threatening e.g. pain resulting from myocardial infarction. Treatments for the pain depend on the root cause

Poor Posture

Poor posture can cause shoulder and neck muscular tension. Just by sitting with your head and shoulders forward can place extra weight on your neck, causing arm pain. Considering the average-sized head is as heavy as a bowling ball, it’s not surprising how poor posture can result in muscular tension to the arms, causing pain.

Fractures of bones in the forearm.

The bones of the forearm are the radius and the ulna. If you hold your arm naturally by your side, the ulna is the bone closer to you and the radius is farther away.

Fractures of the forearm can occur near the wrist at the farthest (distal) end of the bone, in the middle of the forearm, or near the elbow at the top (proximal) end of the bone.

A child’s bones are also subject to a unique injury called a growth plate fracture. Growth plates are made of cartilage near the ends of children’s bones. They help determine the length and shape of the mature bone. 

Fractures of both bones in the forearm.

Fractures in a child’s bones begin to heal much more quickly than an adult’s bones. If you suspect a fracture, you should obtain prompt medical attention for the child so that the bones can be set for proper healing.

• Torus fracture. This is also called a “buckle” fracture. The topmost layer of bone on one side of the bone is compressed, causing the other side to bend away from the growth plate. This is a stable fracture and the broken pieces of bone have not separated apart (displaced).
• Metaphyseal fracture. The fracture is across the upper, or lower, portion of the shaft of the bone and does not affect the growth plate.
• Greenstick fracture. The fracture extends through a portion of the bone, causing it to bend on the other side.
• Galeazzi fracture. The injury affects both bones of the forearm. There is usually a displaced fracture in the radius and a dislocation of the ulna at the wrist, where the radius and ulna come together.
• Monteggia fracture. The injury affects both bones of the forearm. There is usually a fracture in the ulna and the top (head) of the radius is dislocated. This is a very severe injury and requires urgent care.
• Growth plate fracture. Also called a physeal fracture, this fracture occurs at or across the growth plate. Usually these fractures affect the growth plate of the radius near the wrist.

Symptoms

In most cases, a broken forearm causes severe pain to the forearm and hand may also feel numb.

Examination, Signs

 Any type of deformity about the elbow, forearm, or wrist

• Tenderness
• Swelling
• An inability to rotate or turn the forearm

A doctor will also test to make sure that the nerves and circulation in your child’s hand and fingers have not been affected.

Investigation, Tests

The hand, wrist, arm, and elbow can all be injured during a fall on an outstretched arm. To determine exactly what injuries have occurred, a doctor will probably want to see x-rays of the elbow and wrist, as well as the forearm.

Wrist Fractures

In women, the number of wrist fractures increases at menopause and plateaus after age 55. This is most likely related to the rapid loss of bone in the years following menopause. Since men don’t experience menopause, the incidence of wrist fracture in men remains fairly constant.

A wrist Fracture occurs most often in women who are relatively healthy and active and have good reflexes. In fact, the majority of wrist fractures occur outdoors during the winter months when snow and ice make walking treacherous, and falls are common.

The wrist is made up of two bones in the lower arm, the radius and ulna, plus the small bones of the hand. The most common wrist fracture occurs when a person extends an arm to break a fall. The hand and forearm take all the weight and force from the fall, and one of the wrist bones breaks.

Colles Fracture

Colles fracture is the most frequent type of wrist fracture, which can occur when a patient falls on an outstretched hand. Pain accompanies wrist flexion, and there is usually tenderness, swelling, and bruising over the injury site. Some fractures are denoted by deformity of the bone. X-rays are needed to confirm the fracture.

Treatment includes a splint or cast for four to six weeks followed by range-of-motion and forearm strengthening exercises. Surgery may be needed if the bone does not heal correctly.

Prevention of wrist fractures includes wearing wrist guards during activities such as inline skating, skiing, and skateboarding, where falling on an outstretched hand has a higher possibility.

Scaphoid Fractures.

Scaphoid fractures occur when a person falls on an outstretched arm and the palm of the hand hits the ground, causing pain on the thumb side of the wrist, and pain with subsequent wrist motions. Digital-X-rays must be taken to diagnose this condition. Treatment includes a splint or cast for four to six weeks, unless the fracture occurred in the middle portion of the bone, in which case surgical intervention may be needed to stabilize the fracture. The blood normally supplied to the inner structure of the bone is not good enough to help heal the bone, because of this the bone may then require surgery.

There are no specific risk factors or diseases that increase one’s chance of a wrist fracture. Wearing wrist guards during biking, in line skating and snowboarding will decrease the risk of wrist fracture. After cast removal, avoid heavy lifting and activities with a high risk of wrist impaction. Sometimes hand therapy is prescribed to increase strength and range of motion if the patient has been in the cast for an extended period of time.

Diagnosis of Wrist Fractures.

Following a fall, you may be bruised and sore. Sometimes, a fracture may be misdiagnosed as a bad sprain (an injury to the ligaments), and the pain, limited movement, and weak hand grasp in the affected arm is ignored. Your wrist is probably fractured rather than sprained if you have:

• persistent pain
• swelling near the wrist
• changes in finger movement
• numbness

Usually, an X-ray can confirm the diagnosis. Once the fracture is diagnosed, appropriate treatment begins.

A wrist fracture may also be a sign of underlying problems such as:

• low bone density
• poor balance
• vision/hearing problems

Wrist Sprains

Wrist sprains occur when the wrist is forcefully bent backwards, tearing the ligament that connects the bones of the wrist. Symptoms include pain with motion, swelling, bruising, and tenderness over the injury site. X-rays should be taken to rule out a fracture. In some cases, an MRI or CT scan is done to determine the extent of the ligament injury.

Treatment includes splinting, ice, and rest. Prevention includes being careful on wet floors that may cause slipping.

Thumb Sprains — Gamekeeper’s Thumb

Gamekeeper’s thumb occurs when the thumb is forcefully pushed backwards, thus stretching or tearing the ligament. Activities such as catching a ball can cause this injury; football and netball are the most common sports in which it occurs. Symptoms include pain with thumb movement, swelling and tenderness over the injured joint, and the inability to hold objects between the thumb and fingers.

Treatment includes splinting, rest, and ice. X-rays may be taken to rule out any fractures. Surgery may be needed if the joint is unstable. Prevention includes applying proper techniques when catching a ball, and avoiding falling on an outstretched hand.

Finger Injuries

Finger injuries are common and range from simple cuts to bone, tendon, or ligament damage. If not properly treated, finger injuries can lead to deformity and permanent loss

Carpal Tunnel Syndrome

Carpal Tunnel Syndrome affects the wrists and can prevent people from working due to the wrists and hands being very painful. This is a wrist condition that can result in chronic wrist and hand pain.

Carpal: Across the back of the wrist, eight small irregular bones (called carpals) are aligned in 2 rows forming a letter “C.” There is a tough ligament attaching across the inner side of the wrist, thus forming the Carpal Tunnel.

Tunnel: An opening through which something passes through. Nine tendons of the muscles of the forearm that move the fingers along with the soft median nerve pass through this narrow tunnel. This tunnel is about the size of your little finger.

In carpal tunnel syndrome the median nerve becomes either compressed, irritated or swollen resulting in pain.

Carpal Tunnel Syndrome is a condition in which the median nerve becomes irritated and swells. During the swelling the pressure in the canal increases leading to further irritation and compression of the nerve. This leads to more swelling and nerve irritation.

What are Carpal Tunnel Syndrome symptoms?

Typical symptoms of Carpal Tunnel Syndrome include parenthesis (abnormal sensations) such as tingling and numbness in the thumb and index and middle fingers on the palm side, night pain, weakness in grasping, thumb and index finger pinching, and other thumb movements’ clumsiness, such as awkward hand movements and dropping things with increased weakness.

Is Surgery Effective at Treating Carpal Tunnel Syndrome?

Surgical procedures have been developed over the years to “release” the pressure on the nerves at the carpal tunnel by permanently severing the ligament that holds the tunnel together. Unfortunately, these procedures are rarely successful over the long term and almost never address the cause of the nerve irritation. Common sense would tell us that it is unlikely that the carpal tunnel would simply “shrink” without warning. Therefore, increasing the size of the tunnel will only provide temporary benefit especially if the tendons within the tunnel continue to thicken. Also, post-surgical scar tissue can also interfere with proper wrist and nerve function contributing to more pressure on the nerve.

What treatment is available for Carpal Tunnel Syndrome?

Before commencing the treatment patient should be evaluated for the cause of the nerve swelling. Some systemic conditions such as under active thyroid can lead to the swelling of the tendons, thus putting pressure onto the median nerve.

Patients should also be evaluated for possible compression of the nerves at the neck, shoulder and elbow levels that can also present itself as a pain and weakness in the wrist. In majority of cases of wrist and hand pain and weakness the primarily cause is compression of the nerve root at the neck level that forms nerves of the arm and hand. That’s why some patients still experience symptoms of carpal tunnel even after the surgery or cortisone injections were performed.

Cold/low level laser therapy applied over the carpal tunnel has proven to be very effective in reduction of swelling and pain management. Please contact us if you require further information. Cold/Low Level Laser Therapy Section).

Cold/Low Level Laser Research for Carpal Tunnel Syndrome.

Successful management of “Repetitive stress injury” or “Carpal tunnel syndrome” by a new treatment modality- application of Cold/ low level lasers for pain Relief.

E. Wong G LEE J. Zu CHERMAN and D. P. MASON

Western Heart Institute and St. Mary’s Spine Center St. Mary’s Medical Center. San Francisco. CA. USA and Head and Neck Pain Center,  Honolulu HL. USA

 Abstract

Female office workers with desk jobs who are incapacitated by pain and tingling in the hands and fingers are often diagnosed by physicians as “repetitive stress injury” (RSI) or “Carpal tunnel syndrome” (CTS). These patients usually have poor posture with their head and neck stooped forward and shoulders rounded; upon palpation. They have pain and tenderness at the spinous processes C5 – T1 and the medial angle of the scapula. In 35 such patients we focused the treatment primarily at the posterior neck area and not the wrists and hands. A low level laser (100 mW) was used and directed at the tips of the spinous processes C5 – Tl.

The laser rapidly alleviated the pain and tingling in the arms, hands and fingers, and diminished tenderness at the involved spinous processes. Thereby, it has become apparent that many patients labelled as having RSI or CTS have predominantly cervical radicular dysfunction resulting in pain to the upper extremities which can be managed by low level laser.

Successful long-term management involves treating the soft tissue lesions in the neck combined with correcting the abnormal head, neck and shoulder posture by taping. Cervical collars, and clavicle harnesses as well as improved work ergonomics.

LASER THERAPY, 1997:9: 131- 136 09/97

© 1997 by LT Publishers, U.K., Ltd.

Carpal Tunnel Study Results Released

 Laser Focus World

 A physician at UMDNJ-Robert Wood Johnson Medical School is evaluating a “cold” laser to treat patients with carpal tunnel syndrome, a debilitating nerve condition that causes severe pain and numbness in the hand.

Clinical results of a double-blind study of 11 patients afflicted with carpal tunnel syndrome who were treated with a diode-laser device manufactured by Lasermedics (Missouri City, TX) showed that after six to 15 treatments, nine of the 11 patients experienced relief of pain and other associated symptoms as well as normalization of abnormal latencies.

The study was conducted by Michael L. Weintraub, a neurologist from Briarcliff, NY, and reported in the February 1996 issue of Neurology.

The patients all used a 30mW 830nm, a hand-held, battery-operated, nonsurgical laser device that employs the process of photo-biostimulation.

Dr. Weintraub concluded that the results of his study support the efficacy and safety of laser-light treatment in carpal tunnel syndrome.

Research Published in the Lancet, for Cold/ Low Level Laser treatment for neck pain

Neck Pain is common, often persistent, and responds poorly to medication. So it is encouraging to read that a relatively novel, non-invasive treatment shows evidence of effectiveness. A systematic review and meta-analysis of 16 randomised controlled trials of low-level laser therapy (LLLT)’ yielded 820 patients, for whom data was pooled. LLLT was found to reduce pain immediately after treatment in acute neck pain and up to 22 weeks after completion of treatment in patients with chronic neck pain. Low-level laser – or cold laser – is yet to be established as a medical treatment but, according to Wikipedia, papers are appearing at the rate of around 25 per month, mainly investigating treatment of musculoskeletal disorders. We will be watching.

1. Chow RT, Johnson Ml, Lopes-Martins RA, Bjordal JM. Efficacy of low-level laser therapy in the management of neck pain: a systematic review and meta-analysis of randomised placebo or active-treatment controlled trials. Lancet 2009 Dec 5;374(9705):1897-908.

X Tennis Elbow or Lateral Epicondylitis.

Tennis elbow, or lateral epicondylitis, takes its name from a common injury that originally appeared in a high proportion of tennis players. However this condition manifests in a vast proportion of people who never play tennis at all. Lateral epicondylitis is a painful condition involving the tendons that attach or anchor muscles to the bone on the outside (lateral) part of the elbow. The muscle involved in this condition, the extensor carpi radialis brevis, helps to extend and stabilize the wrist. With lateral epicondylitis, there is degeneration or deformity of the collagen of the tendon’s attachment, weakening the anchor site and placing greater stress on the area. This can then lead to pain associated with activities in which this muscle is involved, such as lifting, gripping, and/or grasping. The majority of people who suffer from tennis elbow are between 30 and 60 years old although condition can affect much younger athletes as well. Both men and women are also equally affected.

Causes of Tennis Elbow.

Tennis elbow may occur as a result of repeated extension or overuse of the wrist against resistance such example is using a hammer in the work place and from sporting activities such as tennis, badminton, squash and cricket. Tennis elbow is equally likely to appear in work related activities such as brick laying, carpentry and from the excessive typing on a computer keyboard.

A poor grip or backhand technique with a tennis racquet can be a primary cause and commonly seen in an athlete who miss times or arrives ‘late’ for a backhand this means they cannot get their body fully behind the ball. And therefore the wrist has to compensate and in doing so injuries are caused to muscles and tendons which provide this movement. In addition the wrist needs to be firm and not bent when the ball is struck so the forces can be spread over the arm, shoulder and the body. A small racquet grip will mean the muscles in the elbow must work a harder leading to structural changes in the tendon.

Another possible cause of tennis elbow is direct trauma to the elbow which may result in swelling of the tendon that can lead to degeneration. A sudden extreme action, force, or activity could also injure the tendon.

Two types of onset are commonly seen

Sudden Onset:

Sudden onset of tennis elbow occurs in a single instance of forced exertion such as a late back hand where the extensors of the wrist become strained. This is thought to correspond to micro-tearing of the tendon.

Late Onset (most common):

This normally takes place within 24-72 hours after an intensive overuse of untrained wrist extension. Examples may be a tennis player using a new racket or even a person who’s spent a weekend doing DIY.

Symptoms of Tennis Elbow / Lateral Epicondylitis.

Severe burning pain from about 1-2 cm down from bony area at the outside of the elbow (lateral epicondyle) -Weakness in the wrist associated with pain on the outside of the elbow or radiating into the forearm which causes difficulty when performing simple tasks such as opening the door handles or using a screwdriver. Lifting even very light objects (such as a small book or a cup of coffee) can lead to significant discomfort.

Pain on the outside of the elbow when the hand is bent back (extended) at the wrist against resistance.

Pain on the outside of the elbow when trying to straighten the fingers against resistance.

Pain when pressing just below the lateral bony prominence (epicondyle) on the outside of the elbow.

Non surgical treatment of Tennis elbow.

Tennis elbow treatment involves treatment not only in the elbow area but also treatment of possible pathologies in the neck or shoulder. Each individual will react differently to different treatments. Below are examples only- we always recommend seeing a qualified therapist before attempting any rehabilitation.

• Ice to the elbow (15 min’s on up to six times a day). This will help reduce pain and inflammation if present.
• Cold/low level laser therapy is shown to be extremely effective in settling down the inflammation and promoting healing of the soft tissues. Cold/low level laser therapy has a five star rating in the treatment of Tennis elbow
• Rest – an extremely important component in the healing of this injury.
• A brace or support will help to protect the tendon whilst healing and will provide strengthening, particularly when returning to playing sport or work equivalent. The brace should not be put on the painful area but rather approximately 10cm down the forearm.

 What can a chiropractor do?

Assess the integrity of the neurological supply the elbow from the neck and shoulder and address these areas if necessary by use of manual therapy.

• Correctly diagnose the condition: This may be done by carrying out Mills’ test- resisted wrist extension with the palm facing the floor (pronated) and moving the hand sideways in the direction of the thumb. If pain is elicited then this is a positive sign for the test. Another test is to resist extension of the middle finger-pain is also a strong indicator.
• Apply Cold /low level laser treatment has a five star rating in the treatment of tennis elbow, which helps to reduce pain and inflammation as well as stimulate healing.
• Advice on pain control-such as NSAID’s like Ibuprofen.
• Apply myofacial release and/or transverse friction techniques across the tendon as well as utilize the dry needling techniques
• Identify and correct any predisposing factors which lead to the onset of tennis elbow. Your tennis coach should also be able to provide some advice with regards your backhand technique.
• If the conservative treatments have failed for about a year then referral to the orthopaedic surgeon may be considered.

 How long will Tennis elbow take to get better?

Sometimes tennis elbow may heal quickly within two weeks but some people can suffer with this problem for up to two years. When the pain has settled down it is essential to provide full rehabilitation and strengthening of the elbow.

Few tips on preventing Tennis Elbow.

 Work on the correct technique – play the backhand with the -whole body not just the wrist!

• Use a forearm brace or heat retainer if you have a weak wrist or elbow
• Use a light racket if you do not play very often
• Do not play with wet, heavy balls
• Make sure that racquet strings are not too tight

Rehabilitation includes forearm stretches and strengthening of the wrist extensors and flexors, biceps, and triceps.

Golfer’s Elbow

Golfer’s elbow is pain or inflammation of the muscle on the inside of the elbow causing pain emanating from the bony prominence, and extending into the forearm. It is also known as “Little Leaguer elbow” when caused by excessive throwing. Golfers elbow does not occur only in golfers; it can be caused by activities that include repetitive forearm movement, such as using a screwdriver or painting. (View tennis elbow for diagnosis, treatment and prevention.)

Biceps Tendonitis

Biceps tendonitis refers to inflammation or degeneration of connecting muscle fibres on the front of the arm due to overhead repetitive activities such as throwing or tennis. The biceps are used to accelerate and decelerate the arm during overhead throwing-type motions. Symptoms include tenderness of the involved tendon and pain with overheard movements. Diagnosis is determined by going over a thorough history of activities with a health professional.

Treatment includes modifying activity, such as reducing overhead movements or switching activities to eliminate pain with movement. Physical therapy will include range of motion activities and gradual strengthening of the biceps and surrounding muscle of the shoulder and forearm. Prevention of biceps tendinitis includes a gradual increase in overhead activities, maintaining adequate strength of the biceps and surrounding shoulder musculature, and getting adequate rest between activities. 

Reasearch

Research on Low level laser therapy (LLLT) of tendonitis and myofacial pains a randomized, double-blind, controlled study.

Mimmi Logdberg-Anderssont (1), Sture Mutzell (2), and Ake Hazel (3)

  1: Akersberga Health Care Centre,

  2: Danderyd University Hospital, Danderyd, and

  3: Vaxholm Health Care Centre, Stockholm, Sweden.

The purpose of this randomised, double-blind study was to examine the effect of GaAs laser therapy for tendonitis and myofascial pain in a sample from the general population of Akersberga in the northern part of Greater Stockholm.

176 patients (of an original group of 200) completed the scheduled course of treatment. The patients were assigned randomly to either a laser group (92 patients, of whom 74 had tendonitis, completed the study) or a placebo group (84 patients, of whom 68 had tendonitis, completed the study). All 176 patients received six treatments during a period of 3-4 weeks. Their pain was estimated objectively using a pain threshold meter, and subjectively with a visual analogue scale before, at the end of, and four weeks after the end of treatment.

Laser therapy had a significant, positive effect compared with placebo measured from the first assessment to the third assessment, four weeks after the end of treatment. Laser treatment was most effective on acute tendonitis.

Address for Correspondence

Sture Mutzell, Danderyd University Hospital 5-182 87 Danderyd, Sweden.

03/07 Rep US 10-12-14, 1997 By LT Publishers, U.K., Ltd.

LASER THERAPY, 1997:9: 79-86   Wave- length Power Energy Density Power Density Energy per point Pulses 904nm 8mW av (10Wpeak) 0.5-1.0 J/Cm2 (not given) 1J 4KHz x 180nS 

Cold/Low Level laser Therapy (LLLT) 

Low Level Laser Therapy (LLLT) also so known as Cold Laser Therapy has been tested in over 200 clinical trials (RCTs) and published in the world’s top medical journals including a review by The Lancet, a clinical study in the journal PAIN and is acknowledged by the World Health Organisation Bone and Joint Task Force, and published in the journal Spine.

The lasers used are certified as low level laser therapy  (LLLT).  For the past 30 years the technology of low level laser therapy (also known as Cold/low level Laser Therapy has been formally accepted in North America and in many other parts of the world such as Europe, Russia and Japan.  In all this time there have been no recorded long-term adverse effects from low level laser therapy.  It is considered to be non-invasive, painless and safe.

Cold/Low Level Laser Therapy (LLLT) uses laser light energy to stimulate cells to function optimally.  In the body, light sensitive chromophores and other elements within the cell absorb energy, initiating a series of important photochemical changes such as increased production of ATP. The mitochondria and Kreb’s Cycle stimulation initiates the production of ATP, providing the cell with the extra energy needed to accelerate the healing process and positively influence pain.  These activities can occur in all types of cells and includes ligament, nerves, cartilage and muscle.

Cold/Low Level Laser Therapy (LLLT) is a treatment where by a low level laser is utilized to treat chronic and acute pain. Cold/ Low level laser therapy may be used for patients suffering from tennis elbow, frozen shoulder, sciatica, back and neck, hip, knee, ankle, foot pain and conditions a, musculoskeletal pain, joint pain associated with arthritis, fibromyalgia, tendonitis, bursitis, neuropathy, Achilles tendonitis, migraine headaches, sprains and strains, trapped nerves, carpal tunnel syndrome , back, neck, shoulder pain and other associated pains.Cold/ Low Level laser therapy also treats conditions such as TMJ, reflex sympathetic dystrophy (RSD) and other inflammatory and scarring conditions. By increasing serotonin levels, low level laser therapy contributes to the body’s own healing process. Non-thermal and non-invasive, low level laser therapy involves a combination of low level laser and electric stimulation and is one of the most effective healing therapies. Completed in ten to twelve sessions, Cold/ low level laser therapy (LLLT) can significantly reduce treatment time and costs.

Cold/Low Level Laser Therapy for Carpal Tunnel syndrome,Tennis Elbow, and Fractures including  other injuries, conditions, syndromes,

Soft tissue injuries, Ligaments, Tendons and muscles. Tendonitis, Bursitis, Plantar fasciitis, Back and Lower back pain. Neck, Shoulder, Arm, and Wrist pain. Hip knee ankle pain injuries.

The lasers used at Central Chiropractic Clinic are certified as Cold Laser.  For the past 30 years the technology of Cold Laser Therapy (also known as Low Level Laser Therapy) has been formally accepted in North America and in many other parts of the world such as Europe, Russia and Japan.  In all this time there have been no recorded long-term adverse effects from low level laser therapy.  It is considered to be non-invasive, painless and safe.

Cold/low level Laser Therapy uses laser light energy to stimulate cells to function optimally.  In the body, light sensitive chromophores and other elements within the cell absorb energy, initiating a series of important photochemical changes such as increased production of ATP. The mitochondria and Kreb’s Cycle stimulation initiates the production of ATP, providing the cell with the extra energy needed to accelerate the healing process and positively influence pain.  These activities can occur in all types of cells and includes ligament, nerves, cartilage and muscle.

Cold/Low Level Laser Therapy (LLLT) is a Handheld, non-invasive, light-emitting medical device which is used over different areas of the body. It provides an unmatched advantage in the treatment of conditions such as;

Carpal Tunnel Syndrome.

Chronic Neck and Back Pain.

 “Whiplash injuries” Neck Pain, Cervical Disc injury.

Back pain, Lower Back Pain, Sciatica.

“Slipped disc”, Prolapsed disc, Herniated disc, Bulging disc.

Trapped Nerves. 

Hip Pain Sacroiliac joint inflammation 

Athletic and Sports Injuries. Ligaments. Tendons. and Tendonitis.

Lower Back Pain
Knee and Foot Pain and injury
Shoulder Injury
Carpal Tunnel Syndrome
Arthritic Pain Relief, Muscle Spasm
Relief of Muscle and Joint Pain
Skin infections, 

Wound Management; including Skin Ulcers, Pressure Sores and Burns

Soft Tissue Injuries including; Sprains and Strains, Tendonitis and Haematomas 

Joint Disorders; including  Arthritic Pain Relief, and Tenosynovitis

Chronic Pain   such as Trigeminal Neuralgia and Chronic Neck and Back

 Pain. “Whiplash’ (WAD) injuries”, Neck Pain and injuries.

CONNECTIVE TISSUE / CARTILAGE / LIGAMENT / BONE REPAIR RESEARCH STUDIES

CONNECTIVE TISSUE REPAIR

THE BIOLOGICAL EFFECTS OF LASER THERAPY AND OTHER PHYSICAL MODALITIES ON CONNECTIVE TISSUE REPAIR PROCESSES

Chukuka S. Enwemeka, P.T., Ph.D., FACSM, G. Kesava Reddy, Ph.D.,
Department of Physical Therapy and Rehabilitation Sciences,
University of Kansas Medical Center,
Kansas City, KS 66160-7601, USA
Laser Therapy Vol. 12 Special Millennium Edition, 2000.

Connective tissue injuries, such as tendon rupture and ligamentous strains, are common. Unlike most soft tissues that require 7-10 days to heal, primary healing of tendons and other dense connective tissues take as much as 6 – 8 weeks during which they are inevitably protected in immobilization casts to avoid re-injury. Such long periods of immobilization impair functional rehabilitation and predispose a multitude of complications that could be minimized if healing is quickened and the duration of cast immobilization reduced.

In separate studies, we tested the hypothesis that early function, ultrasound, 632.8 nm He-Ne laser, and 904 nm Ga-As laser, when used singly or in combination, promote healing of experimentally severed and repaired rabbit Achilles tendons as evidenced by biochemical, biomechanical, and morphological indices of healing. Our results demonstrate that: (1) appropriate doses of each modality, i.e., early functional activities, ultrasound, He-Ne and Ga-As laser therapy augment collagen synthesis, modulate maturation of newly synthesized collagen, and overall, enhance the biomechanical characteristics of the repaired tendons. (2) Combinations of either of the two lasers with early function and either ultrasound or electrical stimulation further promote collagen synthesis when compared to functional activities alone. However, the biomechanical effects measured in tendons receiving the multi-therapy were similar, i.e., not better than the earlier single modality trials.

Although tissue repair processes in humans may differ from that of rabbits, these findings suggest that human cases of connective tissue injuries, e.g., Achilles tendon rupture, may benefit from appropriate doses of He-Ne laser, Ga-As laser, and other therapeutic modalities, when used singly or in combination. Our recent meta-analysis of the laser therapy literature further corroborates these findings.

BONE REPAIR

EFFECT OF LOW-LEVEL LASER ON CALVARIAL BONE DEFECT

M. KHADRA1, N. KASEM2, H.R. HAANÆS1, and S.P. LYNGSTADAAS1
1Oslo University, Norway, 2Karolinska Institute, Stockholm, Sweden

Objective: The purpose of the present study was to evaluate by animal means the effect of laser therapy with GaAlAs diode laser device on bone healing and growth in rat calvarial bone defects.

Methods: The study was performed as an animal trial of 4 weeks duration with blinded, placebocontrolled design. 20 rats had a standardised round osseous defect 2,7 mm in diameter made in each parietal bone (2 defects). The animals were then randomly divided into two equal groups. A GaAlAs diode laser (wavelength 830 nm, output power 75 mw and energy density 23 J/cm2) was used immediately after surgery and carried out daily for 7 consecutive days. The rats were thereafter sacrificed at day 14 and 28 after surgery. Levels of calcium, phosphorous and protein were determined in 20 bone defects, while the histological analyses were performed in the other 20 defects. Statistical analyses between the test and control were performed using Student’s t-test.

Results: The results indicate that calcium, phosphorous and protein contents were significantly higher in the laser-irradiated healing tissues than in the sham group on both time-points. The histological analyses showed that proliferation of fibroblasts, osteoid tissue and bone were more prominent in the irradiated group.

Conclusion: The findings suggest that Laser Therapy may promote metabolism and/or mineralisation in bone forming tissues during the healing of bone defects.

BONE REPAIR OF THE PERIAPICAL LESIONS TREATED OR NOT WITH LOW INTENSITY LASER (WAVELENGHT=904 NM). 

Laser Surg Med. Abstract Issue 2002. abstract 303.
Sousa G R, Ribeiro M S, Groth E B.

The effect of bone repair in periapical lesions has been studied by Sousa. 15 patients with atotal of 18 periapical lesions were divided into two groups. One group received endodontic treatment and/or periapical surgery. The patients in the other group were submitted to the same procedure and in addition the lesions were irradiated by GaAs laser, 11 mW, 9 J/cm2. This therapy was performed during 10 sessions with an interval of 72 hours. Bone regeneration was evaluated through X-ray examination. The results showed a significant difference between the laser and the control group in favour of the laser group. 

THE INFLUENCE OF LOW LEVEL INFRA RED LASER THERAPY ON THE
REGENERATION OF CARTILAGE TISSUE.

P.Lievens , Ph.van der Veen

This study concerns the influence of Laser treatment on the regeneration process of cartilage tissue. There is no need saying that the regeneration of cartilage tissue is a very big problem in rheumatic diseases for example. The lack of blood supply is one of the most important factors involved. Lots of previous publications give us proof of the regeneration capacities of Laser therapy (in wound healing, bone repair etc.)

In this study we have chosen to experiment on cartilage tissue of the ear of mice. We are aware of the fact that the elastic cartilage tissue of the ear is not totally comparable with the hyaline cartilage of articulations. For technical reasons however and because of the fact that the chondrocytes are comparable, we decided to use mice ears in our experiment. A 0,4 mm hole was drilled in both ears on 30 mice. The right ears remain untreated, while the left ears were treated daily with IR-Laser (904 nm) for 3 minutes. Macroscopical as well as histological evaluations were performed on the cartilage regeneration of both ears.

Our results show that after one day post-surgery no differences were found between the irradiated and the non-irradiated group. After the second day, only in the irradiated group there is a clear activation of the perichondrium. After four days, there is a significant in-growth of the perichondrium into the drill hole in the experimental group and there is only an active perichondrium zone in our control group. 

LOW-POWER DIODE LASER STIMULATION OF SURGICAL OSTEOCHONDRAL DEFECTS: RESULTS AFTER 24 WEEKS. 

Artificial cells, blood substitutes, and immobilization biotechnology. 2001.29 (3): 235-44.
Guzzardella G A, Tigani D, Torricelli P, Fini M, Martini L, Morrone G, Giardino R.

The purpose of this study was to evaluate osteochondral lesions of the knee, treated intraoperatively with low-power laser stimulation, and assess results at 24 weeks. Surgery was performed under general anesthesia on six rabbits; a bilateral osteochondral lesion was created in the femoral medial condyles with a drill. All of the left lesions underwent immediate stimulation using the diode Ga-Al-As laser (780nm), whereas the right knees were left untreated as control group. After 24 weeks, the explants from the femoral condyles, either treated employing laser energy or left untreated, were examined histomorphometrically. Results obtained on the lased condyles showed good cell morphology and a regular aspect of the repaired osteocartilaginous tissue. 

ASSESSMENT OF LASER BIOSTIMULATION ON CHONDRAL LESIONS: AN “IN VIVO”: EXPERIMENTAL STUDY. 

Artificial cells, blood substitutes, amd immobilization biotechnology.
2000;28 (5): 441-449.
Guzzardella-G-A, Morrone-G, Torricelli-P et al.

The purpose of this study was to evaluate whether intraoperative laser biostimulation can enhance healing of cartilaginous lesions of the knee. Surgery was performed on eighteen rabbits: a bilateral chondral lesion of 1.25 +/- 0.2 mm in length and 0.8 +/- 0.2 mm in width was created in the femoral media l condyle with a scalpel. The lesion in the left knee of each animal was treated intraoperatively using the diode Ga-Al-As 780nm. laser (300 Joules/cm2, 1 Watt, 300 Hertz, 10 minutes), while the right knee was left untreated, as control group. The animals were divided into three groups, A, B and C, according to the survival time after surgery, two, six and twelve weeks, respectively. The explants from the femoral condyles, both treated employing laser energy and left untreated, were examined histologically. Results showed a progressive filling with fibrous tissue of the cartilaginous lesion treated with laser irradiation, while no changes in the original lesion of the untreated group were observed at the end of the study.

LIGAMENT REPAIR

THERAPEUTIC LOW ENERGY LASER IMPROVES THE MECHANICAL STRENGTH OF REPAIRING MEDIAL COLLATERAL LIGAMENT. 

Fung DT, Ng GY, Leung MC, Tay DK. Lasers Surg Med. 2002; 31:91-96.
Twenty-four rats received surgical transection to their right MCL and eight received sham operation. After surgery, 16 received a single dose of gallium aluminum arsenide laser to their transected MCL for 7.5 minutes (n = or 15 minutes (n = and eight served as control with placebo laser, while the sham group didn’t receive any treatment. The MCLs were biomechanically tested at either 3 or 6 weeks post-operation. The normalized ultimate tensile strength (UTS) and stiffness of laser and sham groups were larger than control (P < 0.001). The UTS of laser and sham groups were comparable. Laser and sham groups had improved in stiffness from 3 to 6 weeks (P < 0.001). A single dose of low energy laser therapy improves the UTS and stiffness of repairing MCL at 3 and 6 weeks after injury.

Coccygodynia.   Lower Back Pain, Low level Laser Therapy Research for pain relief and healing .Conclusions: The results of this study show significant improvement in acute Lower back pain treated with Low Level Laser Therapy, (LLLT) used as additional therapy

Coccygodynia

Pathophysiology

 The coccyx is the terminal end of the spine, just inferior to the sacrum. The human coccyx is composed of 3-5 individual segments (coccygeal vertebrae), with variations occurring with regard to the number of segments, the overall angulation (the curve) of the coccyx, and the degree of articulation versus fusion between the individual segments. In 85% of patients, the coccyx is made up of 4 coccygeal vertebrae. The human coccyx is often considered to be a remnant or corollary of a tail; thus, the coccyx is  referred to as the tailbone.

Anatomy and function of the coccyx

In humans, the coccyx serves important functions, including as an attachment site for various muscles, tendons, and ligaments. Chiropractors and patients should remember the importance of these attachments when considering surgical removal of the coccyx.

Muscles inserting on the anterior coccyx include the levator ani, which is sometimes considered as several separate muscle parts, including the coccygeus, iliococcygeus, and pubococcygeus muscles. This important muscle group supports the pelvic floor (preventing inferior sagging of the intrapelvic contents) and plays a role in maintaining fecal continence. Muscles originating on the posterior coccyx include the gluteus maximus, which is the largest of the gluteal (buttock) muscles and which functions to extend the thigh during walking.

The coccyx serves as somewhat of a weight-bearing structure when a person is seated, thus completing the tripod of weight bearing composed of the coccyx and the bilateral ischium. The coccyx bears more weight when the seated person is leaning backward; therefore, many patients with coccydynia sit leaning forward (flexing at the lumbosacral and hip regions), which shifts more of the weight to the bilateral ischium rather than the coccyx . Alternatively, patients with coccyx pain may sit leaning toward one side so that the body weight is exerted mainly on one ischial tuberosity or the other, with less pressure on the coccyx.

The base of the coccyx articulates with the sacral apex via the sacrococcygeal junction. The sacrococcygeal articulation and intracoccygeal articulations contain fibrocartilaginous discs, comparable to the intervertebral discs present at other spinal levels. The apex (distal tip) of the coccyx is typically rounded but may be bifid.

Lower Back Pain, Low Level Laser Therapy (LLLT) Research.

Abstract

Objective: The aim of this study was to investigate the clinical effects of low-level laser therapy (LLLT) in patients with acute low back pain (LBP) with radiculopathy.

Background Data: Acute LBP with radiculopathy is associated with pain and disability and the important pathogenic role of inflammation. LLLT has shown significant anti-inflammatory effects in many studies.

 Materials and Methods: A randomized, double-blind, placebo-controlled trial was performed on 546 patients. Group A (182 patients) was treated with nimesulide 200 mg/day and additionally with active LLLT; group B (182 patients) was treated only with nimesulide; and group C (182 patients) was treated with nimesulide and placebo LLLT. LLLT was applied behind the involved spine segment using a stationary skin-contact method. Patients were treated 5 times weekly, for a total of 15 treatments, with the following parameters: wavelength 904 nm; frequency 5000 Hz; 100-mW average diode power; power density of 20 mW/cm² and dose of 3 J/cm²; treatment time 150 sec at whole doses of 12 J/cm². The outcomes were pain intensity measured with a visual analog scale (VAS); lumbar movement, with a modified Schober test; pain disability, with Oswestry disability score; and quality of life, with a 12-item short-form health survey questionnaire (SF-12). Subjects were evaluated before and after treatment. Statistical analyses were done with SPSS 11.5.

 Results: Statistically significant differences were found in all outcomes measured (p < 0.001), but were larger in group A than in B (p < 0.0005) and C (p < 0.0005). The results in group C were better than in group B (p < 0.0005).

Conclusions: The results of this study show significant improvement in acute LBP treated with LLLT used as additional therapy.

Ljubica M. Konstantinovic, Ph.D.,¹ Zeljko M. Kanjuh, M.S.,¹ Andjela N. Milovanovic, M.S.,² Milisav R. Cutovic, Ph.D.,¹ Aleksandar G. Djurovic, Ph.D.,³ Viktorija G. Savic, M.S.,⁴ Aleksandra S. Dragin, M.S.,¹ and Nesa D. Milovanovic, M.S.¹

¹Clinic for Rehabilitation, Medical School, Belgrade, Serbia ²Center for Physical Medicine, Clinical Center of Serbia, Belgrade, Serbia.³Clinic for Rehabilitation, Military Medical Academy, Belgrade, Serbia.⁴Department for Physical Medicine, Institute for Rheumatology, Belgrade, Serbia.

Address correspondence to: Ljubica Konstantinovic, Ph.D. Clinic for Rehabilitation dr Miroslav ZotovicMedical School, University of Belgrade  Sokobanjska 13, Belgrade

A review on reseach published by The Lancet shows that Low Level Laser Therapy(LLLT) also so known as Cold Laser Therapy has been tested in over 200 clinical trials (RCTs) and published in the world’s top medical journals including a review by The Lancet, a clinical study in the journal PAIN and is acknowledged by the World Health Organisation Bone and Joint Task Force , and published in the journal Spine.

Call 024 7622 2002.Registered with BUPA. AXA  PPP. HSA. AVIVA. Simplyhealth. Standard Life. Mercia health. BHSF. Pru health .Cigna Police health care scheme Medicare  Medisure. Medicash and all other healthcare insurers .

Low Level laser Therapy (LLLT)  also known as Cold Laser Therapy/Treatment

Low Level Laser Therapy(LLLT) also so known as Cold Laser Therapy has been tested in over 200 clinical trials (RCTs) and published in the world’s top medical journals including a review by The Lancet, a clinical study in the journal PAIN and is acknowledged by the World Health Organisation Bone and Joint Task Force , and published in the journal Spine.

The lasers used  are certified as  low level laser therapy  (LLLT).  For the past 30 years the technology of low level laser therapy (also known as Cold Laser Therapy has been formally accepted in North America and in many other parts of the world such as Europe, Russia and Japan.  In all this time there have been no recorded long-term adverse effects from low level laser therapy.  It is considered to be non-invasive, painless and safe.

Low Level Laser Therapy (LLLT) uses laser light energy to stimulate cells to function optimally.  In the body, light sensitive chromophores and other elements within the cell absorb energy, initiating a series of important photochemical changes such as increased production of ATP. The mitochondria and Kreb’s Cycle stimulation initiates the production of ATP, providing the cell with the extra energy needed to accelerate the healing process and positively influence pain.  These activities can occur in all types of cells and includes ligament, nerves, cartilage and muscle.

Low Level Laser Therapy(LLLT) is a treatment where by a low level laser is utilized to treat chronic and acute pain.  Low level laser therapy may be used for patients suffering from Sciatica, back and neck, hip, knee, ankle, foot pain and conditions a, musculoskeletal pain, joint pain associated with arthritis, fibromyalgia, tendonitis, bursitis, neuropathy, Achilles tendonitis, migraine headaches, sprains and strains,trapped nerves, carpal tunnel syndrome , back, neck, shoulder pain and other associated pains. Low Level laser therapy also treats conditions such as TMJ, reflex sympathetic dystrophy (RSD) and other inflammatory and scarring conditions. By increasing serotonin levels, low level laser therapy contributes to the body’s own healing process. Non-thermal and non-invasive, low level laser therapy involves a combination of low level laser and electric stimulation and is one of the most effective healing therapies. Completed in ten to twelve sessions,  low level laser therapy(LLLT) can significantly reduce treatment time and costs.

Low Laser Therapy(LLLT) has been tested in over 200 clinical trials (RCTs) and published in the world’s top medical journals including a review by The Lancet, a clinical study in the journal PAIN and is acknowledged by the World Health Organisation Bone and Joint Task Force  and published in the journal Spine.

A Review on research published by The Lancet, for the treatment of neck pain with Cold/Low Laser Therapy (LLLT)

Low level Laser treatment for neck pain.

Neck pain  is common, often persistent, and responds poorly to medication. So it is encouraging to read that a relatively novel, non-invasive treatment shows evidence of effectiveness. A systematic review and meta-analysis of 16 randomised controlled trials of low-level laser therapy (LLLT)’ yielded 820 patients, for whom data was pooled. LLLT was found to reduce pain immediately after treatment in acute neck pain and up to 22 weeks after completion of treatment in patients with chronic neck pain. Low-level laser – or cold laser – is yet to be established as a medical treatment but, according to Wikipedia, papers are appearing at the rate of around 25 per month, mainly investigating treatment of musculoskeletal disorders.

1. Chow RT, Johnson Ml, Lopes-Martins RA, Bjordal JM. Efficacy of low-level laser therapy in the management of neck pain: a systematic review and meta-analysis of randomised placebo or active-treatment controlled trials. Lancet 2009 Dec 5;374(9705):1897-908.

Low Level Laser Therapy (LLLT)

Low Level  Laser Therapy (LLLT) has a 5 star rating for soft tissue injuries,conditions and inflammation.  Low Level Laser Therapy is a handheld, non-invasive, light-emitting medical device which is used over different areas of the body. It provides an unmatched advantage in the treatment of conditions such as;

Athletic and sports Injuries, Soft tissue injuries including Sprains and Strains, Tendonitis and Haematomas

Lower leg (calf pain) inflammation, Shin splints, Hamstring, Achilles tendonitis, Bursitis, conditions and disorders

Ankle sprains, injury, and fractures, inflammation conditions and disorders

Heel and foot injury, pain, Bursitis, Achilles Tendonitis, Plantar fasciitis, conditions and disorders

Knee pain, injuries, tears, ligament, Tendon injury, ruptures, Runners Knee, inflammation, Bursitis, conditions and disorders

Shoulder injury, pain, Shoulder tears, fractures inflammation, Tenosynovitis ,Tendonitis, Bursitis, conditions such as frozen shoulder, and disorders

Neck injury, Neck Pain, Neck sprain, Whiplash injury.

Back Injury,   Lower back pain, Sciatica, slipped discs, prolapsed disc, herniated / bulging discs, Trapped nerves and inflammation.

Elbow, Wrist and Hand injury, Tendonitis, inflammation, fractures, conditions and disorders, such as Tennis Elbow,(Golfers Elbow) Carpal Tunnel Syndrome,

Hip injury and pain, Sacroiliac Joint inflammation, groin and thigh strain (pull), sports hernia, Hip Bursitis/Tendonitis, Trochanteric Bursitis, conditions and disorders

Muscle sprain and spasms, Cramps, Joint Pain and stiff Joints.

Pain Relief, including Arthritic pain relief.

Wound Management including Skin Ulcers, Pressure Sores and Burns, Skin infections

Chronic pain such as Trigeminal Neuralgia and Chronic Neck and Back pain.

Safety

Low level laser therapy(LLLT) is not harmful. Lasers used for tissue stimulation have insufficient strength to damage cells. 30 years of clinical studies and clinical use have shown no adverse effects whatsoever.

The Advantages of Low Intensity Laser Therapy

• Non-invasive
• Non-toxic
• Easily applied
• Highly effective
• Cure rate > 95%
• No known negative side effects

Mechanism of Action

Therapeutic lasers work by supplying energy to the body in the form of photons of light. The tissues and cells then absorb this energy, where it is used to accelerate the normal rate of tissue healing.

Therapeutic Benefits of Laser Therapy:

• Anti-inflammatory Action: Laser light reduces swelling, leading to decreased pain, less stiffness, and a faster return to normal joint and muscle function.
• Rapid Cell Growth: Laser light accelerates cellular reproduction and growth.
• Faster Wound Healing: Laser light stimulates fibroblast development and accelerates collagen synthesis in damaged tissue.
• Reduced Fibrous Tissue Formation: Laser light reduces formation of scar tissue, leading to more complete healing, with less chance of weakness and re-injury later.
• Increased Vascular Activity: Laser light increases blood flow to the injured area.
• Stimulated Nerve Function: Laser light speeds nerve cell processes which may decrease pain and numbness associated with nerve-related conditions.

Frequency of Treatments

While some patients get immediate results, others require 6-10 treatments before seeing a lasting effect. Less severe or acute injuries will require fewer treatments than chronic or severe conditions.

 Chiropractic Treatment

Chiropractic addresses the function of central nervous system which is the “master system” of the body controlling ad regulating function of all other subsystems including musculoskeletal system. Properly aligned skeletal system would improve performance, reduce the risk of injury and improve healing of existing injuries.

Chiropractors specialize in the non-drug treatment of musculoskeletal problems, including joint sprains and disc injuries. To some extent, the chiropractic approach to sports injuries is similar to that of traditional medical care.

Usually chiropractor’s initial examination would include standard orthopaedic and neurological tests to diagnose whether a particular pain is due to a strain, sprain, or disc problem. X-ray examination is also performed to screen for fractures and other bone disorders, such as osteoporosis.  

Chiropractic management of sports injuries often includes widely used physical therapies such as ice, Low Level laser therapy (LLLT) to reduce swelling and inflammation, or electronic muscle stimulation for muscle strains and spasms. 

Importance of Restoring Structural Body Balance.

Chiropractic management of sport injuries has an emphasis on adjustment and improving function of spinal and other joints through manipulation as well as restoring overall structural balance of the body. Chiropractor assess the effect of the muscle injury on the rest of the body as it would cause tightening of other muscle and joints in order to maintain general balance. Chiropractic adjustments help to restore the natural balance that was present before the injury.

 

Network Spinal Analysis and Research

Network Spinal Analysis is a gentle and extremely effective style of chiropractic care used to evaluate and adjust the spine. The purpose of NSA is to allow restoration of proper nerve function for full health and peak performance. 

Network Spinal Analysis is a chiropractic technique developed in America in the early 80’s by Dr Donald Epstein. Network Spinal Analysis utilises light touches, specific body contacts and body positioning to develop breathing and body oscillations (or waves) that dissipate stored tension. NSA allows your body to develop new strategies to release this tension on its own. This promotes the clarity and flexibility a body needs to adapt to the challenges of our busy lives. 

How Does NSA Work?  

The spinal cord, in addition to being an electrical system, also conducts information through oscillation, or wave-like motion. Like an overstretched rubber band, the spinal cord tissues oscillate at a higher frequency, or “phase”, when they are under tension. As every cell of the body is connected via an elaborate nerve network to the spinal cord, any change in tension of the spinal cord affects the function of every cell in the body… all 75-100 trillion of them!   

From this, we found that most tension in the vertebra of the spine was secondary to tension patterns from the spinal cord. The stress of having too much to do and not enough time to do it is epidemic in our culture. Consistently high stress levels freeze the body in a “fight or flight” mode, tightening muscles, rounding shoulders, making breathing shallow, and limiting blood and oxygen to the parts of your brain responsible for relaxation, revitalization, creativity, and growth.   We find that a busy life is typically not the problem. The problem is an inability to shift gears and “unhook” from the stress-causing factors that are overwhelming you.
That’s why, instead of trying to mechanically adjust or align the spine through manipulation of the vertebra, a Network Chiropractor seeks to understand the physical, emotional, and mental factors related to the tension pattern and then find the specific points on the spine that will help the body resolve its tension using the exact amount of pressure that cues the brain from stress into ease. No twisting, popping, or cracking is necessary. 

The Network Chiropractor is using the principle of leverage. This is when they make the light gentle adjustments. The idea is like moving huge boulder without having to use a great deal of force if you use the leverage of a tree branch.
Putting the lever in the exact right place, at the right time with the right amount of light force, you can easily move the boulder. Likewise, Network Chiropractors are trained during post-graduate courses on Network Spinal Analysis to know the exact leverage point and manoeuvres to utilise on the spine to release tension to allow the body to find equilibrium. 

What scientific evidence do you have that your method works? 

NSA is one of the most researched methods in chiropractic. Network Spinal Analysis™ has been the subject of academic study, research and publication for its unprecedented effect in wellness and quality of life, adaptability to stress, enhanced life enjoyment, facilitation of constructive lifestyle changes. Also studies are being conducted as to its influence on the advancement and evolution of the nervous system’s strategies for self-organization.
A retrospective study of nearly 3,000 people through the University of California Irvine Medical College documented significant improvements in quality of life in the majority of people receiving Network Chiropractic care. 

The wave patterns that occur during a Network entrainment are the focus of University of Southern California mathematician professor Edmund Jonckheere, who is currently studying the relationship between these wave patterns and the energy-efficiency and adaptability of the nervous system.   

The Journal of Alternative and Complementary Medicine featured the evolving paradigm that contains NSA and SRI, called Reorganizational Healing, in May ’09. 

NSA Sessions 

The adjustments are made along the spine and are as gentle as the pressure that you could comfortably apply to your closed eyelid. 

• You keep your clothes on (except your shoes) during a session.
• Sessions last about 30-40 minutes.
• The therapy is not painful, although the bodily sensations can be surprising and emotional releases during sessions are common.
• Practitioners evaluate the client’s progress based on his or her self-reported experience.

Benefits of NSA 

Research has shown that as a spine, body and nervous system becomes healthier, physical wellbeing improves to provide more spinal flexibility, diminished symptoms and a greater ability to cope, developing an internal sense of wellness regardless of circumstances.
Examples of further additional benefits reported include: 

• Less physical pain
• Less tension or stiffness of the spine
• Greater flexibility
• Reduced allergies, eczema, asthma
• Fewer colds flu & headaches
• Less menstrual discomfort
• Improved response to stress
• Improved mental/emotional state
• Improved life enjoyment
• Improved overall quality of life

Basic care typically lasts 6 to 8 weeks, with 2 to 3 sessions per week. At the end of this period, clients generally report better body awareness, stronger spinal movement, and relief from discomfort and more ease in releasing tension.
After basic care sessions, you can choose to continue with treatment and enjoy wellness 

Network Spinal Analysis Research

The following is a list of peer-reviewed publications involving Network Spinal Analysis Care. Further information regarding Network Spinal Analysis Research currently in process or programs where information on Network Spinal Analysis Research has been presented is available at www.associationfornetworkcare.com

Improvement in Attention in Patients Undergoing Network Spinal Analysis: A Case Series Using Objective Measures of Attention
Pauli Y. Journal of Vertebral Subluxation Research, August 23, 2007; 1-9

Objective: Anecdotal preliminary evidence suggests that chiropractic care may be of benefits for individuals suffering from ADHD. This case series presents the improvement in attention experienced by 9 adult patients undergoing Network Spinal Analysis.

Methods: Nine adult patients are presented (4 male, 5 female) with a mean age of 40.4 years (range 22 – 58 years old). All patients were evaluated with the Test of Variable of Attention (TOVA) before receiving Network Spinal Analysis (NSA) care and at 2 months into care. The nine patients received level 1 NSA care for two months, as taught by the Association for Network Care. Neurospinal integrity was evaluated with palpation, as well as surface electromyography. Cognitive process of attention was objectively evaluated using a continuous performance test, the Test of Variables of Attention (TOVA).

Results: We evaluated our patient cohort before and after Network care using sEMG and variables from the continuous performance test (TOVA). Before care, all patients had an abnormal ADHD score with a mean of -3.74 (range: – 8.54 to -1.89). After 2 months of care, all patients had a significant change in ADHD score (p=0.08) and 88% completely normalized the ADHD score. 77% and 66% of patients experienced significant change in reaction time and variability score, respectively. All patients experienced a significant reduction in sEMG pattern of activation (p=0.08). We discuss possible mechanisms by which spinal care may have enhanced the function of the prefrontal cortex, thereby resulting in improved attentional capacities

Conclusion: In this case series the nine adult patients experienced significant improvement in attention, as measured by objective outcomes, after receiving two months of Network Spinal Analysis. The progress documented in this report suggests that NSA care may positively affect the brain by creating plastic changes in the prefrontal cortex and other cortical and subcortical areas serving as neural substrate for the cognitive process of attention. These findings may be of importance for individuals suffering from attention deficit. Further research into this area is greatly needed.

Quality of Life Improvements and Spontaneous Lifestyle Changes in a Patient Undergoing Subluxation-Centered Chiropractic Care: A Case Study
Pauli Y. Journal of Vertebral Subluxation Research, October 11, 2006; 1-15

Purpose of Study: This case study is to report the improvement in quality of life experienced by a patient undergoing subluxation-centered chiropractic care.

Clinical Features: A 36 year old male presented with primary health concerns of stress, eye pain and left leg pain of 14 years duration radiating to the foot and secondary complaints of gastritis, ulcers, nervousness, depression, lack of concentration and general loss of interest in daily life. The patient also smokes, does not exercise, eats a sub-optimal diet and rated his family and friends support, as well as job satisfaction as sufficient.

Intervention and Outcome: We discuss the various analyses employed to evaluate vertebral subluxations, including paraspinal surface electromyography and thermography. Adjustive care included a combination of Network Spinal Analysis, Torque Release Technique and diversified structural adjustments to correct vertebral subluxations over a six month period. We used visual analog scales, open-ended questions and selected items from the Self-Rated Health and Wellness Instrument to monitor health changes, as well as the positive improvements in quality of life as perceived by the patient himself.

Conclusion: This case study demonstrates that the correction of vertebral subluxations over an 11 month period was associated with significant improvements in the quality of life of the patient.

Chiropractic Care of a Battered Woman: A Case Study
Bedell L. Journal of Vertebral Subluxation Research, July 20, 2006; 1-6

Objective: This case study documents the chiropractic care of battered woman struggling with Intimate Partner Violence (IPV). Chiropractic offers battered women a unique service, it is the only profession trained and licensed to detect and correct vertebral subluxations. The relationship between the stresses of abuse and vertebral subluxation, as well as the subsequent changes during chiropractic care, are described.

Clinical Features: A Caucasian, 23-year old female presented with headaches, neck pain, and upper back pain. The initial complaint noted sharp, knife-like pains into the medial scapular borders, worse on the right side. Tingling extended into the right hand, most severe in the 2nd, 3rd, and 4th fingers.

Chiropractic care and outcome: Protocols of both Torque Release and Activator techniques were utilized to evaluate vertebral subluxations. Subjective quality of life issues were evaluated through a Network Spinal Analysis (NSA) Health Status Questionnaire. After commencing chiropractic care, this woman suffered a cervical spine hyper-extension/hyper-flexion type injury from an automobile accident. For the first 30 days after, adjustments were applied twice weekly. Acute exacerbations of symptoms unrelated to the original complaints were displayed and progress became irregular. During the next 60 days, there were various unexplained falls and severe flare-ups of painful symptoms, and she finally admitted to being battered by her husband. Referrals to counselors and programs dealing with domestic violence were provided. Once the physical battering stopped, consistent progress was noted in both clinical symptoms and quality of life issues.

Conclusion: As a battered woman must receive emotional and social support to improve her situation, it is important for chiropractors to recognize the “red flags” of IPV. Chiropractors re-evaluate regularly for changes in vertebral subluxation patterns and can recognize inconsistent responses. They may also be the first caregivers to offer a vitalistic approach; considering a woman’s physical, chemical, and emotional quality of life; a perspective that offers significant connection and trust. This article serves as a foundation on the topic of IPV and chiropractic, for use in both communities.

Wellness lifestyles II: Modeling the dynamic of wellness, health lifestyle practices, and Network Spinal Analysis.
Schuster TL, Dobson M, Jauregui M, Blanks RH. Journal of Alternative and Complimentary Medicine. April 2004;10(2):357-67.
PMID: 15165417

OBJECTIVE: Empirical application of a theoretical framework linking use of Network Spinal Analysis (NSA; a holistic, wellness-oriented form of complementary and alternative medicine [CAM]), health lifestyle practices, and self-reported health and wellness. DESIGN: Cross-sectional self-administered survey study. RESPONDENTS: Two thousand five hundred and ninety-six (2596) patients from 156 offices of doctors who were members of the Association for Network Chiropractic (currently titled Association for Network Care); estimated response rate was 69%. MEASURES: Exogenous variables entered into the structural equation model include gender, age, education, income, marital status, ailments, life change, and trauma. A wellness construct consisted of calculated difference scores between two referents, “presently” and “before Network” care, for self-reported items representing wellness domains of physical state, mental-emotional state, stress evaluation, and life enjoyment. Positive reported change in nine items assembled into dietary practices, health practices, and health risk dimensions serve as indicators of the construct of changes in health lifestyle practices. The NSA care construct consisted of duration of care in months, awareness of energy and awareness of breathing since beginning Network care. RESULTS: Of the exogenous variables only gender, age, and education remain in the final parsimonious structural equation model in these data. Reported wellness benefits accrue to individuals along a direct path from both self-reported positive lifestyle change (0.22), and from NSA care (0.43). The path (0.65) from NSA care to positive health lifestyle changes indicates that NSA care also has an indirect effect on wellness through changes in health lifestyle practices.

CONCLUSIONS: The Structural Equation model tested in these analyses lends support to our theoretical framework linking wellness, health lifestyles, and CAM. This study provides further evidence that our measurements of health and wellness are particularly appropriate for investigating wellness-oriented CAM. There is a positive relationship between the experience of NSA care and self-reported improvements in wellness as well as self-reported changes in lifestyle practices. NSA care users tend toward the practice of a positive health lifestyle, which also has a direct effect on reported improvements in wellness. These empirical links are discussed relative to the sociodemographic characteristics of this population and show that use of NSA care is an aspect of a wellness lifestyle.

Wellness lifestyles I: A theoretical framework linking wellness, health lifestyles, and complementary and alternative medicine.
Schuster TL, Dobson M, Jauregui M, Blanks RH. Journal of Alternative and Complimentary Medicine. April 2004;10(2):349-56.
PMID: 15165416

Scholarship concerning complementary and alternative medicine (CAM) practices within the United States could benefit from incorporating sociological perspectives into the development of a comprehensive research agenda. We review the literature on health and wellness emphasizing definitions and distinctions, the health lifestyles literature emphasizing issues of both life choices and life chances, and studies of CAM suggesting utilization as an aspect of a wellness lifestyle. This review forms the foundation of a new theoretical framework for CAM research based on the interrelationship of CAM with health promotion, wellness, and health lifestyles. To date, few studies have sought to bring these various elements together into a single, comprehensive model that would enable an assessment of the complexity of individual health and wellness in the context of CAM. We argue that attention to literatures on health measurement and health lifestyles are essential for exploring the effectiveness and continuing use of CAM.

The Transition of Network Spinal Analysis Care: Hallmarks of a Client-Centered Wellness Education Multi-Component System of Health Care Delivery
Epstein D. Journal of Vertebral Subluxation Research, April 5, 2004; 1-7

Network Spinal Analysis TM (NSA) care has been transitioned from a health care system with the objective of correction of two types of vertebral subluxation, to a multi-component system of health care delivery with emphasis on wellness education for participating clients. NSA care is now delivered and communicated in discrete Levels of Care with emphasis on client participation through self-evaluation. Emphasis on wellness education will be introduced into NSA practice through training via a Certificate Program currently under development. This paper considers some hallmarks that delineate a wellness education, patient (client)-centered practice. The concepts presented relative to this wellness model of health care delivery are believed to be applicable to any approach with similar practice objectives. The perspective presented considers that the major aspects of a patient-centered, wellness education health care delivery system is multi-dimensional. Hallmarks include differentiating terms, and establishing a wellness mentality. Substantiation of the discipline must be established through credible published research regarding its efficacy and safety as well as a consistent and valid means of measuring progressive outcomes derived from the care received. The relationship of NSA to other disciplines is discussed.

Successful In Vitro Fertilization in a Poor Responder While Under Network Spinal Analysis Care: A Case Report
Senzon SA. Journal of Vertebral Subluxation Research, September 14, 2003; 1-6

Objective: This case report describes the successful in vitro fertilization (IVF) of a 34 year old female who had one previous aborted IVF attempt prior to Network Spinal Analysis (NSA) care. This case report is being presented to add to other case reports that show positive physiological changes in patients receiving NSA care.

Clinical Features: The IVF was attempted due to her partner’s azoospermia. The first IVF attempt was on 3/26/02. The patient had a poor follicular growth after the standard hyper-stimulation process of the ovaries, including pre-treatment with Mircette (birth control pills) and 1mg/0.2ml of Lupron (a gonadotropin releasing hormone agonist), and 3-6 amps of Gonal-F (a recombinant fsh) starting on cycle day 3. Her baseline day 3 estradiol and LH levels were only 21.2pg/me and 5.0 I.U./L respectively. On cycle day 8, estradiol was only 56% and LH was 6.6 I.U./L. The Gonal-F was increased to 6amps. This first attempt was canceled due to the poor follicle growth. Only 3-4 follicles of insufficient size between 10-14mm each were found.

Chiropractic Care and Outcomes: On 4/11/02, the patient commenced regular NSA care. The second IVF attempt began on 6/6/02. The change in IVF protocol was the addition of Repronex (also a gonadotropin a combination of LH and fsh). The total increased dose of Gonal-F and Repronex was 6amps, compared to the first attempt of only 3amps which was then increased to 6amps of Gonal-F only.

Conclusion: On the second IVF attempt, estradiol was 1001pg/ml on day 8, and 2019pg/ml on day 11, with LH at 9.3. The Oocyte retrieval after the second attempt was 10 eggs, each approximately 18mm. A successful aspiration of eggs was completed on 6/17/02, and a successful pregnancy followed. The patient is still under NSA care, and is now in her second trimester with normal fetal heart sounds. The possible role of NSA care in the vigorous follicular growth and other health benefits is discussed.

Insult, Interference and Infertility: An Overview of Chiropractic Research
Behrendt M. Journal of Vertebral Subluxation Research, May 2, 2003; 1

Objective: Infertility is distinct from sterility, implying potential, and therefore raises questions as to what insult or interference influences this sluggish outcome. Interference in physiological function, as viewed by the application of chiropractic principles, suggests a neurological etiology and is approached through the mechanism of detection of vertebral subluxation and subsequent appropriate and specific adjustments to promote potential and function. Parental health and wellness prior to conception influences reproductive success and sustainability, begging efficient, effective consideration and interpretation of overall state and any distortion. A discussion of diverse articles is presented, describing the response to chiropractic care among subluxated infertile women.

Clinical Features: Fourteen retrospective articles are referenced, their diversity includes: all 15 subjects are female, ages 22-65; prior pregnancy history revealed 11 none, 2 successful unassisted, 1 assisted, 1 history of miscarriage. 9 had previous treatment for infertility, 4 were undergoing infertility treatment when starting chiropractic care. Presenting concerns included: severe low back pain, neck pain, colitis, diabetes, and female dysfunction such as absent or irregular menstrual cycle, blocked fallopian tubes, endometriosis, infertility, perimenopause and the fertility window within a religiousbased lifestyle, and a poor responder undergoing multiple cycles of IVF.

Chiropractic Care and Outcome: Outcomes of chiropractic care include but are not limited to benefits regarding neuromuscular concerns, as both historical and modern research describe associations with possible increased physiological functions, in this instance reproductive function. Chiropractic care and outcome are discussed, based on protocols of a variety of arts, including Applied Kinesiology (A.K.), Diversified, Directional Non-Force Technique (D.N.F.T.), Gonstead, Network Spinal Analysis (N.S.A.), Torque Release Technique (T.R.T.), Sacro Occipital Technique (S.O.T.) and Stucky-Thompson Terminal Point Technique. Care is described over a time frame of 1 to 20 months.

Conclusion: The application of chiropractic care and subsequent successful outcomes on reproductive integrity, regardless of factors including age, history and medical intervention, are described through a diversity of chiropractic arts. Future studies that may evaluate more formally and on a larger scale, the effectiveness, safety and cost benefits of chiropractic care on both well-being and physiological function are suggested, as well as pursuit of appropriate funding.

Chaotic Modeling in Network Spinal Analysis: Nonlinear Canonical Correlation with Alternating Conditional Expectation (ACE): A Preliminary Report
Bohacek S, Jonckheere E. Journal of Vertebral Subluxation Research, December 1998; 2(4): 188-195

Abstract – This paper presents a preliminary non-linear mathematical analysis of surface electromyographic (sEMG) signals from a subject receiving Network Spinal Analysis (NSA).The unfiltered sEMG data was collected over a bandwidth of 10-500 Hz and stored on a PC compatible computer. Electrodes were placed at the level of C1/C2,T6, L5, and S2 and voltage signals were recorded during the periods in which the patient was experiencing the “somatopsychic” wave, characteristic of NSA care. The intent of the preliminary study was to initiate mathematical characterization of the wave phenomenon relative to its “chaotic,” and/or nonlinear nature. In the present study the linear and nonlinear Canonical Correlation Analyses (CCA) have been used. The latter, nonlinear CCA, is coupled to specific implementation referred to as Alternating Conditional Expectation (ACE). Preliminary findings obtained by comparing canonical correlation coefficients (CCC’s) indicate that the ACE nonlinear functions of the sEMG waveform data lead to a smaller expected prediction error than if linear functions are used. In particular, the preliminary observations of larger nonlinear CCC’s compared to linear CCC’s indicate that there is some nonlinearity in the data representing the “somatopsychic” waveform. Further analysis of linear and nonlinear predictors indicates that 4th order nonlinear predictors perform 20 % better than linear predictors, and 10th order nonlinear predictors perform 30% better than linear predictors.This suggests that the waveform possesses a nonlinear “attractor” with a dimension between 4 and 10. Continued refinement of the ACE algorithm to allow for detection of more nonlinear distortions is expected to further clarify the extent to which the sEMG signal associated with the “somatopsychic” waveform of NSA is differentiated as nonlinear as opposed to random.

Reduction of Psoriasis in a Patient under Network Spinal Analysis Care: A Case Report
Behrendt M. Journal of Vertebral Subluxation Research, December 1998; 2(4): 196-200

This case report describes the progress of a 52 year old male with chronic psoriasis, first diagnosed in April of 1992. After the condition exacerbated over a five year period, he was placed on 12.5 mg/week methotrexate, and oral immunosuppressant medication in October of 1997.After commencing the medication, the condition reduced from 6% body coverage, with flares of 15-20%, to a body coverage of 5%. Following a cessation of the oral medication in February, 1998, the condition recurred at the previous uncontrolled level within one month. The patient was again placed on 12.5 mg/week methotrexate, and subsequently the condition reduced to 5% body coverage. The patient’s dose was reduced to 10 mg/week, and later to 7.5 mg/week, with the psoriasis remaining at 5% coverage. On 5/18/98, the patient commenced regular NSA care. He reported a reduction in the psoriasis condition on 6/3/98, and was taken off the oral medication on 6/25/98. The reduction continued, and the patient was advised by his medical physician on 7/01/98 to continue the cessation of oral medication. As of 9/30/98 the psoriasis had decreased to 0.5% to 1.0 % of coverage, and prior plans to initiate ultraviolet-A therapy were canceled. As of 11/98, a five month period since cessation of methotrexate, the patient has remained under regular NSA care, with no recurrence of psoriasis body coverage greater than 1%, the only medication being a topical ointment. This is contrasted to the recurrence after one month, following the patient’s first cessation of methotrexate, and prior to NSA care. The possible role of NSA care in the reduction of the patient’s psoriasis, and other health benefits is discussed.

Changes in Digital Skin Temperature, Surface Electromyography, and Electrodermal Activity in Subjects Receiving Network Spinal Analysis Care
Miller E, Redmond P. Journal of Vertebral Subluxation Research, June 1998; 2(2): 87-95

A preliminary study was conducted to evaluate changes in digital skin temperature (DST), surface electromyography (sEMG), and electrodermal activity (EDA) in a group of twenty subjects receiving Network Spinal Analysis (NSA) care. Data, simultaneously derived from all three parameters, were considered to be indirect correlates of sympathetic nervous system activity. Subjects, including a group of five controls, were assessed for a period of 17 minutes. The continuous assessment period included a baseline interval of 4.5 minutes, followed by a 12.5 minute period which was divided into five 2.5 minute intervals. Care was administered to the NSA recipient group immediately after the baseline period, whereas controls received no intervention following baseline. Results revealed no significant differences in DST either within or between the two groups. Surface EMG readings were relatively constant over the five intervals following baseline in the NSA group, while controls showed significant (p < 0.05) increases in sEMG at the second through fifth intervals relative to the first interval following baseline activity. Electrodermal activity was significantly decreased (p < 0.01) in the NSA group in the second through fifth intervals compared to baseline. Moreover, decreases varied between intervals, but exhibited a leveling from the third through fifth interval. Control subjects, alternatively, exhibited an increase in EDA in all intervals following baseline. The extent of increase resulted in EDA activity significantly greater than the NSA group at the third through fifth intervals. It was concluded that the increase in EMG activity in the control groups may have reflected an increasing level of anxiety due to the duration of the recording period. Since the NSA group expressed constancy in sEMG activity during the same period, coupled to significant decreases in EDA, a “sympathetic quieting effect” was postulated to occur in subjects receiving NSA care. This conclusion is consistent with hypothesized neurological pathways linked to responses observed during NSA care, as well as other reports of self-reported improvements in mental/emotional state and stress reduction in patients receiving Network Chiropractic Care.

Functional Magnetic Resonance Imaging: About the Cover
Journal of Vertebral Subluxation Research, 1998; 2(1): Cover

About the Cover: Functional Magnetic resonance Imaging (fMRI), which measures the relative presence of oxy-hemoglobin, has gained attention as a non-invasive medium through which high resolution images of the brain and other tissue may be acquired. This technology may provide a useful assessment of cortical changes following chiropractic intervention. Images of the patient depicted on the cover, on the left, reflect cortical activity (lighted areas in the parietal cortex, frontal cortex areas 9, 10; visual association areas 19, 37, and 39) associated with the learning process of a “novel” muscular maneuver of the foot. Images on the right reflect cortical activity following a Network Spinal Analysis (form of chiropractic) adjustment session, taken approximately 20 minutes after the first set of images, involving the same activity. The decrease in “lighted” areas before and after the adjustment session suggests that less cortical “planning” or “activity” is associated with the “novel” foot maneuver. Thus, the ability of fMRI to visualize changes in cortical activity may play a significant role in elucidating the consequences of vertebral subluxation correction on neurological function.

An Impairment Rating Analysis Of Asthmatic Children Under Chiropractic Care
Graham R, Pistolese R. Journal of Vertebral Subluxation Research, 1997; 1(4): 41-48

A self-reported asthma-related impairment study was conducted on 81 children under chiropractic care. The intent of this study was to quantify self-reported changes in impairment experienced by the pediatric asthmatic subjects, before and after a two month period under chiropractic care. Practitioners, representing a general range of six different approaches to vertebral subluxation correction, administered a specifically designed asthma impairment questionnaire at the appropriate intervals. Subjects were categorized into two groups; 1-10 years and 11-17 years. Parents/guardians completed questionnaires for the younger group, while the older subjects self-reported their perceptions of impairment. Significantly lower impairment rating scores (improvement) were reported for 90.1% of subjects 60 days after chiropractic care when compared to the pre-chiropractic scores (p < 0.05) with an effect size of 0.96. As well, there were no significant differences across the age groups based on parent/guardian versus self rated scores. Girls reported higher (less improvement) before and after care compared to boys, although significant decreases in impairment ratings were reported for each gender. This suggested a greater clinical effect for boys which was supported by effect sizes ranging from 1.2 for boys compared to 0.75 for girls. Additionally, 25 of 81 subjects (30.9%) chose to voluntarily decrease their dosage of medication by an average of 66.5% while under chiropractic care. Moreover, information collected from patients revealed that among 24 patients reporting asthma “attacks” in the 30 day period prior to the study, the number of “attacks” decreased significantly by an average of 44.9% (p <.05). Based on the data obtained in this study, it was concluded that chiropractic care, for correction of vertebral subluxation, is a safe nonpharmacologic health care approach which may also be associated with significant decreases in asthma related impairment as well as a decreased incidence of asthmatic “attacks.” The findings suggest that chiropractic care should be further investigated relative to providing the most efficacious care management regimen for pediatric asthmatics.

[Note: NSA care was one of the chiropractic approaches used in this study supported by the Michigan Chiropractic Council]

A Retrospective Assessment of Network Care Using a Survey of Self-Rated Health, Wellness and Quality of Life
Blanks RH, Schuster TL, Dobson M. Journal of Vertebral Subluxation Research, 1997; 1(4): 15-31

The present study represents a retrospective characterization of Network Care, a health care discipline within the subluxation-based chiropractic model. Data were obtained from 156 Network offices (49% practitioner participation rate) in the United States, Canada, Australia, and Puerto Rico. Sociodemographic characterization of 2818 respondents, representing a 67-71% response rate, revealed a population predominately white, female, well-educated, professional, or white collar workers. A second objective of the study included the development and initial validation of a new health survey instrument. The instrument was specifically designed to assess wellness through patients’ self-rating different health domains and overall quality of life at two “time” points: “presently” and retrospectively, recalling their status before initiating care (“before Network”). Statistical evaluation employing Chronbach’s alpha and theta coefficients derived from principle components factor analyses, indicated a high level of internal reliability in regard to the survey instrument, as well as stable reliability of the retrospective recall method of self-rated perceptions of change as a function of duration of care. Results indicated that patients reported significant, positive perceived change (p < 0.000) in all four domains of health, as well as overall quality of life. Effect sizes for these difference scores were all large (>0.9). Wellness was assessed by summing the scores for the four health domains into a combined wellness scale, and comparing this combined scale “presently” and “before Network.” The difference, or “wellness coefficient” spanning a range of -1 to +1, with zero representing no change, showed positive, progressive increases over the duration of care intervals ranging from 1-3 months to over three years. The evidence of improved health in the four domains (physical state, mental/emotional state, stress evaluation, life enjoyment), overall 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. These findings are being further evaluated through longitudinal studies of current populations under care in combination with investigation of the neurophysiological mechanisms underlying its effects.

Network Spinal Analysis: A System of Health Care Delivery Within the Subluxation-Based Chiropractic Model
Epstein, D. Journal of Vertebral Subluxation Research, August 1996; 1(1): 51-59

The theoretical basis and clinical application of Network Spinal Analysis (NSA) is described. NSA delivers health care within the subluxation-based chiropractic model and seeks to contribute to the distinction of the various techniques and methods within the profession by describing and discussing its major characteristics. In this regard, clinical observations relative to the application of the Network Protocol have been described in relation to the monitoring of patient and practitioner outcomes. Relevant research from a separate Network Care retrospective study, which impacts on its characterization, profiles the patient population as predominantly female. Other data indicates that Network Care is widely and consistently practiced. Additionally, patients report significant, positive changes in health-related quality of life measures linked to certain clinical components of Network Care.
 

Visualization of a stationary CPG-revealing spinal wave* (Abstract from research at the University of Southern California, Professor Edmond Jonchkeere, et al.) 

Program of MEDICINE MEETS VIRTUAL REALITY 14 – ACCELERATING CHANGE IN HEALTH CARE: NEXT MEDICAL TOOLKIT* conference where Professor Jonchkeere will present a paper on the NSA Somatopsychic Wave (Prof. Jonckheere’s presentation is scheduled on pg. 20)

Paper Presentation accepted at the International Society of Quality of Life Research Conference in Prague, Czech Republic Nov. 12-15th, 2003 

Read the latest research articles on Surface Electromyography in Network Spinal Analysis™ (In order to view the files below, it is necessary that you have Adobe Acrobat Reader. If you do not have this please Click Here to download your free copy now.)

• Dynamic Modeling of Spinal Electromyographic activity during various conditions
• Nonlinear Switching Dynamics in Surface Electromyography of the Spine 

This research, which involves human subjects, has been approved by the University Park Institutional Review Board (IRB) of the University of Southern California

Network Spinal Analysis™: A Research Perspective

Statement of Efficacy

The Case Report 

Health & Wellness Quality of Life Questionnaire (Adobe Acrobat Reader Required)
(Questionnaire available to download free of charge courtesy of the Association for Network Care)

For more information on Network Spinal Analysis™  Research please visit the Association For Network Care website at www.associationfornetworkcare.com

Network Spinal Analysis and Research

Network Spinal Analysis is a gentle and extremely effective style of chiropractic care used to evaluate and adjust the spine. The purpose of NSA is to allow restoration of proper nerve function for full health and peak performance. 

Network Spinal Analysis is a chiropractic technique developed in America in the early 80’s by Dr Donald Epstein. Network Spinal Analysis utilises light touches, specific body contacts and body positioning to develop breathing and body oscillations (or waves) that dissipate stored tension. NSA allows your body to develop new strategies to release this tension on its own. This promotes the clarity and flexibility a body needs to adapt to the challenges of our busy lives. 

How Does NSA Work?  

The spinal cord, in addition to being an electrical system, also conducts information through oscillation, or wave-like motion. Like an overstretched rubber band, the spinal cord tissues oscillate at a higher frequency, or “phase”, when they are under tension. As every cell of the body is connected via an elaborate nerve network to the spinal cord, any change in tension of the spinal cord affects the function of every cell in the body… all 75-100 trillion of them!   

From this, we found that most tension in the vertebra of the spine was secondary to tension patterns from the spinal cord. The stress of having too much to do and not enough time to do it is epidemic in our culture. Consistently high stress levels freeze the body in a “fight or flight” mode, tightening muscles, rounding shoulders, making breathing shallow, and limiting blood and oxygen to the parts of your brain responsible for relaxation, revitalization, creativity, and growth.   We find that a busy life is typically not the problem. The problem is an inability to shift gears and “unhook” from the stress-causing factors that are overwhelming you.
That’s why, instead of trying to mechanically adjust or align the spine through manipulation of the vertebra, a Network Chiropractor seeks to understand the physical, emotional, and mental factors related to the tension pattern and then find the specific points on the spine that will help the body resolve its tension using the exact amount of pressure that cues the brain from stress into ease. No twisting, popping, or cracking is necessary. 

The Network Chiropractor is using the principle of leverage. This is when they make the light gentle adjustments. The idea is like moving huge boulder without having to use a great deal of force if you use the leverage of a tree branch.
Putting the lever in the exact right place, at the right time with the right amount of light force, you can easily move the boulder. Likewise, Network Chiropractors are trained during post-graduate courses on Network Spinal Analysis to know the exact leverage point and manoeuvres to utilise on the spine to release tension to allow the body to find equilibrium. 

What scientific evidence do you have that your method works? 

NSA is one of the most researched methods in chiropractic. Network Spinal Analysis™ has been the subject of academic study, research and publication for its unprecedented effect in wellness and quality of life, adaptability to stress, enhanced life enjoyment, facilitation of constructive lifestyle changes. Also studies are being conducted as to its influence on the advancement and evolution of the nervous system’s strategies for self-organization.
A retrospective study of nearly 3,000 people through the University of California Irvine Medical College documented significant improvements in quality of life in the majority of people receiving Network Chiropractic care. 

The wave patterns that occur during a Network entrainment are the focus of University of Southern California mathematician professor Edmund Jonckheere, who is currently studying the relationship between these wave patterns and the energy-efficiency and adaptability of the nervous system.   

The Journal of Alternative and Complementary Medicine featured the evolving paradigm that contains NSA and SRI, called Reorganizational Healing, in May ’09. 

NSA Sessions 

The adjustments are made along the spine and are as gentle as the pressure that you could comfortably apply to your closed eyelid. 

• You keep your clothes on (except your shoes) during a session.
• Sessions last about 30-40 minutes.
• The therapy is not painful, although the bodily sensations can be surprising and emotional releases during sessions are common.
• Practitioners evaluate the client’s progress based on his or her self-reported experience.

Benefits of NSA 

Research has shown that as a spine, body and nervous system becomes healthier, physical wellbeing improves to provide more spinal flexibility, diminished symptoms and a greater ability to cope, developing an internal sense of wellness regardless of circumstances.
Examples of further additional benefits reported include: 

• Less physical pain
• Less tension or stiffness of the spine
• Greater flexibility
• Reduced allergies, eczema, asthma
• Fewer colds flu & headaches
• Less menstrual discomfort
• Improved response to stress
• Improved mental/emotional state
• Improved life enjoyment
• Improved overall quality of life

Basic care typically lasts 6 to 8 weeks, with 2 to 3 sessions per week. At the end of this period, clients generally report better body awareness, stronger spinal movement, and relief from discomfort and more ease in releasing tension.
After basic care sessions, you can choose to continue with treatment and enjoy wellness 

Network Spinal Analysis Research

The following is a list of peer-reviewed publications involving Network Spinal Analysis Care. Further information regarding Network Spinal Analysis Research currently in process or programs where information on Network Spinal Analysis Research has been presented is available at www.associationfornetworkcare.com

Improvement in Attention in Patients Undergoing Network Spinal Analysis: A Case Series Using Objective Measures of Attention
Pauli Y. Journal of Vertebral Subluxation Research, August 23, 2007; 1-9

Objective: Anecdotal preliminary evidence suggests that chiropractic care may be of benefits for individuals suffering from ADHD. This case series presents the improvement in attention experienced by 9 adult patients undergoing Network Spinal Analysis.

Methods: Nine adult patients are presented (4 male, 5 female) with a mean age of 40.4 years (range 22 – 58 years old). All patients were evaluated with the Test of Variable of Attention (TOVA) before receiving Network Spinal Analysis (NSA) care and at 2 months into care. The nine patients received level 1 NSA care for two months, as taught by the Association for Network Care. Neurospinal integrity was evaluated with palpation, as well as surface electromyography. Cognitive process of attention was objectively evaluated using a continuous performance test, the Test of Variables of Attention (TOVA).

Results: We evaluated our patient cohort before and after Network care using sEMG and variables from the continuous performance test (TOVA). Before care, all patients had an abnormal ADHD score with a mean of -3.74 (range: – 8.54 to -1.89). After 2 months of care, all patients had a significant change in ADHD score (p=0.08) and 88% completely normalized the ADHD score. 77% and 66% of patients experienced significant change in reaction time and variability score, respectively. All patients experienced a significant reduction in sEMG pattern of activation (p=0.08). We discuss possible mechanisms by which spinal care may have enhanced the function of the prefrontal cortex, thereby resulting in improved attentional capacities

Conclusion: In this case series the nine adult patients experienced significant improvement in attention, as measured by objective outcomes, after receiving two months of Network Spinal Analysis. The progress documented in this report suggests that NSA care may positively affect the brain by creating plastic changes in the prefrontal cortex and other cortical and subcortical areas serving as neural substrate for the cognitive process of attention. These findings may be of importance for individuals suffering from attention deficit. Further research into this area is greatly needed.

Quality of Life Improvements and Spontaneous Lifestyle Changes in a Patient Undergoing Subluxation-Centered Chiropractic Care: A Case Study
Pauli Y. Journal of Vertebral Subluxation Research, October 11, 2006; 1-15

Purpose of Study: This case study is to report the improvement in quality of life experienced by a patient undergoing subluxation-centered chiropractic care.

Clinical Features: A 36 year old male presented with primary health concerns of stress, eye pain and left leg pain of 14 years duration radiating to the foot and secondary complaints of gastritis, ulcers, nervousness, depression, lack of concentration and general loss of interest in daily life. The patient also smokes, does not exercise, eats a sub-optimal diet and rated his family and friends support, as well as job satisfaction as sufficient.

Intervention and Outcome: We discuss the various analyses employed to evaluate vertebral subluxations, including paraspinal surface electromyography and thermography. Adjustive care included a combination of Network Spinal Analysis, Torque Release Technique and diversified structural adjustments to correct vertebral subluxations over a six month period. We used visual analog scales, open-ended questions and selected items from the Self-Rated Health and Wellness Instrument to monitor health changes, as well as the positive improvements in quality of life as perceived by the patient himself.

Conclusion: This case study demonstrates that the correction of vertebral subluxations over an 11 month period was associated with significant improvements in the quality of life of the patient.

Chiropractic Care of a Battered Woman: A Case Study
Bedell L. Journal of Vertebral Subluxation Research, July 20, 2006; 1-6

Objective: This case study documents the chiropractic care of battered woman struggling with Intimate Partner Violence (IPV). Chiropractic offers battered women a unique service, it is the only profession trained and licensed to detect and correct vertebral subluxations. The relationship between the stresses of abuse and vertebral subluxation, as well as the subsequent changes during chiropractic care, are described.

Clinical Features: A Caucasian, 23-year old female presented with headaches, neck pain, and upper back pain. The initial complaint noted sharp, knife-like pains into the medial scapular borders, worse on the right side. Tingling extended into the right hand, most severe in the 2nd, 3rd, and 4th fingers.

Chiropractic care and outcome: Protocols of both Torque Release and Activator techniques were utilized to evaluate vertebral subluxations. Subjective quality of life issues were evaluated through a Network Spinal Analysis (NSA) Health Status Questionnaire. After commencing chiropractic care, this woman suffered a cervical spine hyper-extension/hyper-flexion type injury from an automobile accident. For the first 30 days after, adjustments were applied twice weekly. Acute exacerbations of symptoms unrelated to the original complaints were displayed and progress became irregular. During the next 60 days, there were various unexplained falls and severe flare-ups of painful symptoms, and she finally admitted to being battered by her husband. Referrals to counselors and programs dealing with domestic violence were provided. Once the physical battering stopped, consistent progress was noted in both clinical symptoms and quality of life issues.

Conclusion: As a battered woman must receive emotional and social support to improve her situation, it is important for chiropractors to recognize the “red flags” of IPV. Chiropractors re-evaluate regularly for changes in vertebral subluxation patterns and can recognize inconsistent responses. They may also be the first caregivers to offer a vitalistic approach; considering a woman’s physical, chemical, and emotional quality of life; a perspective that offers significant connection and trust. This article serves as a foundation on the topic of IPV and chiropractic, for use in both communities.

Wellness lifestyles II: Modeling the dynamic of wellness, health lifestyle practices, and Network Spinal Analysis.
Schuster TL, Dobson M, Jauregui M, Blanks RH. Journal of Alternative and Complimentary Medicine. April 2004;10(2):357-67.
PMID: 15165417

OBJECTIVE: Empirical application of a theoretical framework linking use of Network Spinal Analysis (NSA; a holistic, wellness-oriented form of complementary and alternative medicine [CAM]), health lifestyle practices, and self-reported health and wellness. DESIGN: Cross-sectional self-administered survey study. RESPONDENTS: Two thousand five hundred and ninety-six (2596) patients from 156 offices of doctors who were members of the Association for Network Chiropractic (currently titled Association for Network Care); estimated response rate was 69%. MEASURES: Exogenous variables entered into the structural equation model include gender, age, education, income, marital status, ailments, life change, and trauma. A wellness construct consisted of calculated difference scores between two referents, “presently” and “before Network” care, for self-reported items representing wellness domains of physical state, mental-emotional state, stress evaluation, and life enjoyment. Positive reported change in nine items assembled into dietary practices, health practices, and health risk dimensions serve as indicators of the construct of changes in health lifestyle practices. The NSA care construct consisted of duration of care in months, awareness of energy and awareness of breathing since beginning Network care. RESULTS: Of the exogenous variables only gender, age, and education remain in the final parsimonious structural equation model in these data. Reported wellness benefits accrue to individuals along a direct path from both self-reported positive lifestyle change (0.22), and from NSA care (0.43). The path (0.65) from NSA care to positive health lifestyle changes indicates that NSA care also has an indirect effect on wellness through changes in health lifestyle practices.

CONCLUSIONS: The Structural Equation model tested in these analyses lends support to our theoretical framework linking wellness, health lifestyles, and CAM. This study provides further evidence that our measurements of health and wellness are particularly appropriate for investigating wellness-oriented CAM. There is a positive relationship between the experience of NSA care and self-reported improvements in wellness as well as self-reported changes in lifestyle practices. NSA care users tend toward the practice of a positive health lifestyle, which also has a direct effect on reported improvements in wellness. These empirical links are discussed relative to the sociodemographic characteristics of this population and show that use of NSA care is an aspect of a wellness lifestyle.

Wellness lifestyles I: A theoretical framework linking wellness, health lifestyles, and complementary and alternative medicine.
Schuster TL, Dobson M, Jauregui M, Blanks RH. Journal of Alternative and Complimentary Medicine. April 2004;10(2):349-56.
PMID: 15165416

Scholarship concerning complementary and alternative medicine (CAM) practices within the United States could benefit from incorporating sociological perspectives into the development of a comprehensive research agenda. We review the literature on health and wellness emphasizing definitions and distinctions, the health lifestyles literature emphasizing issues of both life choices and life chances, and studies of CAM suggesting utilization as an aspect of a wellness lifestyle. This review forms the foundation of a new theoretical framework for CAM research based on the interrelationship of CAM with health promotion, wellness, and health lifestyles. To date, few studies have sought to bring these various elements together into a single, comprehensive model that would enable an assessment of the complexity of individual health and wellness in the context of CAM. We argue that attention to literatures on health measurement and health lifestyles are essential for exploring the effectiveness and continuing use of CAM.

The Transition of Network Spinal Analysis Care: Hallmarks of a Client-Centered Wellness Education Multi-Component System of Health Care Delivery
Epstein D. Journal of Vertebral Subluxation Research, April 5, 2004; 1-7

Network Spinal Analysis TM (NSA) care has been transitioned from a health care system with the objective of correction of two types of vertebral subluxation, to a multi-component system of health care delivery with emphasis on wellness education for participating clients. NSA care is now delivered and communicated in discrete Levels of Care with emphasis on client participation through self-evaluation. Emphasis on wellness education will be introduced into NSA practice through training via a Certificate Program currently under development. This paper considers some hallmarks that delineate a wellness education, patient (client)-centered practice. The concepts presented relative to this wellness model of health care delivery are believed to be applicable to any approach with similar practice objectives. The perspective presented considers that the major aspects of a patient-centered, wellness education health care delivery system is multi-dimensional. Hallmarks include differentiating terms, and establishing a wellness mentality. Substantiation of the discipline must be established through credible published research regarding its efficacy and safety as well as a consistent and valid means of measuring progressive outcomes derived from the care received. The relationship of NSA to other disciplines is discussed.

Successful In Vitro Fertilization in a Poor Responder While Under Network Spinal Analysis Care: A Case Report
Senzon SA. Journal of Vertebral Subluxation Research, September 14, 2003; 1-6

Objective: This case report describes the successful in vitro fertilization (IVF) of a 34 year old female who had one previous aborted IVF attempt prior to Network Spinal Analysis (NSA) care. This case report is being presented to add to other case reports that show positive physiological changes in patients receiving NSA care.

Clinical Features: The IVF was attempted due to her partner’s azoospermia. The first IVF attempt was on 3/26/02. The patient had a poor follicular growth after the standard hyper-stimulation process of the ovaries, including pre-treatment with Mircette (birth control pills) and 1mg/0.2ml of Lupron (a gonadotropin releasing hormone agonist), and 3-6 amps of Gonal-F (a recombinant fsh) starting on cycle day 3. Her baseline day 3 estradiol and LH levels were only 21.2pg/me and 5.0 I.U./L respectively. On cycle day 8, estradiol was only 56% and LH was 6.6 I.U./L. The Gonal-F was increased to 6amps. This first attempt was canceled due to the poor follicle growth. Only 3-4 follicles of insufficient size between 10-14mm each were found.

Chiropractic Care and Outcomes: On 4/11/02, the patient commenced regular NSA care. The second IVF attempt began on 6/6/02. The change in IVF protocol was the addition of Repronex (also a gonadotropin a combination of LH and fsh). The total increased dose of Gonal-F and Repronex was 6amps, compared to the first attempt of only 3amps which was then increased to 6amps of Gonal-F only.

Conclusion: On the second IVF attempt, estradiol was 1001pg/ml on day 8, and 2019pg/ml on day 11, with LH at 9.3. The Oocyte retrieval after the second attempt was 10 eggs, each approximately 18mm. A successful aspiration of eggs was completed on 6/17/02, and a successful pregnancy followed. The patient is still under NSA care, and is now in her second trimester with normal fetal heart sounds. The possible role of NSA care in the vigorous follicular growth and other health benefits is discussed.

Insult, Interference and Infertility: An Overview of Chiropractic Research
Behrendt M. Journal of Vertebral Subluxation Research, May 2, 2003; 1

Objective: Infertility is distinct from sterility, implying potential, and therefore raises questions as to what insult or interference influences this sluggish outcome. Interference in physiological function, as viewed by the application of chiropractic principles, suggests a neurological etiology and is approached through the mechanism of detection of vertebral subluxation and subsequent appropriate and specific adjustments to promote potential and function. Parental health and wellness prior to conception influences reproductive success and sustainability, begging efficient, effective consideration and interpretation of overall state and any distortion. A discussion of diverse articles is presented, describing the response to chiropractic care among subluxated infertile women.

Clinical Features: Fourteen retrospective articles are referenced, their diversity includes: all 15 subjects are female, ages 22-65; prior pregnancy history revealed 11 none, 2 successful unassisted, 1 assisted, 1 history of miscarriage. 9 had previous treatment for infertility, 4 were undergoing infertility treatment when starting chiropractic care. Presenting concerns included: severe low back pain, neck pain, colitis, diabetes, and female dysfunction such as absent or irregular menstrual cycle, blocked fallopian tubes, endometriosis, infertility, perimenopause and the fertility window within a religiousbased lifestyle, and a poor responder undergoing multiple cycles of IVF.

Chiropractic Care and Outcome: Outcomes of chiropractic care include but are not limited to benefits regarding neuromuscular concerns, as both historical and modern research describe associations with possible increased physiological functions, in this instance reproductive function. Chiropractic care and outcome are discussed, based on protocols of a variety of arts, including Applied Kinesiology (A.K.), Diversified, Directional Non-Force Technique (D.N.F.T.), Gonstead, Network Spinal Analysis (N.S.A.), Torque Release Technique (T.R.T.), Sacro Occipital Technique (S.O.T.) and Stucky-Thompson Terminal Point Technique. Care is described over a time frame of 1 to 20 months.

Conclusion: The application of chiropractic care and subsequent successful outcomes on reproductive integrity, regardless of factors including age, history and medical intervention, are described through a diversity of chiropractic arts. Future studies that may evaluate more formally and on a larger scale, the effectiveness, safety and cost benefits of chiropractic care on both well-being and physiological function are suggested, as well as pursuit of appropriate funding.

Chaotic Modeling in Network Spinal Analysis: Nonlinear Canonical Correlation with Alternating Conditional Expectation (ACE): A Preliminary Report
Bohacek S, Jonckheere E. Journal of Vertebral Subluxation Research, December 1998; 2(4): 188-195

Abstract – This paper presents a preliminary non-linear mathematical analysis of surface electromyographic (sEMG) signals from a subject receiving Network Spinal Analysis (NSA).The unfiltered sEMG data was collected over a bandwidth of 10-500 Hz and stored on a PC compatible computer. Electrodes were placed at the level of C1/C2,T6, L5, and S2 and voltage signals were recorded during the periods in which the patient was experiencing the “somatopsychic” wave, characteristic of NSA care. The intent of the preliminary study was to initiate mathematical characterization of the wave phenomenon relative to its “chaotic,” and/or nonlinear nature. In the present study the linear and nonlinear Canonical Correlation Analyses (CCA) have been used. The latter, nonlinear CCA, is coupled to specific implementation referred to as Alternating Conditional Expectation (ACE). Preliminary findings obtained by comparing canonical correlation coefficients (CCC’s) indicate that the ACE nonlinear functions of the sEMG waveform data lead to a smaller expected prediction error than if linear functions are used. In particular, the preliminary observations of larger nonlinear CCC’s compared to linear CCC’s indicate that there is some nonlinearity in the data representing the “somatopsychic” waveform. Further analysis of linear and nonlinear predictors indicates that 4th order nonlinear predictors perform 20 % better than linear predictors, and 10th order nonlinear predictors perform 30% better than linear predictors.This suggests that the waveform possesses a nonlinear “attractor” with a dimension between 4 and 10. Continued refinement of the ACE algorithm to allow for detection of more nonlinear distortions is expected to further clarify the extent to which the sEMG signal associated with the “somatopsychic” waveform of NSA is differentiated as nonlinear as opposed to random.

Reduction of Psoriasis in a Patient under Network Spinal Analysis Care: A Case Report
Behrendt M. Journal of Vertebral Subluxation Research, December 1998; 2(4): 196-200

This case report describes the progress of a 52 year old male with chronic psoriasis, first diagnosed in April of 1992. After the condition exacerbated over a five year period, he was placed on 12.5 mg/week methotrexate, and oral immunosuppressant medication in October of 1997.After commencing the medication, the condition reduced from 6% body coverage, with flares of 15-20%, to a body coverage of 5%. Following a cessation of the oral medication in February, 1998, the condition recurred at the previous uncontrolled level within one month. The patient was again placed on 12.5 mg/week methotrexate, and subsequently the condition reduced to 5% body coverage. The patient’s dose was reduced to 10 mg/week, and later to 7.5 mg/week, with the psoriasis remaining at 5% coverage. On 5/18/98, the patient commenced regular NSA care. He reported a reduction in the psoriasis condition on 6/3/98, and was taken off the oral medication on 6/25/98. The reduction continued, and the patient was advised by his medical physician on 7/01/98 to continue the cessation of oral medication. As of 9/30/98 the psoriasis had decreased to 0.5% to 1.0 % of coverage, and prior plans to initiate ultraviolet-A therapy were canceled. As of 11/98, a five month period since cessation of methotrexate, the patient has remained under regular NSA care, with no recurrence of psoriasis body coverage greater than 1%, the only medication being a topical ointment. This is contrasted to the recurrence after one month, following the patient’s first cessation of methotrexate, and prior to NSA care. The possible role of NSA care in the reduction of the patient’s psoriasis, and other health benefits is discussed.

Changes in Digital Skin Temperature, Surface Electromyography, and Electrodermal Activity in Subjects Receiving Network Spinal Analysis Care
Miller E, Redmond P. Journal of Vertebral Subluxation Research, June 1998; 2(2): 87-95

A preliminary study was conducted to evaluate changes in digital skin temperature (DST), surface electromyography (sEMG), and electrodermal activity (EDA) in a group of twenty subjects receiving Network Spinal Analysis (NSA) care. Data, simultaneously derived from all three parameters, were considered to be indirect correlates of sympathetic nervous system activity. Subjects, including a group of five controls, were assessed for a period of 17 minutes. The continuous assessment period included a baseline interval of 4.5 minutes, followed by a 12.5 minute period which was divided into five 2.5 minute intervals. Care was administered to the NSA recipient group immediately after the baseline period, whereas controls received no intervention following baseline. Results revealed no significant differences in DST either within or between the two groups. Surface EMG readings were relatively constant over the five intervals following baseline in the NSA group, while controls showed significant (p < 0.05) increases in sEMG at the second through fifth intervals relative to the first interval following baseline activity. Electrodermal activity was significantly decreased (p < 0.01) in the NSA group in the second through fifth intervals compared to baseline. Moreover, decreases varied between intervals, but exhibited a leveling from the third through fifth interval. Control subjects, alternatively, exhibited an increase in EDA in all intervals following baseline. The extent of increase resulted in EDA activity significantly greater than the NSA group at the third through fifth intervals. It was concluded that the increase in EMG activity in the control groups may have reflected an increasing level of anxiety due to the duration of the recording period. Since the NSA group expressed constancy in sEMG activity during the same period, coupled to significant decreases in EDA, a “sympathetic quieting effect” was postulated to occur in subjects receiving NSA care. This conclusion is consistent with hypothesized neurological pathways linked to responses observed during NSA care, as well as other reports of self-reported improvements in mental/emotional state and stress reduction in patients receiving Network Chiropractic Care.

Functional Magnetic Resonance Imaging: About the Cover
Journal of Vertebral Subluxation Research, 1998; 2(1): Cover

About the Cover: Functional Magnetic resonance Imaging (fMRI), which measures the relative presence of oxy-hemoglobin, has gained attention as a non-invasive medium through which high resolution images of the brain and other tissue may be acquired. This technology may provide a useful assessment of cortical changes following chiropractic intervention. Images of the patient depicted on the cover, on the left, reflect cortical activity (lighted areas in the parietal cortex, frontal cortex areas 9, 10; visual association areas 19, 37, and 39) associated with the learning process of a “novel” muscular maneuver of the foot. Images on the right reflect cortical activity following a Network Spinal Analysis (form of chiropractic) adjustment session, taken approximately 20 minutes after the first set of images, involving the same activity. The decrease in “lighted” areas before and after the adjustment session suggests that less cortical “planning” or “activity” is associated with the “novel” foot maneuver. Thus, the ability of fMRI to visualize changes in cortical activity may play a significant role in elucidating the consequences of vertebral subluxation correction on neurological function.

An Impairment Rating Analysis Of Asthmatic Children Under Chiropractic Care
Graham R, Pistolese R. Journal of Vertebral Subluxation Research, 1997; 1(4): 41-48

A self-reported asthma-related impairment study was conducted on 81 children under chiropractic care. The intent of this study was to quantify self-reported changes in impairment experienced by the pediatric asthmatic subjects, before and after a two month period under chiropractic care. Practitioners, representing a general range of six different approaches to vertebral subluxation correction, administered a specifically designed asthma impairment questionnaire at the appropriate intervals. Subjects were categorized into two groups; 1-10 years and 11-17 years. Parents/guardians completed questionnaires for the younger group, while the older subjects self-reported their perceptions of impairment. Significantly lower impairment rating scores (improvement) were reported for 90.1% of subjects 60 days after chiropractic care when compared to the pre-chiropractic scores (p < 0.05) with an effect size of 0.96. As well, there were no significant differences across the age groups based on parent/guardian versus self rated scores. Girls reported higher (less improvement) before and after care compared to boys, although significant decreases in impairment ratings were reported for each gender. This suggested a greater clinical effect for boys which was supported by effect sizes ranging from 1.2 for boys compared to 0.75 for girls. Additionally, 25 of 81 subjects (30.9%) chose to voluntarily decrease their dosage of medication by an average of 66.5% while under chiropractic care. Moreover, information collected from patients revealed that among 24 patients reporting asthma “attacks” in the 30 day period prior to the study, the number of “attacks” decreased significantly by an average of 44.9% (p <.05). Based on the data obtained in this study, it was concluded that chiropractic care, for correction of vertebral subluxation, is a safe nonpharmacologic health care approach which may also be associated with significant decreases in asthma related impairment as well as a decreased incidence of asthmatic “attacks.” The findings suggest that chiropractic care should be further investigated relative to providing the most efficacious care management regimen for pediatric asthmatics.

[Note: NSA care was one of the chiropractic approaches used in this study supported by the Michigan Chiropractic Council]

A Retrospective Assessment of Network Care Using a Survey of Self-Rated Health, Wellness and Quality of Life
Blanks RH, Schuster TL, Dobson M. Journal of Vertebral Subluxation Research, 1997; 1(4): 15-31

The present study represents a retrospective characterization of Network Care, a health care discipline within the subluxation-based chiropractic model. Data were obtained from 156 Network offices (49% practitioner participation rate) in the United States, Canada, Australia, and Puerto Rico. Sociodemographic characterization of 2818 respondents, representing a 67-71% response rate, revealed a population predominately white, female, well-educated, professional, or white collar workers. A second objective of the study included the development and initial validation of a new health survey instrument. The instrument was specifically designed to assess wellness through patients’ self-rating different health domains and overall quality of life at two “time” points: “presently” and retrospectively, recalling their status before initiating care (“before Network”). Statistical evaluation employing Chronbach’s alpha and theta coefficients derived from principle components factor analyses, indicated a high level of internal reliability in regard to the survey instrument, as well as stable reliability of the retrospective recall method of self-rated perceptions of change as a function of duration of care. Results indicated that patients reported significant, positive perceived change (p < 0.000) in all four domains of health, as well as overall quality of life. Effect sizes for these difference scores were all large (>0.9). Wellness was assessed by summing the scores for the four health domains into a combined wellness scale, and comparing this combined scale “presently” and “before Network.” The difference, or “wellness coefficient” spanning a range of -1 to +1, with zero representing no change, showed positive, progressive increases over the duration of care intervals ranging from 1-3 months to over three years. The evidence of improved health in the four domains (physical state, mental/emotional state, stress evaluation, life enjoyment), overall 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. These findings are being further evaluated through longitudinal studies of current populations under care in combination with investigation of the neurophysiological mechanisms underlying its effects.

Network Spinal Analysis: A System of Health Care Delivery Within the Subluxation-Based Chiropractic Model
Epstein, D. Journal of Vertebral Subluxation Research, August 1996; 1(1): 51-59

The theoretical basis and clinical application of Network Spinal Analysis (NSA) is described. NSA delivers health care within the subluxation-based chiropractic model and seeks to contribute to the distinction of the various techniques and methods within the profession by describing and discussing its major characteristics. In this regard, clinical observations relative to the application of the Network Protocol have been described in relation to the monitoring of patient and practitioner outcomes. Relevant research from a separate Network Care retrospective study, which impacts on its characterization, profiles the patient population as predominantly female. Other data indicates that Network Care is widely and consistently practiced. Additionally, patients report significant, positive changes in health-related quality of life measures linked to certain clinical components of Network Care.
 

Visualization of a stationary CPG-revealing spinal wave* (Abstract from research at the University of Southern California, Professor Edmond Jonchkeere, et al.) 

Program of MEDICINE MEETS VIRTUAL REALITY 14 – ACCELERATING CHANGE IN HEALTH CARE: NEXT MEDICAL TOOLKIT* conference where Professor Jonchkeere will present a paper on the NSA Somatopsychic Wave (Prof. Jonckheere’s presentation is scheduled on pg. 20)

Paper Presentation accepted at the International Society of Quality of Life Research Conference in Prague, Czech Republic Nov. 12-15th, 2003 

Read the latest research articles on Surface Electromyography in Network Spinal Analysis™ (In order to view the files below, it is necessary that you have Adobe Acrobat Reader. If you do not have this please Click Here to download your free copy now.)

• Dynamic Modeling of Spinal Electromyographic activity during various conditions
• Nonlinear Switching Dynamics in Surface Electromyography of the Spine 

This research, which involves human subjects, has been approved by the University Park Institutional Review Board (IRB) of the University of Southern California

Network Spinal Analysis™: A Research Perspective

Statement of Efficacy

The Case Report 

Health & Wellness Quality of Life Questionnaire (Adobe Acrobat Reader Required)
(Questionnaire available to download free of charge courtesy of the Association for Network Care)

For more information on Network Spinal Analysis™  Research please visit the Association For Network Care website at www.associationfornetworkcare.com

Network Spinal Analysis and Research

Network Spinal Analysis is a gentle and extremely effective style of chiropractic care used to evaluate and adjust the spine. The purpose of NSA is to allow restoration of proper nerve function for full health and peak performance. 

Network Spinal Analysis is a chiropractic technique developed in America in the early 80’s by Dr Donald Epstein. Network Spinal Analysis utilises light touches, specific body contacts and body positioning to develop breathing and body oscillations (or waves) that dissipate stored tension. NSA allows your body to develop new strategies to release this tension on its own. This promotes the clarity and flexibility a body needs to adapt to the challenges of our busy lives. 

How Does NSA Work?  

The spinal cord, in addition to being an electrical system, also conducts information through oscillation, or wave-like motion. Like an overstretched rubber band, the spinal cord tissues oscillate at a higher frequency, or “phase”, when they are under tension. As every cell of the body is connected via an elaborate nerve network to the spinal cord, any change in tension of the spinal cord affects the function of every cell in the body… all 75-100 trillion of them!   

From this, we found that most tension in the vertebra of the spine was secondary to tension patterns from the spinal cord. The stress of having too much to do and not enough time to do it is epidemic in our culture. Consistently high stress levels freeze the body in a “fight or flight” mode, tightening muscles, rounding shoulders, making breathing shallow, and limiting blood and oxygen to the parts of your brain responsible for relaxation, revitalization, creativity, and growth.   We find that a busy life is typically not the problem. The problem is an inability to shift gears and “unhook” from the stress-causing factors that are overwhelming you.
That’s why, instead of trying to mechanically adjust or align the spine through manipulation of the vertebra, a Network Chiropractor seeks to understand the physical, emotional, and mental factors related to the tension pattern and then find the specific points on the spine that will help the body resolve its tension using the exact amount of pressure that cues the brain from stress into ease. No twisting, popping, or cracking is necessary. 

The Network Chiropractor is using the principle of leverage. This is when they make the light gentle adjustments. The idea is like moving huge boulder without having to use a great deal of force if you use the leverage of a tree branch.
Putting the lever in the exact right place, at the right time with the right amount of light force, you can easily move the boulder. Likewise, Network Chiropractors are trained during post-graduate courses on Network Spinal Analysis to know the exact leverage point and manoeuvres to utilise on the spine to release tension to allow the body to find equilibrium. 

What scientific evidence do you have that your method works? 

NSA is one of the most researched methods in chiropractic. Network Spinal Analysis™ has been the subject of academic study, research and publication for its unprecedented effect in wellness and quality of life, adaptability to stress, enhanced life enjoyment, facilitation of constructive lifestyle changes. Also studies are being conducted as to its influence on the advancement and evolution of the nervous system’s strategies for self-organization.
A retrospective study of nearly 3,000 people through the University of California Irvine Medical College documented significant improvements in quality of life in the majority of people receiving Network Chiropractic care. 

The wave patterns that occur during a Network entrainment are the focus of University of Southern California mathematician professor Edmund Jonckheere, who is currently studying the relationship between these wave patterns and the energy-efficiency and adaptability of the nervous system.   

The Journal of Alternative and Complementary Medicine featured the evolving paradigm that contains NSA and SRI, called Reorganizational Healing, in May ’09. 

NSA Sessions 

The adjustments are made along the spine and are as gentle as the pressure that you could comfortably apply to your closed eyelid. 

• You keep your clothes on (except your shoes) during a session.
• Sessions last about 30-40 minutes.
• The therapy is not painful, although the bodily sensations can be surprising and emotional releases during sessions are common.
• Practitioners evaluate the client’s progress based on his or her self-reported experience.

Benefits of NSA 

Research has shown that as a spine, body and nervous system becomes healthier, physical wellbeing improves to provide more spinal flexibility, diminished symptoms and a greater ability to cope, developing an internal sense of wellness regardless of circumstances.
Examples of further additional benefits reported include: 

• Less physical pain
• Less tension or stiffness of the spine
• Greater flexibility
• Reduced allergies, eczema, asthma
• Fewer colds flu & headaches
• Less menstrual discomfort
• Improved response to stress
• Improved mental/emotional state
• Improved life enjoyment
• Improved overall quality of life

Basic care typically lasts 6 to 8 weeks, with 2 to 3 sessions per week. At the end of this period, clients generally report better body awareness, stronger spinal movement, and relief from discomfort and more ease in releasing tension.
After basic care sessions, you can choose to continue with treatment and enjoy wellness 

Network Spinal Analysis Research

The following is a list of peer-reviewed publications involving Network Spinal Analysis Care. Further information regarding Network Spinal Analysis Research currently in process or programs where information on Network Spinal Analysis Research has been presented is available at www.associationfornetworkcare.com

Improvement in Attention in Patients Undergoing Network Spinal Analysis: A Case Series Using Objective Measures of Attention
Pauli Y. Journal of Vertebral Subluxation Research, August 23, 2007; 1-9

Objective: Anecdotal preliminary evidence suggests that chiropractic care may be of benefits for individuals suffering from ADHD. This case series presents the improvement in attention experienced by 9 adult patients undergoing Network Spinal Analysis.

Methods: Nine adult patients are presented (4 male, 5 female) with a mean age of 40.4 years (range 22 – 58 years old). All patients were evaluated with the Test of Variable of Attention (TOVA) before receiving Network Spinal Analysis (NSA) care and at 2 months into care. The nine patients received level 1 NSA care for two months, as taught by the Association for Network Care. Neurospinal integrity was evaluated with palpation, as well as surface electromyography. Cognitive process of attention was objectively evaluated using a continuous performance test, the Test of Variables of Attention (TOVA).

Results: We evaluated our patient cohort before and after Network care using sEMG and variables from the continuous performance test (TOVA). Before care, all patients had an abnormal ADHD score with a mean of -3.74 (range: – 8.54 to -1.89). After 2 months of care, all patients had a significant change in ADHD score (p=0.08) and 88% completely normalized the ADHD score. 77% and 66% of patients experienced significant change in reaction time and variability score, respectively. All patients experienced a significant reduction in sEMG pattern of activation (p=0.08). We discuss possible mechanisms by which spinal care may have enhanced the function of the prefrontal cortex, thereby resulting in improved attentional capacities

Conclusion: In this case series the nine adult patients experienced significant improvement in attention, as measured by objective outcomes, after receiving two months of Network Spinal Analysis. The progress documented in this report suggests that NSA care may positively affect the brain by creating plastic changes in the prefrontal cortex and other cortical and subcortical areas serving as neural substrate for the cognitive process of attention. These findings may be of importance for individuals suffering from attention deficit. Further research into this area is greatly needed.

Quality of Life Improvements and Spontaneous Lifestyle Changes in a Patient Undergoing Subluxation-Centered Chiropractic Care: A Case Study
Pauli Y. Journal of Vertebral Subluxation Research, October 11, 2006; 1-15

Purpose of Study: This case study is to report the improvement in quality of life experienced by a patient undergoing subluxation-centered chiropractic care.

Clinical Features: A 36 year old male presented with primary health concerns of stress, eye pain and left leg pain of 14 years duration radiating to the foot and secondary complaints of gastritis, ulcers, nervousness, depression, lack of concentration and general loss of interest in daily life. The patient also smokes, does not exercise, eats a sub-optimal diet and rated his family and friends support, as well as job satisfaction as sufficient.

Intervention and Outcome: We discuss the various analyses employed to evaluate vertebral subluxations, including paraspinal surface electromyography and thermography. Adjustive care included a combination of Network Spinal Analysis, Torque Release Technique and diversified structural adjustments to correct vertebral subluxations over a six month period. We used visual analog scales, open-ended questions and selected items from the Self-Rated Health and Wellness Instrument to monitor health changes, as well as the positive improvements in quality of life as perceived by the patient himself.

Conclusion: This case study demonstrates that the correction of vertebral subluxations over an 11 month period was associated with significant improvements in the quality of life of the patient.

Chiropractic Care of a Battered Woman: A Case Study
Bedell L. Journal of Vertebral Subluxation Research, July 20, 2006; 1-6

Objective: This case study documents the chiropractic care of battered woman struggling with Intimate Partner Violence (IPV). Chiropractic offers battered women a unique service, it is the only profession trained and licensed to detect and correct vertebral subluxations. The relationship between the stresses of abuse and vertebral subluxation, as well as the subsequent changes during chiropractic care, are described.

Clinical Features: A Caucasian, 23-year old female presented with headaches, neck pain, and upper back pain. The initial complaint noted sharp, knife-like pains into the medial scapular borders, worse on the right side. Tingling extended into the right hand, most severe in the 2nd, 3rd, and 4th fingers.

Chiropractic care and outcome: Protocols of both Torque Release and Activator techniques were utilized to evaluate vertebral subluxations. Subjective quality of life issues were evaluated through a Network Spinal Analysis (NSA) Health Status Questionnaire. After commencing chiropractic care, this woman suffered a cervical spine hyper-extension/hyper-flexion type injury from an automobile accident. For the first 30 days after, adjustments were applied twice weekly. Acute exacerbations of symptoms unrelated to the original complaints were displayed and progress became irregular. During the next 60 days, there were various unexplained falls and severe flare-ups of painful symptoms, and she finally admitted to being battered by her husband. Referrals to counselors and programs dealing with domestic violence were provided. Once the physical battering stopped, consistent progress was noted in both clinical symptoms and quality of life issues.

Conclusion: As a battered woman must receive emotional and social support to improve her situation, it is important for chiropractors to recognize the “red flags” of IPV. Chiropractors re-evaluate regularly for changes in vertebral subluxation patterns and can recognize inconsistent responses. They may also be the first caregivers to offer a vitalistic approach; considering a woman’s physical, chemical, and emotional quality of life; a perspective that offers significant connection and trust. This article serves as a foundation on the topic of IPV and chiropractic, for use in both communities.

Wellness lifestyles II: Modeling the dynamic of wellness, health lifestyle practices, and Network Spinal Analysis.
Schuster TL, Dobson M, Jauregui M, Blanks RH. Journal of Alternative and Complimentary Medicine. April 2004;10(2):357-67.
PMID: 15165417

OBJECTIVE: Empirical application of a theoretical framework linking use of Network Spinal Analysis (NSA; a holistic, wellness-oriented form of complementary and alternative medicine [CAM]), health lifestyle practices, and self-reported health and wellness. DESIGN: Cross-sectional self-administered survey study. RESPONDENTS: Two thousand five hundred and ninety-six (2596) patients from 156 offices of doctors who were members of the Association for Network Chiropractic (currently titled Association for Network Care); estimated response rate was 69%. MEASURES: Exogenous variables entered into the structural equation model include gender, age, education, income, marital status, ailments, life change, and trauma. A wellness construct consisted of calculated difference scores between two referents, “presently” and “before Network” care, for self-reported items representing wellness domains of physical state, mental-emotional state, stress evaluation, and life enjoyment. Positive reported change in nine items assembled into dietary practices, health practices, and health risk dimensions serve as indicators of the construct of changes in health lifestyle practices. The NSA care construct consisted of duration of care in months, awareness of energy and awareness of breathing since beginning Network care. RESULTS: Of the exogenous variables only gender, age, and education remain in the final parsimonious structural equation model in these data. Reported wellness benefits accrue to individuals along a direct path from both self-reported positive lifestyle change (0.22), and from NSA care (0.43). The path (0.65) from NSA care to positive health lifestyle changes indicates that NSA care also has an indirect effect on wellness through changes in health lifestyle practices.

CONCLUSIONS: The Structural Equation model tested in these analyses lends support to our theoretical framework linking wellness, health lifestyles, and CAM. This study provides further evidence that our measurements of health and wellness are particularly appropriate for investigating wellness-oriented CAM. There is a positive relationship between the experience of NSA care and self-reported improvements in wellness as well as self-reported changes in lifestyle practices. NSA care users tend toward the practice of a positive health lifestyle, which also has a direct effect on reported improvements in wellness. These empirical links are discussed relative to the sociodemographic characteristics of this population and show that use of NSA care is an aspect of a wellness lifestyle.

Wellness lifestyles I: A theoretical framework linking wellness, health lifestyles, and complementary and alternative medicine.
Schuster TL, Dobson M, Jauregui M, Blanks RH. Journal of Alternative and Complimentary Medicine. April 2004;10(2):349-56.
PMID: 15165416

Scholarship concerning complementary and alternative medicine (CAM) practices within the United States could benefit from incorporating sociological perspectives into the development of a comprehensive research agenda. We review the literature on health and wellness emphasizing definitions and distinctions, the health lifestyles literature emphasizing issues of both life choices and life chances, and studies of CAM suggesting utilization as an aspect of a wellness lifestyle. This review forms the foundation of a new theoretical framework for CAM research based on the interrelationship of CAM with health promotion, wellness, and health lifestyles. To date, few studies have sought to bring these various elements together into a single, comprehensive model that would enable an assessment of the complexity of individual health and wellness in the context of CAM. We argue that attention to literatures on health measurement and health lifestyles are essential for exploring the effectiveness and continuing use of CAM.

The Transition of Network Spinal Analysis Care: Hallmarks of a Client-Centered Wellness Education Multi-Component System of Health Care Delivery
Epstein D. Journal of Vertebral Subluxation Research, April 5, 2004; 1-7

Network Spinal Analysis TM (NSA) care has been transitioned from a health care system with the objective of correction of two types of vertebral subluxation, to a multi-component system of health care delivery with emphasis on wellness education for participating clients. NSA care is now delivered and communicated in discrete Levels of Care with emphasis on client participation through self-evaluation. Emphasis on wellness education will be introduced into NSA practice through training via a Certificate Program currently under development. This paper considers some hallmarks that delineate a wellness education, patient (client)-centered practice. The concepts presented relative to this wellness model of health care delivery are believed to be applicable to any approach with similar practice objectives. The perspective presented considers that the major aspects of a patient-centered, wellness education health care delivery system is multi-dimensional. Hallmarks include differentiating terms, and establishing a wellness mentality. Substantiation of the discipline must be established through credible published research regarding its efficacy and safety as well as a consistent and valid means of measuring progressive outcomes derived from the care received. The relationship of NSA to other disciplines is discussed.

Successful In Vitro Fertilization in a Poor Responder While Under Network Spinal Analysis Care: A Case Report
Senzon SA. Journal of Vertebral Subluxation Research, September 14, 2003; 1-6

Objective: This case report describes the successful in vitro fertilization (IVF) of a 34 year old female who had one previous aborted IVF attempt prior to Network Spinal Analysis (NSA) care. This case report is being presented to add to other case reports that show positive physiological changes in patients receiving NSA care.

Clinical Features: The IVF was attempted due to her partner’s azoospermia. The first IVF attempt was on 3/26/02. The patient had a poor follicular growth after the standard hyper-stimulation process of the ovaries, including pre-treatment with Mircette (birth control pills) and 1mg/0.2ml of Lupron (a gonadotropin releasing hormone agonist), and 3-6 amps of Gonal-F (a recombinant fsh) starting on cycle day 3. Her baseline day 3 estradiol and LH levels were only 21.2pg/me and 5.0 I.U./L respectively. On cycle day 8, estradiol was only 56% and LH was 6.6 I.U./L. The Gonal-F was increased to 6amps. This first attempt was canceled due to the poor follicle growth. Only 3-4 follicles of insufficient size between 10-14mm each were found.

Chiropractic Care and Outcomes: On 4/11/02, the patient commenced regular NSA care. The second IVF attempt began on 6/6/02. The change in IVF protocol was the addition of Repronex (also a gonadotropin a combination of LH and fsh). The total increased dose of Gonal-F and Repronex was 6amps, compared to the first attempt of only 3amps which was then increased to 6amps of Gonal-F only.

Conclusion: On the second IVF attempt, estradiol was 1001pg/ml on day 8, and 2019pg/ml on day 11, with LH at 9.3. The Oocyte retrieval after the second attempt was 10 eggs, each approximately 18mm. A successful aspiration of eggs was completed on 6/17/02, and a successful pregnancy followed. The patient is still under NSA care, and is now in her second trimester with normal fetal heart sounds. The possible role of NSA care in the vigorous follicular growth and other health benefits is discussed.

Insult, Interference and Infertility: An Overview of Chiropractic Research
Behrendt M. Journal of Vertebral Subluxation Research, May 2, 2003; 1

Objective: Infertility is distinct from sterility, implying potential, and therefore raises questions as to what insult or interference influences this sluggish outcome. Interference in physiological function, as viewed by the application of chiropractic principles, suggests a neurological etiology and is approached through the mechanism of detection of vertebral subluxation and subsequent appropriate and specific adjustments to promote potential and function. Parental health and wellness prior to conception influences reproductive success and sustainability, begging efficient, effective consideration and interpretation of overall state and any distortion. A discussion of diverse articles is presented, describing the response to chiropractic care among subluxated infertile women.

Clinical Features: Fourteen retrospective articles are referenced, their diversity includes: all 15 subjects are female, ages 22-65; prior pregnancy history revealed 11 none, 2 successful unassisted, 1 assisted, 1 history of miscarriage. 9 had previous treatment for infertility, 4 were undergoing infertility treatment when starting chiropractic care. Presenting concerns included: severe low back pain, neck pain, colitis, diabetes, and female dysfunction such as absent or irregular menstrual cycle, blocked fallopian tubes, endometriosis, infertility, perimenopause and the fertility window within a religiousbased lifestyle, and a poor responder undergoing multiple cycles of IVF.

Chiropractic Care and Outcome: Outcomes of chiropractic care include but are not limited to benefits regarding neuromuscular concerns, as both historical and modern research describe associations with possible increased physiological functions, in this instance reproductive function. Chiropractic care and outcome are discussed, based on protocols of a variety of arts, including Applied Kinesiology (A.K.), Diversified, Directional Non-Force Technique (D.N.F.T.), Gonstead, Network Spinal Analysis (N.S.A.), Torque Release Technique (T.R.T.), Sacro Occipital Technique (S.O.T.) and Stucky-Thompson Terminal Point Technique. Care is described over a time frame of 1 to 20 months.

Conclusion: The application of chiropractic care and subsequent successful outcomes on reproductive integrity, regardless of factors including age, history and medical intervention, are described through a diversity of chiropractic arts. Future studies that may evaluate more formally and on a larger scale, the effectiveness, safety and cost benefits of chiropractic care on both well-being and physiological function are suggested, as well as pursuit of appropriate funding.

Chaotic Modeling in Network Spinal Analysis: Nonlinear Canonical Correlation with Alternating Conditional Expectation (ACE): A Preliminary Report
Bohacek S, Jonckheere E. Journal of Vertebral Subluxation Research, December 1998; 2(4): 188-195

Abstract – This paper presents a preliminary non-linear mathematical analysis of surface electromyographic (sEMG) signals from a subject receiving Network Spinal Analysis (NSA).The unfiltered sEMG data was collected over a bandwidth of 10-500 Hz and stored on a PC compatible computer. Electrodes were placed at the level of C1/C2,T6, L5, and S2 and voltage signals were recorded during the periods in which the patient was experiencing the “somatopsychic” wave, characteristic of NSA care. The intent of the preliminary study was to initiate mathematical characterization of the wave phenomenon relative to its “chaotic,” and/or nonlinear nature. In the present study the linear and nonlinear Canonical Correlation Analyses (CCA) have been used. The latter, nonlinear CCA, is coupled to specific implementation referred to as Alternating Conditional Expectation (ACE). Preliminary findings obtained by comparing canonical correlation coefficients (CCC’s) indicate that the ACE nonlinear functions of the sEMG waveform data lead to a smaller expected prediction error than if linear functions are used. In particular, the preliminary observations of larger nonlinear CCC’s compared to linear CCC’s indicate that there is some nonlinearity in the data representing the “somatopsychic” waveform. Further analysis of linear and nonlinear predictors indicates that 4th order nonlinear predictors perform 20 % better than linear predictors, and 10th order nonlinear predictors perform 30% better than linear predictors.This suggests that the waveform possesses a nonlinear “attractor” with a dimension between 4 and 10. Continued refinement of the ACE algorithm to allow for detection of more nonlinear distortions is expected to further clarify the extent to which the sEMG signal associated with the “somatopsychic” waveform of NSA is differentiated as nonlinear as opposed to random.

Reduction of Psoriasis in a Patient under Network Spinal Analysis Care: A Case Report
Behrendt M. Journal of Vertebral Subluxation Research, December 1998; 2(4): 196-200

This case report describes the progress of a 52 year old male with chronic psoriasis, first diagnosed in April of 1992. After the condition exacerbated over a five year period, he was placed on 12.5 mg/week methotrexate, and oral immunosuppressant medication in October of 1997.After commencing the medication, the condition reduced from 6% body coverage, with flares of 15-20%, to a body coverage of 5%. Following a cessation of the oral medication in February, 1998, the condition recurred at the previous uncontrolled level within one month. The patient was again placed on 12.5 mg/week methotrexate, and subsequently the condition reduced to 5% body coverage. The patient’s dose was reduced to 10 mg/week, and later to 7.5 mg/week, with the psoriasis remaining at 5% coverage. On 5/18/98, the patient commenced regular NSA care. He reported a reduction in the psoriasis condition on 6/3/98, and was taken off the oral medication on 6/25/98. The reduction continued, and the patient was advised by his medical physician on 7/01/98 to continue the cessation of oral medication. As of 9/30/98 the psoriasis had decreased to 0.5% to 1.0 % of coverage, and prior plans to initiate ultraviolet-A therapy were canceled. As of 11/98, a five month period since cessation of methotrexate, the patient has remained under regular NSA care, with no recurrence of psoriasis body coverage greater than 1%, the only medication being a topical ointment. This is contrasted to the recurrence after one month, following the patient’s first cessation of methotrexate, and prior to NSA care. The possible role of NSA care in the reduction of the patient’s psoriasis, and other health benefits is discussed.

Changes in Digital Skin Temperature, Surface Electromyography, and Electrodermal Activity in Subjects Receiving Network Spinal Analysis Care
Miller E, Redmond P. Journal of Vertebral Subluxation Research, June 1998; 2(2): 87-95

A preliminary study was conducted to evaluate changes in digital skin temperature (DST), surface electromyography (sEMG), and electrodermal activity (EDA) in a group of twenty subjects receiving Network Spinal Analysis (NSA) care. Data, simultaneously derived from all three parameters, were considered to be indirect correlates of sympathetic nervous system activity. Subjects, including a group of five controls, were assessed for a period of 17 minutes. The continuous assessment period included a baseline interval of 4.5 minutes, followed by a 12.5 minute period which was divided into five 2.5 minute intervals. Care was administered to the NSA recipient group immediately after the baseline period, whereas controls received no intervention following baseline. Results revealed no significant differences in DST either within or between the two groups. Surface EMG readings were relatively constant over the five intervals following baseline in the NSA group, while controls showed significant (p < 0.05) increases in sEMG at the second through fifth intervals relative to the first interval following baseline activity. Electrodermal activity was significantly decreased (p < 0.01) in the NSA group in the second through fifth intervals compared to baseline. Moreover, decreases varied between intervals, but exhibited a leveling from the third through fifth interval. Control subjects, alternatively, exhibited an increase in EDA in all intervals following baseline. The extent of increase resulted in EDA activity significantly greater than the NSA group at the third through fifth intervals. It was concluded that the increase in EMG activity in the control groups may have reflected an increasing level of anxiety due to the duration of the recording period. Since the NSA group expressed constancy in sEMG activity during the same period, coupled to significant decreases in EDA, a “sympathetic quieting effect” was postulated to occur in subjects receiving NSA care. This conclusion is consistent with hypothesized neurological pathways linked to responses observed during NSA care, as well as other reports of self-reported improvements in mental/emotional state and stress reduction in patients receiving Network Chiropractic Care.

Functional Magnetic Resonance Imaging: About the Cover
Journal of Vertebral Subluxation Research, 1998; 2(1): Cover

About the Cover: Functional Magnetic resonance Imaging (fMRI), which measures the relative presence of oxy-hemoglobin, has gained attention as a non-invasive medium through which high resolution images of the brain and other tissue may be acquired. This technology may provide a useful assessment of cortical changes following chiropractic intervention. Images of the patient depicted on the cover, on the left, reflect cortical activity (lighted areas in the parietal cortex, frontal cortex areas 9, 10; visual association areas 19, 37, and 39) associated with the learning process of a “novel” muscular maneuver of the foot. Images on the right reflect cortical activity following a Network Spinal Analysis (form of chiropractic) adjustment session, taken approximately 20 minutes after the first set of images, involving the same activity. The decrease in “lighted” areas before and after the adjustment session suggests that less cortical “planning” or “activity” is associated with the “novel” foot maneuver. Thus, the ability of fMRI to visualize changes in cortical activity may play a significant role in elucidating the consequences of vertebral subluxation correction on neurological function.

An Impairment Rating Analysis Of Asthmatic Children Under Chiropractic Care
Graham R, Pistolese R. Journal of Vertebral Subluxation Research, 1997; 1(4): 41-48

A self-reported asthma-related impairment study was conducted on 81 children under chiropractic care. The intent of this study was to quantify self-reported changes in impairment experienced by the pediatric asthmatic subjects, before and after a two month period under chiropractic care. Practitioners, representing a general range of six different approaches to vertebral subluxation correction, administered a specifically designed asthma impairment questionnaire at the appropriate intervals. Subjects were categorized into two groups; 1-10 years and 11-17 years. Parents/guardians completed questionnaires for the younger group, while the older subjects self-reported their perceptions of impairment. Significantly lower impairment rating scores (improvement) were reported for 90.1% of subjects 60 days after chiropractic care when compared to the pre-chiropractic scores (p < 0.05) with an effect size of 0.96. As well, there were no significant differences across the age groups based on parent/guardian versus self rated scores. Girls reported higher (less improvement) before and after care compared to boys, although significant decreases in impairment ratings were reported for each gender. This suggested a greater clinical effect for boys which was supported by effect sizes ranging from 1.2 for boys compared to 0.75 for girls. Additionally, 25 of 81 subjects (30.9%) chose to voluntarily decrease their dosage of medication by an average of 66.5% while under chiropractic care. Moreover, information collected from patients revealed that among 24 patients reporting asthma “attacks” in the 30 day period prior to the study, the number of “attacks” decreased significantly by an average of 44.9% (p <.05). Based on the data obtained in this study, it was concluded that chiropractic care, for correction of vertebral subluxation, is a safe nonpharmacologic health care approach which may also be associated with significant decreases in asthma related impairment as well as a decreased incidence of asthmatic “attacks.” The findings suggest that chiropractic care should be further investigated relative to providing the most efficacious care management regimen for pediatric asthmatics.

[Note: NSA care was one of the chiropractic approaches used in this study supported by the Michigan Chiropractic Council]

A Retrospective Assessment of Network Care Using a Survey of Self-Rated Health, Wellness and Quality of Life
Blanks RH, Schuster TL, Dobson M. Journal of Vertebral Subluxation Research, 1997; 1(4): 15-31

The present study represents a retrospective characterization of Network Care, a health care discipline within the subluxation-based chiropractic model. Data were obtained from 156 Network offices (49% practitioner participation rate) in the United States, Canada, Australia, and Puerto Rico. Sociodemographic characterization of 2818 respondents, representing a 67-71% response rate, revealed a population predominately white, female, well-educated, professional, or white collar workers. A second objective of the study included the development and initial validation of a new health survey instrument. The instrument was specifically designed to assess wellness through patients’ self-rating different health domains and overall quality of life at two “time” points: “presently” and retrospectively, recalling their status before initiating care (“before Network”). Statistical evaluation employing Chronbach’s alpha and theta coefficients derived from principle components factor analyses, indicated a high level of internal reliability in regard to the survey instrument, as well as stable reliability of the retrospective recall method of self-rated perceptions of change as a function of duration of care. Results indicated that patients reported significant, positive perceived change (p < 0.000) in all four domains of health, as well as overall quality of life. Effect sizes for these difference scores were all large (>0.9). Wellness was assessed by summing the scores for the four health domains into a combined wellness scale, and comparing this combined scale “presently” and “before Network.” The difference, or “wellness coefficient” spanning a range of -1 to +1, with zero representing no change, showed positive, progressive increases over the duration of care intervals ranging from 1-3 months to over three years. The evidence of improved health in the four domains (physical state, mental/emotional state, stress evaluation, life enjoyment), overall 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. These findings are being further evaluated through longitudinal studies of current populations under care in combination with investigation of the neurophysiological mechanisms underlying its effects.

Network Spinal Analysis: A System of Health Care Delivery Within the Subluxation-Based Chiropractic Model
Epstein, D. Journal of Vertebral Subluxation Research, August 1996; 1(1): 51-59

The theoretical basis and clinical application of Network Spinal Analysis (NSA) is described. NSA delivers health care within the subluxation-based chiropractic model and seeks to contribute to the distinction of the various techniques and methods within the profession by describing and discussing its major characteristics. In this regard, clinical observations relative to the application of the Network Protocol have been described in relation to the monitoring of patient and practitioner outcomes. Relevant research from a separate Network Care retrospective study, which impacts on its characterization, profiles the patient population as predominantly female. Other data indicates that Network Care is widely and consistently practiced. Additionally, patients report significant, positive changes in health-related quality of life measures linked to certain clinical components of Network Care.
 

Visualization of a stationary CPG-revealing spinal wave* (Abstract from research at the University of Southern California, Professor Edmond Jonchkeere, et al.) 

Program of MEDICINE MEETS VIRTUAL REALITY 14 – ACCELERATING CHANGE IN HEALTH CARE: NEXT MEDICAL TOOLKIT* conference where Professor Jonchkeere will present a paper on the NSA Somatopsychic Wave (Prof. Jonckheere’s presentation is scheduled on pg. 20)

Paper Presentation accepted at the International Society of Quality of Life Research Conference in Prague, Czech Republic Nov. 12-15th, 2003 

Read the latest research articles on Surface Electromyography in Network Spinal Analysis™ (In order to view the files below, it is necessary that you have Adobe Acrobat Reader. If you do not have this please Click Here to download your free copy now.)

• Dynamic Modeling of Spinal Electromyographic activity during various conditions
• Nonlinear Switching Dynamics in Surface Electromyography of the Spine 

This research, which involves human subjects, has been approved by the University Park Institutional Review Board (IRB) of the University of Southern California

Network Spinal Analysis™: A Research Perspective

Statement of Efficacy

The Case Report 

Health & Wellness Quality of Life Questionnaire (Adobe Acrobat Reader Required)
(Questionnaire available to download free of charge courtesy of the Association for Network Care)

For more information on Network Spinal Analysis™  Research please visit the Association For Network Care website at www.associationfornetworkcare.com

Network Spinal Analysis and Research

Network Spinal Analysis is a gentle and extremely effective style of chiropractic care used to evaluate and adjust the spine. The purpose of NSA is to allow restoration of proper nerve function for full health and peak performance. 

Network Spinal Analysis is a chiropractic technique developed in America in the early 80’s by Dr Donald Epstein. Network Spinal Analysis utilises light touches, specific body contacts and body positioning to develop breathing and body oscillations (or waves) that dissipate stored tension. NSA allows your body to develop new strategies to release this tension on its own. This promotes the clarity and flexibility a body needs to adapt to the challenges of our busy lives. 

How Does NSA Work?  

The spinal cord, in addition to being an electrical system, also conducts information through oscillation, or wave-like motion. Like an overstretched rubber band, the spinal cord tissues oscillate at a higher frequency, or “phase”, when they are under tension. As every cell of the body is connected via an elaborate nerve network to the spinal cord, any change in tension of the spinal cord affects the function of every cell in the body… all 75-100 trillion of them!   

From this, we found that most tension in the vertebra of the spine was secondary to tension patterns from the spinal cord. The stress of having too much to do and not enough time to do it is epidemic in our culture. Consistently high stress levels freeze the body in a “fight or flight” mode, tightening muscles, rounding shoulders, making breathing shallow, and limiting blood and oxygen to the parts of your brain responsible for relaxation, revitalization, creativity, and growth.   We find that a busy life is typically not the problem. The problem is an inability to shift gears and “unhook” from the stress-causing factors that are overwhelming you.
That’s why, instead of trying to mechanically adjust or align the spine through manipulation of the vertebra, a Network Chiropractor seeks to understand the physical, emotional, and mental factors related to the tension pattern and then find the specific points on the spine that will help the body resolve its tension using the exact amount of pressure that cues the brain from stress into ease. No twisting, popping, or cracking is necessary. 

The Network Chiropractor is using the principle of leverage. This is when they make the light gentle adjustments. The idea is like moving huge boulder without having to use a great deal of force if you use the leverage of a tree branch.
Putting the lever in the exact right place, at the right time with the right amount of light force, you can easily move the boulder. Likewise, Network Chiropractors are trained during post-graduate courses on Network Spinal Analysis to know the exact leverage point and manoeuvres to utilise on the spine to release tension to allow the body to find equilibrium. 

What scientific evidence do you have that your method works? 

NSA is one of the most researched methods in chiropractic. Network Spinal Analysis™ has been the subject of academic study, research and publication for its unprecedented effect in wellness and quality of life, adaptability to stress, enhanced life enjoyment, facilitation of constructive lifestyle changes. Also studies are being conducted as to its influence on the advancement and evolution of the nervous system’s strategies for self-organization.
A retrospective study of nearly 3,000 people through the University of California Irvine Medical College documented significant improvements in quality of life in the majority of people receiving Network Chiropractic care. 

The wave patterns that occur during a Network entrainment are the focus of University of Southern California mathematician professor Edmund Jonckheere, who is currently studying the relationship between these wave patterns and the energy-efficiency and adaptability of the nervous system.   

The Journal of Alternative and Complementary Medicine featured the evolving paradigm that contains NSA and SRI, called Reorganizational Healing, in May ’09. 

NSA Sessions 

The adjustments are made along the spine and are as gentle as the pressure that you could comfortably apply to your closed eyelid. 

• You keep your clothes on (except your shoes) during a session.
• Sessions last about 30-40 minutes.
• The therapy is not painful, although the bodily sensations can be surprising and emotional releases during sessions are common.
• Practitioners evaluate the client’s progress based on his or her self-reported experience.

Benefits of NSA 

Research has shown that as a spine, body and nervous system becomes healthier, physical wellbeing improves to provide more spinal flexibility, diminished symptoms and a greater ability to cope, developing an internal sense of wellness regardless of circumstances.
Examples of further additional benefits reported include: 

• Less physical pain
• Less tension or stiffness of the spine
• Greater flexibility
• Reduced allergies, eczema, asthma
• Fewer colds flu & headaches
• Less menstrual discomfort
• Improved response to stress
• Improved mental/emotional state
• Improved life enjoyment
• Improved overall quality of life

Basic care typically lasts 6 to 8 weeks, with 2 to 3 sessions per week. At the end of this period, clients generally report better body awareness, stronger spinal movement, and relief from discomfort and more ease in releasing tension.
After basic care sessions, you can choose to continue with treatment and enjoy wellness 

Network Spinal Analysis Research

The following is a list of peer-reviewed publications involving Network Spinal Analysis Care. Further information regarding Network Spinal Analysis Research currently in process or programs where information on Network Spinal Analysis Research has been presented is available at www.associationfornetworkcare.com

Improvement in Attention in Patients Undergoing Network Spinal Analysis: A Case Series Using Objective Measures of Attention
Pauli Y. Journal of Vertebral Subluxation Research, August 23, 2007; 1-9

Objective: Anecdotal preliminary evidence suggests that chiropractic care may be of benefits for individuals suffering from ADHD. This case series presents the improvement in attention experienced by 9 adult patients undergoing Network Spinal Analysis.

Methods: Nine adult patients are presented (4 male, 5 female) with a mean age of 40.4 years (range 22 – 58 years old). All patients were evaluated with the Test of Variable of Attention (TOVA) before receiving Network Spinal Analysis (NSA) care and at 2 months into care. The nine patients received level 1 NSA care for two months, as taught by the Association for Network Care. Neurospinal integrity was evaluated with palpation, as well as surface electromyography. Cognitive process of attention was objectively evaluated using a continuous performance test, the Test of Variables of Attention (TOVA).

Results: We evaluated our patient cohort before and after Network care using sEMG and variables from the continuous performance test (TOVA). Before care, all patients had an abnormal ADHD score with a mean of -3.74 (range: – 8.54 to -1.89). After 2 months of care, all patients had a significant change in ADHD score (p=0.08) and 88% completely normalized the ADHD score. 77% and 66% of patients experienced significant change in reaction time and variability score, respectively. All patients experienced a significant reduction in sEMG pattern of activation (p=0.08). We discuss possible mechanisms by which spinal care may have enhanced the function of the prefrontal cortex, thereby resulting in improved attentional capacities

Conclusion: In this case series the nine adult patients experienced significant improvement in attention, as measured by objective outcomes, after receiving two months of Network Spinal Analysis. The progress documented in this report suggests that NSA care may positively affect the brain by creating plastic changes in the prefrontal cortex and other cortical and subcortical areas serving as neural substrate for the cognitive process of attention. These findings may be of importance for individuals suffering from attention deficit. Further research into this area is greatly needed.

Quality of Life Improvements and Spontaneous Lifestyle Changes in a Patient Undergoing Subluxation-Centered Chiropractic Care: A Case Study
Pauli Y. Journal of Vertebral Subluxation Research, October 11, 2006; 1-15

Purpose of Study: This case study is to report the improvement in quality of life experienced by a patient undergoing subluxation-centered chiropractic care.

Clinical Features: A 36 year old male presented with primary health concerns of stress, eye pain and left leg pain of 14 years duration radiating to the foot and secondary complaints of gastritis, ulcers, nervousness, depression, lack of concentration and general loss of interest in daily life. The patient also smokes, does not exercise, eats a sub-optimal diet and rated his family and friends support, as well as job satisfaction as sufficient.

Intervention and Outcome: We discuss the various analyses employed to evaluate vertebral subluxations, including paraspinal surface electromyography and thermography. Adjustive care included a combination of Network Spinal Analysis, Torque Release Technique and diversified structural adjustments to correct vertebral subluxations over a six month period. We used visual analog scales, open-ended questions and selected items from the Self-Rated Health and Wellness Instrument to monitor health changes, as well as the positive improvements in quality of life as perceived by the patient himself.

Conclusion: This case study demonstrates that the correction of vertebral subluxations over an 11 month period was associated with significant improvements in the quality of life of the patient.

Chiropractic Care of a Battered Woman: A Case Study
Bedell L. Journal of Vertebral Subluxation Research, July 20, 2006; 1-6

Objective: This case study documents the chiropractic care of battered woman struggling with Intimate Partner Violence (IPV). Chiropractic offers battered women a unique service, it is the only profession trained and licensed to detect and correct vertebral subluxations. The relationship between the stresses of abuse and vertebral subluxation, as well as the subsequent changes during chiropractic care, are described.

Clinical Features: A Caucasian, 23-year old female presented with headaches, neck pain, and upper back pain. The initial complaint noted sharp, knife-like pains into the medial scapular borders, worse on the right side. Tingling extended into the right hand, most severe in the 2nd, 3rd, and 4th fingers.

Chiropractic care and outcome: Protocols of both Torque Release and Activator techniques were utilized to evaluate vertebral subluxations. Subjective quality of life issues were evaluated through a Network Spinal Analysis (NSA) Health Status Questionnaire. After commencing chiropractic care, this woman suffered a cervical spine hyper-extension/hyper-flexion type injury from an automobile accident. For the first 30 days after, adjustments were applied twice weekly. Acute exacerbations of symptoms unrelated to the original complaints were displayed and progress became irregular. During the next 60 days, there were various unexplained falls and severe flare-ups of painful symptoms, and she finally admitted to being battered by her husband. Referrals to counselors and programs dealing with domestic violence were provided. Once the physical battering stopped, consistent progress was noted in both clinical symptoms and quality of life issues.

Conclusion: As a battered woman must receive emotional and social support to improve her situation, it is important for chiropractors to recognize the “red flags” of IPV. Chiropractors re-evaluate regularly for changes in vertebral subluxation patterns and can recognize inconsistent responses. They may also be the first caregivers to offer a vitalistic approach; considering a woman’s physical, chemical, and emotional quality of life; a perspective that offers significant connection and trust. This article serves as a foundation on the topic of IPV and chiropractic, for use in both communities.

Wellness lifestyles II: Modeling the dynamic of wellness, health lifestyle practices, and Network Spinal Analysis.
Schuster TL, Dobson M, Jauregui M, Blanks RH. Journal of Alternative and Complimentary Medicine. April 2004;10(2):357-67.
PMID: 15165417

OBJECTIVE: Empirical application of a theoretical framework linking use of Network Spinal Analysis (NSA; a holistic, wellness-oriented form of complementary and alternative medicine [CAM]), health lifestyle practices, and self-reported health and wellness. DESIGN: Cross-sectional self-administered survey study. RESPONDENTS: Two thousand five hundred and ninety-six (2596) patients from 156 offices of doctors who were members of the Association for Network Chiropractic (currently titled Association for Network Care); estimated response rate was 69%. MEASURES: Exogenous variables entered into the structural equation model include gender, age, education, income, marital status, ailments, life change, and trauma. A wellness construct consisted of calculated difference scores between two referents, “presently” and “before Network” care, for self-reported items representing wellness domains of physical state, mental-emotional state, stress evaluation, and life enjoyment. Positive reported change in nine items assembled into dietary practices, health practices, and health risk dimensions serve as indicators of the construct of changes in health lifestyle practices. The NSA care construct consisted of duration of care in months, awareness of energy and awareness of breathing since beginning Network care. RESULTS: Of the exogenous variables only gender, age, and education remain in the final parsimonious structural equation model in these data. Reported wellness benefits accrue to individuals along a direct path from both self-reported positive lifestyle change (0.22), and from NSA care (0.43). The path (0.65) from NSA care to positive health lifestyle changes indicates that NSA care also has an indirect effect on wellness through changes in health lifestyle practices.

CONCLUSIONS: The Structural Equation model tested in these analyses lends support to our theoretical framework linking wellness, health lifestyles, and CAM. This study provides further evidence that our measurements of health and wellness are particularly appropriate for investigating wellness-oriented CAM. There is a positive relationship between the experience of NSA care and self-reported improvements in wellness as well as self-reported changes in lifestyle practices. NSA care users tend toward the practice of a positive health lifestyle, which also has a direct effect on reported improvements in wellness. These empirical links are discussed relative to the sociodemographic characteristics of this population and show that use of NSA care is an aspect of a wellness lifestyle.

Wellness lifestyles I: A theoretical framework linking wellness, health lifestyles, and complementary and alternative medicine.
Schuster TL, Dobson M, Jauregui M, Blanks RH. Journal of Alternative and Complimentary Medicine. April 2004;10(2):349-56.
PMID: 15165416

Scholarship concerning complementary and alternative medicine (CAM) practices within the United States could benefit from incorporating sociological perspectives into the development of a comprehensive research agenda. We review the literature on health and wellness emphasizing definitions and distinctions, the health lifestyles literature emphasizing issues of both life choices and life chances, and studies of CAM suggesting utilization as an aspect of a wellness lifestyle. This review forms the foundation of a new theoretical framework for CAM research based on the interrelationship of CAM with health promotion, wellness, and health lifestyles. To date, few studies have sought to bring these various elements together into a single, comprehensive model that would enable an assessment of the complexity of individual health and wellness in the context of CAM. We argue that attention to literatures on health measurement and health lifestyles are essential for exploring the effectiveness and continuing use of CAM.

The Transition of Network Spinal Analysis Care: Hallmarks of a Client-Centered Wellness Education Multi-Component System of Health Care Delivery
Epstein D. Journal of Vertebral Subluxation Research, April 5, 2004; 1-7

Network Spinal Analysis TM (NSA) care has been transitioned from a health care system with the objective of correction of two types of vertebral subluxation, to a multi-component system of health care delivery with emphasis on wellness education for participating clients. NSA care is now delivered and communicated in discrete Levels of Care with emphasis on client participation through self-evaluation. Emphasis on wellness education will be introduced into NSA practice through training via a Certificate Program currently under development. This paper considers some hallmarks that delineate a wellness education, patient (client)-centered practice. The concepts presented relative to this wellness model of health care delivery are believed to be applicable to any approach with similar practice objectives. The perspective presented considers that the major aspects of a patient-centered, wellness education health care delivery system is multi-dimensional. Hallmarks include differentiating terms, and establishing a wellness mentality. Substantiation of the discipline must be established through credible published research regarding its efficacy and safety as well as a consistent and valid means of measuring progressive outcomes derived from the care received. The relationship of NSA to other disciplines is discussed.

Successful In Vitro Fertilization in a Poor Responder While Under Network Spinal Analysis Care: A Case Report
Senzon SA. Journal of Vertebral Subluxation Research, September 14, 2003; 1-6

Objective: This case report describes the successful in vitro fertilization (IVF) of a 34 year old female who had one previous aborted IVF attempt prior to Network Spinal Analysis (NSA) care. This case report is being presented to add to other case reports that show positive physiological changes in patients receiving NSA care.

Clinical Features: The IVF was attempted due to her partner’s azoospermia. The first IVF attempt was on 3/26/02. The patient had a poor follicular growth after the standard hyper-stimulation process of the ovaries, including pre-treatment with Mircette (birth control pills) and 1mg/0.2ml of Lupron (a gonadotropin releasing hormone agonist), and 3-6 amps of Gonal-F (a recombinant fsh) starting on cycle day 3. Her baseline day 3 estradiol and LH levels were only 21.2pg/me and 5.0 I.U./L respectively. On cycle day 8, estradiol was only 56% and LH was 6.6 I.U./L. The Gonal-F was increased to 6amps. This first attempt was canceled due to the poor follicle growth. Only 3-4 follicles of insufficient size between 10-14mm each were found.

Chiropractic Care and Outcomes: On 4/11/02, the patient commenced regular NSA care. The second IVF attempt began on 6/6/02. The change in IVF protocol was the addition of Repronex (also a gonadotropin a combination of LH and fsh). The total increased dose of Gonal-F and Repronex was 6amps, compared to the first attempt of only 3amps which was then increased to 6amps of Gonal-F only.

Conclusion: On the second IVF attempt, estradiol was 1001pg/ml on day 8, and 2019pg/ml on day 11, with LH at 9.3. The Oocyte retrieval after the second attempt was 10 eggs, each approximately 18mm. A successful aspiration of eggs was completed on 6/17/02, and a successful pregnancy followed. The patient is still under NSA care, and is now in her second trimester with normal fetal heart sounds. The possible role of NSA care in the vigorous follicular growth and other health benefits is discussed.

Insult, Interference and Infertility: An Overview of Chiropractic Research
Behrendt M. Journal of Vertebral Subluxation Research, May 2, 2003; 1

Objective: Infertility is distinct from sterility, implying potential, and therefore raises questions as to what insult or interference influences this sluggish outcome. Interference in physiological function, as viewed by the application of chiropractic principles, suggests a neurological etiology and is approached through the mechanism of detection of vertebral subluxation and subsequent appropriate and specific adjustments to promote potential and function. Parental health and wellness prior to conception influences reproductive success and sustainability, begging efficient, effective consideration and interpretation of overall state and any distortion. A discussion of diverse articles is presented, describing the response to chiropractic care among subluxated infertile women.

Clinical Features: Fourteen retrospective articles are referenced, their diversity includes: all 15 subjects are female, ages 22-65; prior pregnancy history revealed 11 none, 2 successful unassisted, 1 assisted, 1 history of miscarriage. 9 had previous treatment for infertility, 4 were undergoing infertility treatment when starting chiropractic care. Presenting concerns included: severe low back pain, neck pain, colitis, diabetes, and female dysfunction such as absent or irregular menstrual cycle, blocked fallopian tubes, endometriosis, infertility, perimenopause and the fertility window within a religiousbased lifestyle, and a poor responder undergoing multiple cycles of IVF.

Chiropractic Care and Outcome: Outcomes of chiropractic care include but are not limited to benefits regarding neuromuscular concerns, as both historical and modern research describe associations with possible increased physiological functions, in this instance reproductive function. Chiropractic care and outcome are discussed, based on protocols of a variety of arts, including Applied Kinesiology (A.K.), Diversified, Directional Non-Force Technique (D.N.F.T.), Gonstead, Network Spinal Analysis (N.S.A.), Torque Release Technique (T.R.T.), Sacro Occipital Technique (S.O.T.) and Stucky-Thompson Terminal Point Technique. Care is described over a time frame of 1 to 20 months.

Conclusion: The application of chiropractic care and subsequent successful outcomes on reproductive integrity, regardless of factors including age, history and medical intervention, are described through a diversity of chiropractic arts. Future studies that may evaluate more formally and on a larger scale, the effectiveness, safety and cost benefits of chiropractic care on both well-being and physiological function are suggested, as well as pursuit of appropriate funding.

Chaotic Modeling in Network Spinal Analysis: Nonlinear Canonical Correlation with Alternating Conditional Expectation (ACE): A Preliminary Report
Bohacek S, Jonckheere E. Journal of Vertebral Subluxation Research, December 1998; 2(4): 188-195

Abstract – This paper presents a preliminary non-linear mathematical analysis of surface electromyographic (sEMG) signals from a subject receiving Network Spinal Analysis (NSA).The unfiltered sEMG data was collected over a bandwidth of 10-500 Hz and stored on a PC compatible computer. Electrodes were placed at the level of C1/C2,T6, L5, and S2 and voltage signals were recorded during the periods in which the patient was experiencing the “somatopsychic” wave, characteristic of NSA care. The intent of the preliminary study was to initiate mathematical characterization of the wave phenomenon relative to its “chaotic,” and/or nonlinear nature. In the present study the linear and nonlinear Canonical Correlation Analyses (CCA) have been used. The latter, nonlinear CCA, is coupled to specific implementation referred to as Alternating Conditional Expectation (ACE). Preliminary findings obtained by comparing canonical correlation coefficients (CCC’s) indicate that the ACE nonlinear functions of the sEMG waveform data lead to a smaller expected prediction error than if linear functions are used. In particular, the preliminary observations of larger nonlinear CCC’s compared to linear CCC’s indicate that there is some nonlinearity in the data representing the “somatopsychic” waveform. Further analysis of linear and nonlinear predictors indicates that 4th order nonlinear predictors perform 20 % better than linear predictors, and 10th order nonlinear predictors perform 30% better than linear predictors.This suggests that the waveform possesses a nonlinear “attractor” with a dimension between 4 and 10. Continued refinement of the ACE algorithm to allow for detection of more nonlinear distortions is expected to further clarify the extent to which the sEMG signal associated with the “somatopsychic” waveform of NSA is differentiated as nonlinear as opposed to random.

Reduction of Psoriasis in a Patient under Network Spinal Analysis Care: A Case Report
Behrendt M. Journal of Vertebral Subluxation Research, December 1998; 2(4): 196-200

This case report describes the progress of a 52 year old male with chronic psoriasis, first diagnosed in April of 1992. After the condition exacerbated over a five year period, he was placed on 12.5 mg/week methotrexate, and oral immunosuppressant medication in October of 1997.After commencing the medication, the condition reduced from 6% body coverage, with flares of 15-20%, to a body coverage of 5%. Following a cessation of the oral medication in February, 1998, the condition recurred at the previous uncontrolled level within one month. The patient was again placed on 12.5 mg/week methotrexate, and subsequently the condition reduced to 5% body coverage. The patient’s dose was reduced to 10 mg/week, and later to 7.5 mg/week, with the psoriasis remaining at 5% coverage. On 5/18/98, the patient commenced regular NSA care. He reported a reduction in the psoriasis condition on 6/3/98, and was taken off the oral medication on 6/25/98. The reduction continued, and the patient was advised by his medical physician on 7/01/98 to continue the cessation of oral medication. As of 9/30/98 the psoriasis had decreased to 0.5% to 1.0 % of coverage, and prior plans to initiate ultraviolet-A therapy were canceled. As of 11/98, a five month period since cessation of methotrexate, the patient has remained under regular NSA care, with no recurrence of psoriasis body coverage greater than 1%, the only medication being a topical ointment. This is contrasted to the recurrence after one month, following the patient’s first cessation of methotrexate, and prior to NSA care. The possible role of NSA care in the reduction of the patient’s psoriasis, and other health benefits is discussed.

Changes in Digital Skin Temperature, Surface Electromyography, and Electrodermal Activity in Subjects Receiving Network Spinal Analysis Care
Miller E, Redmond P. Journal of Vertebral Subluxation Research, June 1998; 2(2): 87-95

A preliminary study was conducted to evaluate changes in digital skin temperature (DST), surface electromyography (sEMG), and electrodermal activity (EDA) in a group of twenty subjects receiving Network Spinal Analysis (NSA) care. Data, simultaneously derived from all three parameters, were considered to be indirect correlates of sympathetic nervous system activity. Subjects, including a group of five controls, were assessed for a period of 17 minutes. The continuous assessment period included a baseline interval of 4.5 minutes, followed by a 12.5 minute period which was divided into five 2.5 minute intervals. Care was administered to the NSA recipient group immediately after the baseline period, whereas controls received no intervention following baseline. Results revealed no significant differences in DST either within or between the two groups. Surface EMG readings were relatively constant over the five intervals following baseline in the NSA group, while controls showed significant (p < 0.05) increases in sEMG at the second through fifth intervals relative to the first interval following baseline activity. Electrodermal activity was significantly decreased (p < 0.01) in the NSA group in the second through fifth intervals compared to baseline. Moreover, decreases varied between intervals, but exhibited a leveling from the third through fifth interval. Control subjects, alternatively, exhibited an increase in EDA in all intervals following baseline. The extent of increase resulted in EDA activity significantly greater than the NSA group at the third through fifth intervals. It was concluded that the increase in EMG activity in the control groups may have reflected an increasing level of anxiety due to the duration of the recording period. Since the NSA group expressed constancy in sEMG activity during the same period, coupled to significant decreases in EDA, a “sympathetic quieting effect” was postulated to occur in subjects receiving NSA care. This conclusion is consistent with hypothesized neurological pathways linked to responses observed during NSA care, as well as other reports of self-reported improvements in mental/emotional state and stress reduction in patients receiving Network Chiropractic Care.

Functional Magnetic Resonance Imaging: About the Cover
Journal of Vertebral Subluxation Research, 1998; 2(1): Cover

About the Cover: Functional Magnetic resonance Imaging (fMRI), which measures the relative presence of oxy-hemoglobin, has gained attention as a non-invasive medium through which high resolution images of the brain and other tissue may be acquired. This technology may provide a useful assessment of cortical changes following chiropractic intervention. Images of the patient depicted on the cover, on the left, reflect cortical activity (lighted areas in the parietal cortex, frontal cortex areas 9, 10; visual association areas 19, 37, and 39) associated with the learning process of a “novel” muscular maneuver of the foot. Images on the right reflect cortical activity following a Network Spinal Analysis (form of chiropractic) adjustment session, taken approximately 20 minutes after the first set of images, involving the same activity. The decrease in “lighted” areas before and after the adjustment session suggests that less cortical “planning” or “activity” is associated with the “novel” foot maneuver. Thus, the ability of fMRI to visualize changes in cortical activity may play a significant role in elucidating the consequences of vertebral subluxation correction on neurological function.

An Impairment Rating Analysis Of Asthmatic Children Under Chiropractic Care
Graham R, Pistolese R. Journal of Vertebral Subluxation Research, 1997; 1(4): 41-48

A self-reported asthma-related impairment study was conducted on 81 children under chiropractic care. The intent of this study was to quantify self-reported changes in impairment experienced by the pediatric asthmatic subjects, before and after a two month period under chiropractic care. Practitioners, representing a general range of six different approaches to vertebral subluxation correction, administered a specifically designed asthma impairment questionnaire at the appropriate intervals. Subjects were categorized into two groups; 1-10 years and 11-17 years. Parents/guardians completed questionnaires for the younger group, while the older subjects self-reported their perceptions of impairment. Significantly lower impairment rating scores (improvement) were reported for 90.1% of subjects 60 days after chiropractic care when compared to the pre-chiropractic scores (p < 0.05) with an effect size of 0.96. As well, there were no significant differences across the age groups based on parent/guardian versus self rated scores. Girls reported higher (less improvement) before and after care compared to boys, although significant decreases in impairment ratings were reported for each gender. This suggested a greater clinical effect for boys which was supported by effect sizes ranging from 1.2 for boys compared to 0.75 for girls. Additionally, 25 of 81 subjects (30.9%) chose to voluntarily decrease their dosage of medication by an average of 66.5% while under chiropractic care. Moreover, information collected from patients revealed that among 24 patients reporting asthma “attacks” in the 30 day period prior to the study, the number of “attacks” decreased significantly by an average of 44.9% (p <.05). Based on the data obtained in this study, it was concluded that chiropractic care, for correction of vertebral subluxation, is a safe nonpharmacologic health care approach which may also be associated with significant decreases in asthma related impairment as well as a decreased incidence of asthmatic “attacks.” The findings suggest that chiropractic care should be further investigated relative to providing the most efficacious care management regimen for pediatric asthmatics.

[Note: NSA care was one of the chiropractic approaches used in this study supported by the Michigan Chiropractic Council]

A Retrospective Assessment of Network Care Using a Survey of Self-Rated Health, Wellness and Quality of Life
Blanks RH, Schuster TL, Dobson M. Journal of Vertebral Subluxation Research, 1997; 1(4): 15-31

The present study represents a retrospective characterization of Network Care, a health care discipline within the subluxation-based chiropractic model. Data were obtained from 156 Network offices (49% practitioner participation rate) in the United States, Canada, Australia, and Puerto Rico. Sociodemographic characterization of 2818 respondents, representing a 67-71% response rate, revealed a population predominately white, female, well-educated, professional, or white collar workers. A second objective of the study included the development and initial validation of a new health survey instrument. The instrument was specifically designed to assess wellness through patients’ self-rating different health domains and overall quality of life at two “time” points: “presently” and retrospectively, recalling their status before initiating care (“before Network”). Statistical evaluation employing Chronbach’s alpha and theta coefficients derived from principle components factor analyses, indicated a high level of internal reliability in regard to the survey instrument, as well as stable reliability of the retrospective recall method of self-rated perceptions of change as a function of duration of care. Results indicated that patients reported significant, positive perceived change (p < 0.000) in all four domains of health, as well as overall quality of life. Effect sizes for these difference scores were all large (>0.9). Wellness was assessed by summing the scores for the four health domains into a combined wellness scale, and comparing this combined scale “presently” and “before Network.” The difference, or “wellness coefficient” spanning a range of -1 to +1, with zero representing no change, showed positive, progressive increases over the duration of care intervals ranging from 1-3 months to over three years. The evidence of improved health in the four domains (physical state, mental/emotional state, stress evaluation, life enjoyment), overall 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. These findings are being further evaluated through longitudinal studies of current populations under care in combination with investigation of the neurophysiological mechanisms underlying its effects.

Network Spinal Analysis: A System of Health Care Delivery Within the Subluxation-Based Chiropractic Model
Epstein, D. Journal of Vertebral Subluxation Research, August 1996; 1(1): 51-59

The theoretical basis and clinical application of Network Spinal Analysis (NSA) is described. NSA delivers health care within the subluxation-based chiropractic model and seeks to contribute to the distinction of the various techniques and methods within the profession by describing and discussing its major characteristics. In this regard, clinical observations relative to the application of the Network Protocol have been described in relation to the monitoring of patient and practitioner outcomes. Relevant research from a separate Network Care retrospective study, which impacts on its characterization, profiles the patient population as predominantly female. Other data indicates that Network Care is widely and consistently practiced. Additionally, patients report significant, positive changes in health-related quality of life measures linked to certain clinical components of Network Care.
 

Visualization of a stationary CPG-revealing spinal wave* (Abstract from research at the University of Southern California, Professor Edmond Jonchkeere, et al.) 

Program of MEDICINE MEETS VIRTUAL REALITY 14 – ACCELERATING CHANGE IN HEALTH CARE: NEXT MEDICAL TOOLKIT* conference where Professor Jonchkeere will present a paper on the NSA Somatopsychic Wave (Prof. Jonckheere’s presentation is scheduled on pg. 20)

Paper Presentation accepted at the International Society of Quality of Life Research Conference in Prague, Czech Republic Nov. 12-15th, 2003 

Read the latest research articles on Surface Electromyography in Network Spinal Analysis™ (In order to view the files below, it is necessary that you have Adobe Acrobat Reader. If you do not have this please Click Here to download your free copy now.)

• Dynamic Modeling of Spinal Electromyographic activity during various conditions
• Nonlinear Switching Dynamics in Surface Electromyography of the Spine 

This research, which involves human subjects, has been approved by the University Park Institutional Review Board (IRB) of the University of Southern California

Network Spinal Analysis™: A Research Perspective

Statement of Efficacy

The Case Report 

Health & Wellness Quality of Life Questionnaire (Adobe Acrobat Reader Required)
(Questionnaire available to download free of charge courtesy of the Association for Network Care)

For more information on Network Spinal Analysis™  Research please visit the Association For Network Care website at www.associationfornetworkcare.com

Network Spinal Analysis and Research

Network Spinal Analysis is a gentle and extremely effective style of chiropractic care used to evaluate and adjust the spine. The purpose of NSA is to allow restoration of proper nerve function for full health and peak performance. 

Network Spinal Analysis is a chiropractic technique developed in America in the early 80’s by Dr Donald Epstein. Network Spinal Analysis utilises light touches, specific body contacts and body positioning to develop breathing and body oscillations (or waves) that dissipate stored tension. NSA allows your body to develop new strategies to release this tension on its own. This promotes the clarity and flexibility a body needs to adapt to the challenges of our busy lives. 

How Does NSA Work?  

The spinal cord, in addition to being an electrical system, also conducts information through oscillation, or wave-like motion. Like an overstretched rubber band, the spinal cord tissues oscillate at a higher frequency, or “phase”, when they are under tension. As every cell of the body is connected via an elaborate nerve network to the spinal cord, any change in tension of the spinal cord affects the function of every cell in the body… all 75-100 trillion of them!   

From this, we found that most tension in the vertebra of the spine was secondary to tension patterns from the spinal cord. The stress of having too much to do and not enough time to do it is epidemic in our culture. Consistently high stress levels freeze the body in a “fight or flight” mode, tightening muscles, rounding shoulders, making breathing shallow, and limiting blood and oxygen to the parts of your brain responsible for relaxation, revitalization, creativity, and growth.   We find that a busy life is typically not the problem. The problem is an inability to shift gears and “unhook” from the stress-causing factors that are overwhelming you.
That’s why, instead of trying to mechanically adjust or align the spine through manipulation of the vertebra, a Network Chiropractor seeks to understand the physical, emotional, and mental factors related to the tension pattern and then find the specific points on the spine that will help the body resolve its tension using the exact amount of pressure that cues the brain from stress into ease. No twisting, popping, or cracking is necessary. 

The Network Chiropractor is using the principle of leverage. This is when they make the light gentle adjustments. The idea is like moving huge boulder without having to use a great deal of force if you use the leverage of a tree branch.
Putting the lever in the exact right place, at the right time with the right amount of light force, you can easily move the boulder. Likewise, Network Chiropractors are trained during post-graduate courses on Network Spinal Analysis to know the exact leverage point and manoeuvres to utilise on the spine to release tension to allow the body to find equilibrium. 

What scientific evidence do you have that your method works? 

NSA is one of the most researched methods in chiropractic. Network Spinal Analysis™ has been the subject of academic study, research and publication for its unprecedented effect in wellness and quality of life, adaptability to stress, enhanced life enjoyment, facilitation of constructive lifestyle changes. Also studies are being conducted as to its influence on the advancement and evolution of the nervous system’s strategies for self-organization.
A retrospective study of nearly 3,000 people through the University of California Irvine Medical College documented significant improvements in quality of life in the majority of people receiving Network Chiropractic care. 

The wave patterns that occur during a Network entrainment are the focus of University of Southern California mathematician professor Edmund Jonckheere, who is currently studying the relationship between these wave patterns and the energy-efficiency and adaptability of the nervous system.   

The Journal of Alternative and Complementary Medicine featured the evolving paradigm that contains NSA and SRI, called Reorganizational Healing, in May ’09. 

NSA Sessions 

The adjustments are made along the spine and are as gentle as the pressure that you could comfortably apply to your closed eyelid. 

• You keep your clothes on (except your shoes) during a session.
• Sessions last about 30-40 minutes.
• The therapy is not painful, although the bodily sensations can be surprising and emotional releases during sessions are common.
• Practitioners evaluate the client’s progress based on his or her self-reported experience.

Benefits of NSA 

Research has shown that as a spine, body and nervous system becomes healthier, physical wellbeing improves to provide more spinal flexibility, diminished symptoms and a greater ability to cope, developing an internal sense of wellness regardless of circumstances.
Examples of further additional benefits reported include: 

• Less physical pain
• Less tension or stiffness of the spine
• Greater flexibility
• Reduced allergies, eczema, asthma
• Fewer colds flu & headaches
• Less menstrual discomfort
• Improved response to stress
• Improved mental/emotional state
• Improved life enjoyment
• Improved overall quality of life

Basic care typically lasts 6 to 8 weeks, with 2 to 3 sessions per week. At the end of this period, clients generally report better body awareness, stronger spinal movement, and relief from discomfort and more ease in releasing tension.
After basic care sessions, you can choose to continue with treatment and enjoy wellness 

Network Spinal Analysis Research

The following is a list of peer-reviewed publications involving Network Spinal Analysis Care. Further information regarding Network Spinal Analysis Research currently in process or programs where information on Network Spinal Analysis Research has been presented is available at www.associationfornetworkcare.com

Improvement in Attention in Patients Undergoing Network Spinal Analysis: A Case Series Using Objective Measures of Attention
Pauli Y. Journal of Vertebral Subluxation Research, August 23, 2007; 1-9

Objective: Anecdotal preliminary evidence suggests that chiropractic care may be of benefits for individuals suffering from ADHD. This case series presents the improvement in attention experienced by 9 adult patients undergoing Network Spinal Analysis.

Methods: Nine adult patients are presented (4 male, 5 female) with a mean age of 40.4 years (range 22 – 58 years old). All patients were evaluated with the Test of Variable of Attention (TOVA) before receiving Network Spinal Analysis (NSA) care and at 2 months into care. The nine patients received level 1 NSA care for two months, as taught by the Association for Network Care. Neurospinal integrity was evaluated with palpation, as well as surface electromyography. Cognitive process of attention was objectively evaluated using a continuous performance test, the Test of Variables of Attention (TOVA).

Results: We evaluated our patient cohort before and after Network care using sEMG and variables from the continuous performance test (TOVA). Before care, all patients had an abnormal ADHD score with a mean of -3.74 (range: – 8.54 to -1.89). After 2 months of care, all patients had a significant change in ADHD score (p=0.08) and 88% completely normalized the ADHD score. 77% and 66% of patients experienced significant change in reaction time and variability score, respectively. All patients experienced a significant reduction in sEMG pattern of activation (p=0.08). We discuss possible mechanisms by which spinal care may have enhanced the function of the prefrontal cortex, thereby resulting in improved attentional capacities

Conclusion: In this case series the nine adult patients experienced significant improvement in attention, as measured by objective outcomes, after receiving two months of Network Spinal Analysis. The progress documented in this report suggests that NSA care may positively affect the brain by creating plastic changes in the prefrontal cortex and other cortical and subcortical areas serving as neural substrate for the cognitive process of attention. These findings may be of importance for individuals suffering from attention deficit. Further research into this area is greatly needed.

Quality of Life Improvements and Spontaneous Lifestyle Changes in a Patient Undergoing Subluxation-Centered Chiropractic Care: A Case Study
Pauli Y. Journal of Vertebral Subluxation Research, October 11, 2006; 1-15

Purpose of Study: This case study is to report the improvement in quality of life experienced by a patient undergoing subluxation-centered chiropractic care.

Clinical Features: A 36 year old male presented with primary health concerns of stress, eye pain and left leg pain of 14 years duration radiating to the foot and secondary complaints of gastritis, ulcers, nervousness, depression, lack of concentration and general loss of interest in daily life. The patient also smokes, does not exercise, eats a sub-optimal diet and rated his family and friends support, as well as job satisfaction as sufficient.

Intervention and Outcome: We discuss the various analyses employed to evaluate vertebral subluxations, including paraspinal surface electromyography and thermography. Adjustive care included a combination of Network Spinal Analysis, Torque Release Technique and diversified structural adjustments to correct vertebral subluxations over a six month period. We used visual analog scales, open-ended questions and selected items from the Self-Rated Health and Wellness Instrument to monitor health changes, as well as the positive improvements in quality of life as perceived by the patient himself.

Conclusion: This case study demonstrates that the correction of vertebral subluxations over an 11 month period was associated with significant improvements in the quality of life of the patient.

Chiropractic Care of a Battered Woman: A Case Study
Bedell L. Journal of Vertebral Subluxation Research, July 20, 2006; 1-6

Objective: This case study documents the chiropractic care of battered woman struggling with Intimate Partner Violence (IPV). Chiropractic offers battered women a unique service, it is the only profession trained and licensed to detect and correct vertebral subluxations. The relationship between the stresses of abuse and vertebral subluxation, as well as the subsequent changes during chiropractic care, are described.

Clinical Features: A Caucasian, 23-year old female presented with headaches, neck pain, and upper back pain. The initial complaint noted sharp, knife-like pains into the medial scapular borders, worse on the right side. Tingling extended into the right hand, most severe in the 2nd, 3rd, and 4th fingers.

Chiropractic care and outcome: Protocols of both Torque Release and Activator techniques were utilized to evaluate vertebral subluxations. Subjective quality of life issues were evaluated through a Network Spinal Analysis (NSA) Health Status Questionnaire. After commencing chiropractic care, this woman suffered a cervical spine hyper-extension/hyper-flexion type injury from an automobile accident. For the first 30 days after, adjustments were applied twice weekly. Acute exacerbations of symptoms unrelated to the original complaints were displayed and progress became irregular. During the next 60 days, there were various unexplained falls and severe flare-ups of painful symptoms, and she finally admitted to being battered by her husband. Referrals to counselors and programs dealing with domestic violence were provided. Once the physical battering stopped, consistent progress was noted in both clinical symptoms and quality of life issues.

Conclusion: As a battered woman must receive emotional and social support to improve her situation, it is important for chiropractors to recognize the “red flags” of IPV. Chiropractors re-evaluate regularly for changes in vertebral subluxation patterns and can recognize inconsistent responses. They may also be the first caregivers to offer a vitalistic approach; considering a woman’s physical, chemical, and emotional quality of life; a perspective that offers significant connection and trust. This article serves as a foundation on the topic of IPV and chiropractic, for use in both communities.

Wellness lifestyles II: Modeling the dynamic of wellness, health lifestyle practices, and Network Spinal Analysis.
Schuster TL, Dobson M, Jauregui M, Blanks RH. Journal of Alternative and Complimentary Medicine. April 2004;10(2):357-67.
PMID: 15165417

OBJECTIVE: Empirical application of a theoretical framework linking use of Network Spinal Analysis (NSA; a holistic, wellness-oriented form of complementary and alternative medicine [CAM]), health lifestyle practices, and self-reported health and wellness. DESIGN: Cross-sectional self-administered survey study. RESPONDENTS: Two thousand five hundred and ninety-six (2596) patients from 156 offices of doctors who were members of the Association for Network Chiropractic (currently titled Association for Network Care); estimated response rate was 69%. MEASURES: Exogenous variables entered into the structural equation model include gender, age, education, income, marital status, ailments, life change, and trauma. A wellness construct consisted of calculated difference scores between two referents, “presently” and “before Network” care, for self-reported items representing wellness domains of physical state, mental-emotional state, stress evaluation, and life enjoyment. Positive reported change in nine items assembled into dietary practices, health practices, and health risk dimensions serve as indicators of the construct of changes in health lifestyle practices. The NSA care construct consisted of duration of care in months, awareness of energy and awareness of breathing since beginning Network care. RESULTS: Of the exogenous variables only gender, age, and education remain in the final parsimonious structural equation model in these data. Reported wellness benefits accrue to individuals along a direct path from both self-reported positive lifestyle change (0.22), and from NSA care (0.43). The path (0.65) from NSA care to positive health lifestyle changes indicates that NSA care also has an indirect effect on wellness through changes in health lifestyle practices.

CONCLUSIONS: The Structural Equation model tested in these analyses lends support to our theoretical framework linking wellness, health lifestyles, and CAM. This study provides further evidence that our measurements of health and wellness are particularly appropriate for investigating wellness-oriented CAM. There is a positive relationship between the experience of NSA care and self-reported improvements in wellness as well as self-reported changes in lifestyle practices. NSA care users tend toward the practice of a positive health lifestyle, which also has a direct effect on reported improvements in wellness. These empirical links are discussed relative to the sociodemographic characteristics of this population and show that use of NSA care is an aspect of a wellness lifestyle.

Wellness lifestyles I: A theoretical framework linking wellness, health lifestyles, and complementary and alternative medicine.
Schuster TL, Dobson M, Jauregui M, Blanks RH. Journal of Alternative and Complimentary Medicine. April 2004;10(2):349-56.
PMID: 15165416

Scholarship concerning complementary and alternative medicine (CAM) practices within the United States could benefit from incorporating sociological perspectives into the development of a comprehensive research agenda. We review the literature on health and wellness emphasizing definitions and distinctions, the health lifestyles literature emphasizing issues of both life choices and life chances, and studies of CAM suggesting utilization as an aspect of a wellness lifestyle. This review forms the foundation of a new theoretical framework for CAM research based on the interrelationship of CAM with health promotion, wellness, and health lifestyles. To date, few studies have sought to bring these various elements together into a single, comprehensive model that would enable an assessment of the complexity of individual health and wellness in the context of CAM. We argue that attention to literatures on health measurement and health lifestyles are essential for exploring the effectiveness and continuing use of CAM.

The Transition of Network Spinal Analysis Care: Hallmarks of a Client-Centered Wellness Education Multi-Component System of Health Care Delivery
Epstein D. Journal of Vertebral Subluxation Research, April 5, 2004; 1-7

Network Spinal Analysis TM (NSA) care has been transitioned from a health care system with the objective of correction of two types of vertebral subluxation, to a multi-component system of health care delivery with emphasis on wellness education for participating clients. NSA care is now delivered and communicated in discrete Levels of Care with emphasis on client participation through self-evaluation. Emphasis on wellness education will be introduced into NSA practice through training via a Certificate Program currently under development. This paper considers some hallmarks that delineate a wellness education, patient (client)-centered practice. The concepts presented relative to this wellness model of health care delivery are believed to be applicable to any approach with similar practice objectives. The perspective presented considers that the major aspects of a patient-centered, wellness education health care delivery system is multi-dimensional. Hallmarks include differentiating terms, and establishing a wellness mentality. Substantiation of the discipline must be established through credible published research regarding its efficacy and safety as well as a consistent and valid means of measuring progressive outcomes derived from the care received. The relationship of NSA to other disciplines is discussed.

Successful In Vitro Fertilization in a Poor Responder While Under Network Spinal Analysis Care: A Case Report
Senzon SA. Journal of Vertebral Subluxation Research, September 14, 2003; 1-6

Objective: This case report describes the successful in vitro fertilization (IVF) of a 34 year old female who had one previous aborted IVF attempt prior to Network Spinal Analysis (NSA) care. This case report is being presented to add to other case reports that show positive physiological changes in patients receiving NSA care.

Clinical Features: The IVF was attempted due to her partner’s azoospermia. The first IVF attempt was on 3/26/02. The patient had a poor follicular growth after the standard hyper-stimulation process of the ovaries, including pre-treatment with Mircette (birth control pills) and 1mg/0.2ml of Lupron (a gonadotropin releasing hormone agonist), and 3-6 amps of Gonal-F (a recombinant fsh) starting on cycle day 3. Her baseline day 3 estradiol and LH levels were only 21.2pg/me and 5.0 I.U./L respectively. On cycle day 8, estradiol was only 56% and LH was 6.6 I.U./L. The Gonal-F was increased to 6amps. This first attempt was canceled due to the poor follicle growth. Only 3-4 follicles of insufficient size between 10-14mm each were found.

Chiropractic Care and Outcomes: On 4/11/02, the patient commenced regular NSA care. The second IVF attempt began on 6/6/02. The change in IVF protocol was the addition of Repronex (also a gonadotropin a combination of LH and fsh). The total increased dose of Gonal-F and Repronex was 6amps, compared to the first attempt of only 3amps which was then increased to 6amps of Gonal-F only.

Conclusion: On the second IVF attempt, estradiol was 1001pg/ml on day 8, and 2019pg/ml on day 11, with LH at 9.3. The Oocyte retrieval after the second attempt was 10 eggs, each approximately 18mm. A successful aspiration of eggs was completed on 6/17/02, and a successful pregnancy followed. The patient is still under NSA care, and is now in her second trimester with normal fetal heart sounds. The possible role of NSA care in the vigorous follicular growth and other health benefits is discussed.

Insult, Interference and Infertility: An Overview of Chiropractic Research
Behrendt M. Journal of Vertebral Subluxation Research, May 2, 2003; 1

Objective: Infertility is distinct from sterility, implying potential, and therefore raises questions as to what insult or interference influences this sluggish outcome. Interference in physiological function, as viewed by the application of chiropractic principles, suggests a neurological etiology and is approached through the mechanism of detection of vertebral subluxation and subsequent appropriate and specific adjustments to promote potential and function. Parental health and wellness prior to conception influences reproductive success and sustainability, begging efficient, effective consideration and interpretation of overall state and any distortion. A discussion of diverse articles is presented, describing the response to chiropractic care among subluxated infertile women.

Clinical Features: Fourteen retrospective articles are referenced, their diversity includes: all 15 subjects are female, ages 22-65; prior pregnancy history revealed 11 none, 2 successful unassisted, 1 assisted, 1 history of miscarriage. 9 had previous treatment for infertility, 4 were undergoing infertility treatment when starting chiropractic care. Presenting concerns included: severe low back pain, neck pain, colitis, diabetes, and female dysfunction such as absent or irregular menstrual cycle, blocked fallopian tubes, endometriosis, infertility, perimenopause and the fertility window within a religiousbased lifestyle, and a poor responder undergoing multiple cycles of IVF.

Chiropractic Care and Outcome: Outcomes of chiropractic care include but are not limited to benefits regarding neuromuscular concerns, as both historical and modern research describe associations with possible increased physiological functions, in this instance reproductive function. Chiropractic care and outcome are discussed, based on protocols of a variety of arts, including Applied Kinesiology (A.K.), Diversified, Directional Non-Force Technique (D.N.F.T.), Gonstead, Network Spinal Analysis (N.S.A.), Torque Release Technique (T.R.T.), Sacro Occipital Technique (S.O.T.) and Stucky-Thompson Terminal Point Technique. Care is described over a time frame of 1 to 20 months.

Conclusion: The application of chiropractic care and subsequent successful outcomes on reproductive integrity, regardless of factors including age, history and medical intervention, are described through a diversity of chiropractic arts. Future studies that may evaluate more formally and on a larger scale, the effectiveness, safety and cost benefits of chiropractic care on both well-being and physiological function are suggested, as well as pursuit of appropriate funding.

Chaotic Modeling in Network Spinal Analysis: Nonlinear Canonical Correlation with Alternating Conditional Expectation (ACE): A Preliminary Report
Bohacek S, Jonckheere E. Journal of Vertebral Subluxation Research, December 1998; 2(4): 188-195

Abstract – This paper presents a preliminary non-linear mathematical analysis of surface electromyographic (sEMG) signals from a subject receiving Network Spinal Analysis (NSA).The unfiltered sEMG data was collected over a bandwidth of 10-500 Hz and stored on a PC compatible computer. Electrodes were placed at the level of C1/C2,T6, L5, and S2 and voltage signals were recorded during the periods in which the patient was experiencing the “somatopsychic” wave, characteristic of NSA care. The intent of the preliminary study was to initiate mathematical characterization of the wave phenomenon relative to its “chaotic,” and/or nonlinear nature. In the present study the linear and nonlinear Canonical Correlation Analyses (CCA) have been used. The latter, nonlinear CCA, is coupled to specific implementation referred to as Alternating Conditional Expectation (ACE). Preliminary findings obtained by comparing canonical correlation coefficients (CCC’s) indicate that the ACE nonlinear functions of the sEMG waveform data lead to a smaller expected prediction error than if linear functions are used. In particular, the preliminary observations of larger nonlinear CCC’s compared to linear CCC’s indicate that there is some nonlinearity in the data representing the “somatopsychic” waveform. Further analysis of linear and nonlinear predictors indicates that 4th order nonlinear predictors perform 20 % better than linear predictors, and 10th order nonlinear predictors perform 30% better than linear predictors.This suggests that the waveform possesses a nonlinear “attractor” with a dimension between 4 and 10. Continued refinement of the ACE algorithm to allow for detection of more nonlinear distortions is expected to further clarify the extent to which the sEMG signal associated with the “somatopsychic” waveform of NSA is differentiated as nonlinear as opposed to random.

Reduction of Psoriasis in a Patient under Network Spinal Analysis Care: A Case Report
Behrendt M. Journal of Vertebral Subluxation Research, December 1998; 2(4): 196-200

This case report describes the progress of a 52 year old male with chronic psoriasis, first diagnosed in April of 1992. After the condition exacerbated over a five year period, he was placed on 12.5 mg/week methotrexate, and oral immunosuppressant medication in October of 1997.After commencing the medication, the condition reduced from 6% body coverage, with flares of 15-20%, to a body coverage of 5%. Following a cessation of the oral medication in February, 1998, the condition recurred at the previous uncontrolled level within one month. The patient was again placed on 12.5 mg/week methotrexate, and subsequently the condition reduced to 5% body coverage. The patient’s dose was reduced to 10 mg/week, and later to 7.5 mg/week, with the psoriasis remaining at 5% coverage. On 5/18/98, the patient commenced regular NSA care. He reported a reduction in the psoriasis condition on 6/3/98, and was taken off the oral medication on 6/25/98. The reduction continued, and the patient was advised by his medical physician on 7/01/98 to continue the cessation of oral medication. As of 9/30/98 the psoriasis had decreased to 0.5% to 1.0 % of coverage, and prior plans to initiate ultraviolet-A therapy were canceled. As of 11/98, a five month period since cessation of methotrexate, the patient has remained under regular NSA care, with no recurrence of psoriasis body coverage greater than 1%, the only medication being a topical ointment. This is contrasted to the recurrence after one month, following the patient’s first cessation of methotrexate, and prior to NSA care. The possible role of NSA care in the reduction of the patient’s psoriasis, and other health benefits is discussed.

Changes in Digital Skin Temperature, Surface Electromyography, and Electrodermal Activity in Subjects Receiving Network Spinal Analysis Care
Miller E, Redmond P. Journal of Vertebral Subluxation Research, June 1998; 2(2): 87-95

A preliminary study was conducted to evaluate changes in digital skin temperature (DST), surface electromyography (sEMG), and electrodermal activity (EDA) in a group of twenty subjects receiving Network Spinal Analysis (NSA) care. Data, simultaneously derived from all three parameters, were considered to be indirect correlates of sympathetic nervous system activity. Subjects, including a group of five controls, were assessed for a period of 17 minutes. The continuous assessment period included a baseline interval of 4.5 minutes, followed by a 12.5 minute period which was divided into five 2.5 minute intervals. Care was administered to the NSA recipient group immediately after the baseline period, whereas controls received no intervention following baseline. Results revealed no significant differences in DST either within or between the two groups. Surface EMG readings were relatively constant over the five intervals following baseline in the NSA group, while controls showed significant (p < 0.05) increases in sEMG at the second through fifth intervals relative to the first interval following baseline activity. Electrodermal activity was significantly decreased (p < 0.01) in the NSA group in the second through fifth intervals compared to baseline. Moreover, decreases varied between intervals, but exhibited a leveling from the third through fifth interval. Control subjects, alternatively, exhibited an increase in EDA in all intervals following baseline. The extent of increase resulted in EDA activity significantly greater than the NSA group at the third through fifth intervals. It was concluded that the increase in EMG activity in the control groups may have reflected an increasing level of anxiety due to the duration of the recording period. Since the NSA group expressed constancy in sEMG activity during the same period, coupled to significant decreases in EDA, a “sympathetic quieting effect” was postulated to occur in subjects receiving NSA care. This conclusion is consistent with hypothesized neurological pathways linked to responses observed during NSA care, as well as other reports of self-reported improvements in mental/emotional state and stress reduction in patients receiving Network Chiropractic Care.

Functional Magnetic Resonance Imaging: About the Cover
Journal of Vertebral Subluxation Research, 1998; 2(1): Cover

About the Cover: Functional Magnetic resonance Imaging (fMRI), which measures the relative presence of oxy-hemoglobin, has gained attention as a non-invasive medium through which high resolution images of the brain and other tissue may be acquired. This technology may provide a useful assessment of cortical changes following chiropractic intervention. Images of the patient depicted on the cover, on the left, reflect cortical activity (lighted areas in the parietal cortex, frontal cortex areas 9, 10; visual association areas 19, 37, and 39) associated with the learning process of a “novel” muscular maneuver of the foot. Images on the right reflect cortical activity following a Network Spinal Analysis (form of chiropractic) adjustment session, taken approximately 20 minutes after the first set of images, involving the same activity. The decrease in “lighted” areas before and after the adjustment session suggests that less cortical “planning” or “activity” is associated with the “novel” foot maneuver. Thus, the ability of fMRI to visualize changes in cortical activity may play a significant role in elucidating the consequences of vertebral subluxation correction on neurological function.

An Impairment Rating Analysis Of Asthmatic Children Under Chiropractic Care
Graham R, Pistolese R. Journal of Vertebral Subluxation Research, 1997; 1(4): 41-48

A self-reported asthma-related impairment study was conducted on 81 children under chiropractic care. The intent of this study was to quantify self-reported changes in impairment experienced by the pediatric asthmatic subjects, before and after a two month period under chiropractic care. Practitioners, representing a general range of six different approaches to vertebral subluxation correction, administered a specifically designed asthma impairment questionnaire at the appropriate intervals. Subjects were categorized into two groups; 1-10 years and 11-17 years. Parents/guardians completed questionnaires for the younger group, while the older subjects self-reported their perceptions of impairment. Significantly lower impairment rating scores (improvement) were reported for 90.1% of subjects 60 days after chiropractic care when compared to the pre-chiropractic scores (p < 0.05) with an effect size of 0.96. As well, there were no significant differences across the age groups based on parent/guardian versus self rated scores. Girls reported higher (less improvement) before and after care compared to boys, although significant decreases in impairment ratings were reported for each gender. This suggested a greater clinical effect for boys which was supported by effect sizes ranging from 1.2 for boys compared to 0.75 for girls. Additionally, 25 of 81 subjects (30.9%) chose to voluntarily decrease their dosage of medication by an average of 66.5% while under chiropractic care. Moreover, information collected from patients revealed that among 24 patients reporting asthma “attacks” in the 30 day period prior to the study, the number of “attacks” decreased significantly by an average of 44.9% (p <.05). Based on the data obtained in this study, it was concluded that chiropractic care, for correction of vertebral subluxation, is a safe nonpharmacologic health care approach which may also be associated with significant decreases in asthma related impairment as well as a decreased incidence of asthmatic “attacks.” The findings suggest that chiropractic care should be further investigated relative to providing the most efficacious care management regimen for pediatric asthmatics.

[Note: NSA care was one of the chiropractic approaches used in this study supported by the Michigan Chiropractic Council]

A Retrospective Assessment of Network Care Using a Survey of Self-Rated Health, Wellness and Quality of Life
Blanks RH, Schuster TL, Dobson M. Journal of Vertebral Subluxation Research, 1997; 1(4): 15-31

The present study represents a retrospective characterization of Network Care, a health care discipline within the subluxation-based chiropractic model. Data were obtained from 156 Network offices (49% practitioner participation rate) in the United States, Canada, Australia, and Puerto Rico. Sociodemographic characterization of 2818 respondents, representing a 67-71% response rate, revealed a population predominately white, female, well-educated, professional, or white collar workers. A second objective of the study included the development and initial validation of a new health survey instrument. The instrument was specifically designed to assess wellness through patients’ self-rating different health domains and overall quality of life at two “time” points: “presently” and retrospectively, recalling their status before initiating care (“before Network”). Statistical evaluation employing Chronbach’s alpha and theta coefficients derived from principle components factor analyses, indicated a high level of internal reliability in regard to the survey instrument, as well as stable reliability of the retrospective recall method of self-rated perceptions of change as a function of duration of care. Results indicated that patients reported significant, positive perceived change (p < 0.000) in all four domains of health, as well as overall quality of life. Effect sizes for these difference scores were all large (>0.9). Wellness was assessed by summing the scores for the four health domains into a combined wellness scale, and comparing this combined scale “presently” and “before Network.” The difference, or “wellness coefficient” spanning a range of -1 to +1, with zero representing no change, showed positive, progressive increases over the duration of care intervals ranging from 1-3 months to over three years. The evidence of improved health in the four domains (physical state, mental/emotional state, stress evaluation, life enjoyment), overall 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. These findings are being further evaluated through longitudinal studies of current populations under care in combination with investigation of the neurophysiological mechanisms underlying its effects.

Network Spinal Analysis: A System of Health Care Delivery Within the Subluxation-Based Chiropractic Model
Epstein, D. Journal of Vertebral Subluxation Research, August 1996; 1(1): 51-59

The theoretical basis and clinical application of Network Spinal Analysis (NSA) is described. NSA delivers health care within the subluxation-based chiropractic model and seeks to contribute to the distinction of the various techniques and methods within the profession by describing and discussing its major characteristics. In this regard, clinical observations relative to the application of the Network Protocol have been described in relation to the monitoring of patient and practitioner outcomes. Relevant research from a separate Network Care retrospective study, which impacts on its characterization, profiles the patient population as predominantly female. Other data indicates that Network Care is widely and consistently practiced. Additionally, patients report significant, positive changes in health-related quality of life measures linked to certain clinical components of Network Care.
 

Visualization of a stationary CPG-revealing spinal wave* (Abstract from research at the University of Southern California, Professor Edmond Jonchkeere, et al.) 

Program of MEDICINE MEETS VIRTUAL REALITY 14 – ACCELERATING CHANGE IN HEALTH CARE: NEXT MEDICAL TOOLKIT* conference where Professor Jonchkeere will present a paper on the NSA Somatopsychic Wave (Prof. Jonckheere’s presentation is scheduled on pg. 20)

Paper Presentation accepted at the International Society of Quality of Life Research Conference in Prague, Czech Republic Nov. 12-15th, 2003 

Read the latest research articles on Surface Electromyography in Network Spinal Analysis™ (In order to view the files below, it is necessary that you have Adobe Acrobat Reader. If you do not have this please Click Here to download your free copy now.)

• Dynamic Modeling of Spinal Electromyographic activity during various conditions
• Nonlinear Switching Dynamics in Surface Electromyography of the Spine 

This research, which involves human subjects, has been approved by the University Park Institutional Review Board (IRB) of the University of Southern California

Network Spinal Analysis™: A Research Perspective

Statement of Efficacy

The Case Report 

Health & Wellness Quality of Life Questionnaire (Adobe Acrobat Reader Required)
(Questionnaire available to download free of charge courtesy of the Association for Network Care)

For more information on Network Spinal Analysis™  Research please visit the Association For Network Care website at www.associationfornetworkcare.com

Call 02476 222002.Registered with AXA , PPP, HSA, AVIVA.,Simplyhealth, Standard Life, Mercia health, BHSF, Pru health,Cigna, Police health care scheme, Medicare  Medisure, Medicash,Groupma, Allianz, Bupa, and all other healthcare insurers .

The National Institute for Health and Clinical Excellence (NICE) recommends chiropractic treatment within NHS.

Coventry Central  Physiotherapy & Chiropractic Sports Injury Clinic.

The Chiropractors at Central Chiropractic are registered with the General Chiropractic Council (GCC) and the British Chiropractic AssioationThe Physiotherapists at Central Physiotherapy are  registered with The Chartered Society of Physiotherapy (CSP) they are also registered with Health Professionals Council ( HPC ).

At Central Physiotherapy and Chiropractic, Sports Injury Clinic at 12 Park Road Coventry CV1 we offer comprehensive assessment, treatment and rehabilitation of your condition.  The Physiotherapists at our clinic are registered with UK Chartered Society of Physiotherapy and Health Professionals Council.Physiotherapists treat a range of pain syndromes and injuries through the combination Physiotherapy/Exercise Therapy/Sports Massage and Complementary Therapies. The Chiropractors at Central Chiropractic are registered with the General Chiropractic Council (GCC) and the British Chiropractic Association

Where are we?

We are an established Physiotherapy and Chiropractic practice in Coventry CV1 and just 200 meters from Coventry train station with our own parking area for around 25 cars. We are experience in providing thousands of individuals, in the same situation as you, with accurate diagnosis and treatment of a whole range of physical and sporting injuries.

What do we treat?

Areas of the body and the problems we treat;

Back Pain injury and conditions,Neck Pain injury and conditions ,Whiplash (WAD),Shoulder pain injury and conditions,Knee Pain pain injury and conditions,Ankle, Heel, Foot pain injury and conditions,Achilles tendonitis, Plantar fascists,Headaches/Migraines/Tension headaches,Arm/Hand Wrist  Pain/RSI/ Tennis Elbow ,Golfer Elbow, Carpal tunnel syndrome,Sciatica and Trapped nerves,Disc injuries “Slipped disc”/Prolapsed disc,Neck and shoulder problems,Pins and needles,Arthritic pain relief and Osteoarthritis pain relief Muscle Tension/Spasm,Poor posture,Lack of energy,Discomfort during pregnancy, pregnancy and Pelvic Pain,Stress,Sports injury

Chiropractic Treatment.

Chiropractors Are fully Registered

Chiropractors are fully registered in the UK with The General Chiropractic Council (BCA) and the British Chiropractic Association (BCA). Chiropractors usually get awarded either Bachelor of Science degree or Master of Science degree upon graduation. You should always check there credentials, this is important in the respect of their professional liability insurance.  Chiropractors aim to diagnose and treat problems associated with the joints, ligaments, tendons and nerves, especially of those relating to the spine restoring normal function of the body. They rely on using a hands-on approach by the process of manipulation of the spine without the use of drugs surgery. Occasionally the manipulation of the extremities is required to alleviate symptoms.

Founded in 1895, chiropractic treatment was once thought of as a purely complementary and alternative therapy, their importance is now widely recognised by medical and healthcare professionals as a beneficial and legitimate branch of therapy in the treatment of spinal and musculo-skeletal conditions. The National Institute for Health and Clinical Excellence (NICE) recommends chiropractic treatment within NHS.

Chiropractic in Sport

In modern sport, increasing levels of intensity have brought extra physical demands from athletes. This has also unfortunately led to an increase in injuries. Fast moving, high contact and tactical positioning based competition has led to an increased pressure on backs and musculo-skeletal systems. Injuries can come in a variety of types. Some can be played through, others lead to time on the sidelines and even worse still, there are occasions when injuries fail to respond to traditional treatment. However, in recent years we have seen the emergence of chiropractic treatment geared towards the needs of an athlete. The treatment has always stressed the importance of maintaining proper function in all areas of body which in turn promotes fast and natural healing from injuries, thus making the treatment nearly ideal for athletic training. Based on the founding principal of human body as a fully integrated being, chiropractic treatment places its focus on spinal, muscular, tendon, ligament, nerve and joint related care. Professionals from a variety of sports both international and domestic now deploy chiropractic therapy and a primary source of treatment with some of the attending specialists at the Olympic Games falling into the category of trained chiropractors.

Chiropractic addresses the function of central nervous system which is the “master system” of the body controlling ad regulating function of all other subsystems including musculoskeletal system. Properly aligned skeletal system would improve performance, reduce the risk of injury and improve healing of existing injuries.

Chiropractors specialize in the non-drug treatment of musculoskeletal problems, including joint sprains and disc injuries. To some extent, the chiropractic approach to sports injuries is similar to that of traditional medical care.

Usually chiropractor’s initial examination would include standard orthopaedic and neurological tests to diagnose whether a particular pain is due to a strain, sprain, or disc problem. X-ray examination is also performed to screen for fractures and other bone disorders, such as osteoporosis.  

Chiropractic management of sports injuries often includes widely used physical therapies such as ice, Cold laser therapy to reduce swelling and inflammation, or electronic muscle stimulation for muscle strains and spasms. 

The Importance of Restoring the Structural Body Balance.

Chiropractic management of sport injuries has an emphasis on adjustment and improving function of spinal and other joints through manipulation as well as restoring overall structural balance of the body. Chiropractor assess the effect of the muscle injury on the rest of the body as it would cause tightening of other muscle and joints in order to maintain general balance. Chiropractic adjustments help to restore the natural balance that was present before the injury.

In modern sport, increasing levels of intensity have brought increased physical requirements from athletes. This has also unfortunately led to an increase in injuries. Fast moving, high contact and tactical positioning based competition has led to an increased pressure on backs and physical structural systems. Injuries can come in a variety of types. Some can be played through, others lead to time on the sidelines and even worse still, there are occasions when injuries fail to respond to traditional treatment. However, in recent years we have seen the emergence of chiropractic treatment geared towards the needs of the athlete.

The treatment has always stressed the importance of maintaining efficiency in all areas of body function which in turn promotes fast and natural healing abilities, thus making the treatment nearly ideal for athletic training. Based on the founding principal of a person as a fully integrated being, chiropractic treatment places its focus on spinal, muscular, tendon, ligament, nerve and joint related care. Professionals from a variety of sports both international and domestic now deploy chiropractic therapy and a primary source of treatment with some of the attending specialists at the Olympic Games falling into the category of trained chiropractors.

Chiropractors are fully registered practitioners who aim to diagnose and treat pain in those suffering problems of the joints, ligaments, tendons and nerves, especially of those relating to the spine, and try to restore normal function of the body. They rely on using a hands-on approach by the process of manipulation of the spine without the use of drugs surgery. Occasionally the manipulation of the extremities is required to alleviate symptoms.

Founded in 1895, chiropractic treatment was once thought of as a purely complementary and alternative therapy, their importance is now widely recognised by medical and healthcare professionals as a beneficial and legitimate aid in the treatment of spinal conditions. The theory is based upon the misalignment of the spine, particularly that which interferes with the nervous system.

Many mechanical problems of the back can benefit from the consultation of a chiropractor, with treatments including the freeing of stiff joints which in turn will reduce nerve irritation.

During initial consultation chiropractor will take a full history from and perform a thorough physical examination. Using a holistic approach the chiropractor will ask many questions relating to occupation, diet, existing exercise programmes and lifestyle and a treatment plan devised using this information. Apart from the manual treatment chiropractor will also work in improving the posture and will advise on preventative measures to avoid a recurrence of pain by suggesting activities and exercises that will help strengthen the spinal components, and those to avoid.

What Is Chiropractic Treatment? 

Chiropractic treatment has gained increasing acceptance by both consumers and insurance agencies, many of which now offer plans covering the treatment. Chiropractic is  safe, there are a few risks associated with it.

Chiropractic, which means ” done by hand,” is a  system founded approximately 100 years ago by Daniel David Palmer. It is based on the theory that many illnesses originate in the spine, and for this reason it focuses on spinal manipulation. Chiropractic physicians may also utilize physical therapy techniques, as well as methods drawn from other branches of alternative medicine.

Clinical Applications

Most visits to chiropractors are for back neck joint pain, but it is also commonly used to treat:

• Headache  pains
• Neck, shoulders, back (disc injury), hip injury and conditions including joint  pain
• Pain in other areas such as the TMJ ( jaw), headaches, migraine, soft tissue injuries, knees, ankle injury and conditions.
• Pregnancy-related pelvic pain

How Chiropractic Works 

Since its origin, chiropractic theory has based itself on “vertebral subluxations,” or vertebrae that have shifted position in the spine. These subluxations are said to impede nerve outflow and contribute to dysfunction of various organs. A chiropractic treatment is supposed to “realign” these “missed placed” vertebrae. , this is called an “adjustment.”

Other theories suggest that chiropractic manipulation may relieve pain by “loosening” vertebrae that have become relatively immobile rather than by changing their position. In addition, the sudden movements of manipulation may alter the response patterns of nerves in the spine, again relieving pain.

Depending on your condition, chiropractic treatment is usually conducted on a two- or three-times-a-week basis, for a month or so. Some chiropractors feel that regular care is necessary to help maintain sound health and fitness. Others will ask to see you only as needed. This depends on your injury or condition at the time of your consultation

What Do Studies Show About Chiropractic Treatment? 

Does It Work? 

There is evidence that chiropractic treatment may relieve pain. The best evidence regards migraine headaches and other forms of headache. Studies on chiropractic for back, neck, hip, knee ankle and joint pain have by far the best results. Chiropractic treatment does seem to be very effective compared with other commonly used treatments for these conditions.

Is It Safe? 

Chiropractic manipulation is safe, rarely causing significant side effects. The most common reaction is local discomfort following therapy, which generally disappears within hours of treatment. Other side effects include temporary headache, tiredness, and discomfort radiating from the site of the adjustment. To put this in perspective, however, the rate of complications from chiropractic is extremely low; according to many estimates, only one complication per million individual sessions occurs. Among people receiving a course of treatment involving manipulation of the neck,

By comparison, serious medical complications involving common drugs in the ibuprofen family (nonsteroidal anti-inflammatory drugs, or NSAIDs) are far more common. Among people using them for arthritis, NSAIDs result in hospitalizations at a rate of about 5 in 1200 people, and death at a rate of 5 in 12,000. The rate of complications with these common over-the-counter drugs is perhaps 100-500 times greater than with chiropractic.

Is It Cost Effective? 

There is a lot of evidence that chiropractic may be less expensive than other forms of care.

If You Decide To Visit A Chiropractor 

If you’re suffering from headaches, migraine, TMJ ( jaw) pain, back pain or neck pain,shoulders, hip, pregnancy-related pelvic pain, joint pain, knee and ankle injuries and conditions  including soft tissue injuries seeking chiropractic care is worth a try, since it appears to be at least as helpful as other commonly used therapies. Chiropractic treatment is now available within United States of America’s  Military,and Medisure with the help and insistence from President Barack Obama.

Look for a chiropractor who:

• Does not require long-term or preventive care
• Does not routinely take x-rays, However, X-rays may be necessary, so always look for a chiropractor within house x-ray facilities, for this can be very important in diagnosing certain conditions.
• Does not object to you seeing a specialist for a second opinion
• Limits his practice to the treatment of musculoskeletal problems (pain/discomfort associated with muscles and joints)

The National Institute for Health and Clinical Excellence (NICE) recommends Chiropractic Treatment

Registered with BUPA. AXA PPP. HSA. AVIVA. CIGNA. Simplyhealth. Standard life. Pru health. Mercia health.Medicash Medisure. All health insurance accepted.

Lower Back Pain  Sciatica how is Sciatica Treated? With Cold Laser Therapy for Pain Relief and Recovery. What causes Sciatica? How do I know if I have sciatica?

Sprained ligaments, strained muscles, ruptured discs, trigger points and inflamed joints are the many of different conditions that can result in low back pain. While sports injuries or accidents can lead to an injury and pain, sometimes even the simplest movements, like picking up a pencil from the floor, can have painful results. In addition, conditions such as poor posture, stress, arthritis, kidney stones and kidney infections, can be the cause of low back pain.

There may be many other things that can cause low back pain, and some of those things can be serious if left untreated. Physiotherapists are trained in diagnosing the cause and determining a proper course of treatment for lower back pain.

Following are some of the most common causes.

Subluxations

When a disruption in the normal movement or position of the vertebrae occurs it results in pain and inflammation. In the lumbar spine these occur at the transition between the lower spine and the sacrum. Subluxations can lead to debilitating low back pain, however, subluxations are easily treatable and there is often a significant reduction in pain experienced almost immediately after treatment.

Disc Herniations

A herniated disc does not automatically mean that you may suffer from low back pain. In one study almost 60% of all adults had at least one bulging or herniated disc, even though they did not experienced any back pain. However, herniated discs can be a source of severe and debilitating pain, which may radiate to other areas of the body. Unfortunately, when a disc herniates, they rarely, completely heal. Further deterioration can be avoided through chiropractic care, but a complete recovery is less common.

Sprains, Strains and Spasms

Sprains strains and spasms, are the most common source of low back pain. Overworking the muscles or ligaments of the low back may lead to tears in the tissues, which become painful, swollen and may even ache, with a tightening to the area affected.

Stress

When you become stressed, your body responds by increasing the levels of stress hormones leading to the rise of blood pressure and heart rate and tightening up of your muscles. By becoming stressed all the time your muscles will become weak and painful loaded with trigger points.

Physiotherapy for low back pain is normally straight forward, and simply a matter of adjusting the lower lumbar vertebrae and pelvis to re-establish normal motion and position of your bones and joints.

Sciatica how is Sciatica Treated? With Cold Laser Therapy for Pain relief and recovery. What causes Sciatica? How do I know if I have sciatica?

 The sciatic nerve is the longest nerve in your body. It runs from your pelvis, through your hip area and buttocks and down each leg. The sciatic nerve branches into smaller nerves as it travels down the legs providing feeling to your thighs, legs, and feet as well as controlling many of the muscles in your lower legs. The term sciatica refers to pain that radiates along the path of this nerve.

What causes Sciatica?

Sciatica is actually a sign that you have an underlying problem putting pressure on a nerve in your lower back. The most common cause of this nerve compression is a bulging or herniated lumbar disc. Piriformis syndrome is another common cause of sciatica. The piriformis is a muscle that lies directly over the sciatic nerve. If this muscle becomes tight or if you have a spasm in this muscle, it puts pressure directly on the sciatic nerve. Occasionally, sciatic pain in men is caused by sitting on a wallet.

How do I know if I have sciatica?

Pain that radiates from your lower (lumbar) spine to your buttock and down the back of your leg is the hallmark of sciatica. Sciatica may be accompanied by numbness, tingling, and muscle weakness in the affected leg. This pain can vary widely, from a mild ache to a sharp, burning sensation or excruciating discomfort. Sometimes it may feel like a jolt or electric shock. Sciatic pain often starts gradually and intensifies over time. It’s likely to be worse when you sit, cough or sneeze.

How is Sciatica Treated?

The vast majority of the time, sciatic pain can be relieved through a combination of stretches, deep tissue massage of the piriformis muscle and chiropractic care. Occasionally, in cases where chronic spasm of the low back or piriformis muscles is causing the sciatic pain, it may be necessary to do a procedure called a trigger point injection, where a medical pain specialist injects a small amount of anaesthetic directly into a spasmed muscle to break the spasm cycle.

(Listed in our Cold Laser Therapy Section .)

Complementary and alternative medicine

Complementary and alternative medicine (CAM) refers to medical and health care systems, practices, and treatments that aren’t currently part of conventional medicine, i.e. the care you receive in your primary care doctors’ surgery. Many of these therapies and treatments are being studied intensely and some have proved to help alleviate back pain.  

o    Massage. To conduct an objective clinical trial in massage can be difficult due to variances in practitioners and in massage types however, studies that have been conducted suggest that massage may ease low back pain symptoms by reducing muscle spasm.

Risk factors.

The greatest risk factors for sciatica include:

o    Age related changes in the spine are a common cause of sciatica. You’re likely to have some deterioration in the discs in your back by the time you’re in your late 20s, and most people who develop herniated discs are in their early 30s and 40s and Previous injuries from sport and work related, activity are also common factors.

o    Occupation. jobs that requires you to twist your back, and carry heavy loads, driving a motor vehicle for extended periods makes you more prone to develop sciatica.

o    Prolonged sitting. People who sit for prolonged periods or have a sedentary lifestyle are more likely to develop sciatica than people with active lifestyle.

o    Diabetes. This condition, which affects the way your body uses blood sugar, increases your risk of nerve damage.

When to seek medical advice Seek immediate medical treatment if:

o    You experience sudden, severe pain in your low back or both legs and  numbness or muscle weakness in either or both of the legs.

o    The pain follows a injury, from a traffic or work related accident

o    You have trouble controlling your bowels or bladder.

·         Seek medical advice urgently.

Screening and diagnosis of sciatica.

To help diagnose sciatica and pinpoint which nerves, if any, are affected. your Physiotherapist will ask about your medical history and perform a thorough physical exam, paying special attention to your spine and legs.

You’re also likely to have some basic tests that check your muscle strength and reflexes. For example, you may be asked to walk on your toes or heels, and, while lying on your back, lift your legs one at a time straight in the air. Pain that results from sciatica will usually become worse during this examination.

If your pain lasts longer than four weeks or is very severe, or you have another serious condition such as cancer, you may have one or more imaging tests to help identity why the sciatic nerve is compressed and to rule out other causes for your symptoms’ 

These tests include:

o    Spinal X-ray. Because ordinary X-rays can’t detect herniated disc problems or nerve damage, they’re not usually helpful for pinpointing the cause of sciatica. A spinal X-ray can show most cancers affecting the bony structures of the spine, narrowed discs and spondylolisthesis, however, and can help rule out other causes of nerve root impingement.

o    Magnetic resonance imaging (MRI).

        This is probably the most sensitive test for assessing sciatic nerve pain. Instead of X-rays, MRI uses a powerful magnet and radio waves to produce cross-sectional images of your back. The test can detect damage to your discs and ligaments as well as the presence of tumors. MRI is non-invasive and has no harmful side effects. During the test; you lie on a movable table inside the MRI machine, which is essentially a large magnet. If you have a hard time lying still for the required period of time or you’re anxious about the enclosed space, you may be given a sedative. Some MRI units may be wider, shorter or open on all sides, which may be more comfortable for you, although the quality of images taken with these systems may vary. 

o    Computerized tomography (CT) scan. This test uses a narrow beam of radiation to produce detailed, cross-sectional images of your body. When CT is used to image the spine, you may have a contrast dye injected into your spinal canal before the X-rays are taken a procedure called a CT myelogram. The dye then circulates around your spinal cord and spinal nerves, which appear white on the scan 

Complications of Sciatica.

Although people recover from sciatica, sciatica can potentially cause permanent nerve damage. Depending on what’s causing the nerve to be compressed, other complications may occur,

They included

o    Loss of feeling, may affected one or both or legs.

o    Loss of movement may affected one or both legs

o    Loss of bowel or bladder function

Different Treatment of Sciatica Include following:

Physical therapy.

For a herniated disc, physical therapy can play a role in your recovery. Once acute pain is reduced and range of movement improves a physical therapist or Chiropractor can design a rehabilitation program to help prevent further injuries. Rehabilitation includes exercises to help correct your posture, strengthen the muscles supporting your back and improve your flexibility. Physical therapy, exercises should be Started as early as possible. 

Prescription drugs. 

Doctors may prescribe an anti-inflammatory medication along with a muscle relaxant. Narcotics also may be prescribed for short-term pain relief. Antidepressants and anticonvulsant drugs can be used in easing chronic pain. They may help by blocking pain messages to the brain or by enhancing the production of endorphins, the body’s natural painkillers. 

More invasive treatment   Epidural steroid injections.

In some cases, doctors may inject a corticosteroid medication into the affected area. Corticosteroids mimic the effects of the hormones cortisone and hydrocortisone, which are made by the outer layer (cortex) of your adrenal glands; Corticosteroids suppress inflammation around the irritated nerve thus giving pain relief. Their usefulness in treating sciatica remains a matter of debate. Some research has found that corticosteroids can provide short-term symptom relief, but that these medications aren’t a long-term solution. In addition, corticosteroids can have side effects, so the number of injections you can receive is limited usually no more than four per joint.

Surgery.

This is usually occurs when the compressed nerve causes significant weakness, bowel or bladder incontinence, (when this occurs seek medical advice urgently) or you have pain that gets progressively worse or does not improve.Surgical options include lumbar laminectomy and microdiscectomy. In lumbar laminectomy with discectomy, surgeons remove a portion of a herniated disc that’s pressing on a nerve. Most of the disc is left intact to preserve as much of the normal anatomy as possible. Sometimes a surgeon will perform this operation through a small incision while looking through a microscope (microdiscectomy).

Success rates of standard discectomy and microdiscectomy are about equal, but you may have less pain and recover more quickly with microdiscectomy. Discuss which option might be best for you with your doctor, and carefully weigh the potential benefits of surgery against the risks as surgery is not always successful.

                        (Always get a second opinion).

 Prevention

 Exercise regularly.

This is the most important thing you can do for your overall health as well as for your back. Pay attention to your core muscles the muscles in your abdomen and lower back that are essential for proper posture and alignment. For cardiovascular benefits, try using an exercise bike or treadmill. Swimming is also recommended. 

Maintain proper posture when you sit.

A good chair should comfortably support your hips, and the seat should not press on the back of your thighs or knees. If the chair does not support the natural curve in your lower spine, place a rolled towel or pillow behind your back. When working at a computer, adjust your chair so that your feet are flat on the floor and your arms rest on your desk or the chair’s arms, with your elbows bent at a right angle. Take frequent breaks every 20 minutes, even if it’s just to walk around your office a little stretching will also help.

Driving.  

Before setting off adjust your seat to keep your knees and hips level, and move the seat forward to avoid overreaching for the pedals. 

Using body mechanics. 

Being aware of how you stand and lift heavy objects and even how you sleep can go a long way toward keeping your back healthy. That’s because poor posture stresses your back, leading to fatigue and stress on joints and nerves. Always hold reading material at eye level instead of bending forward, and if you’re standing for long periods rest one foot on a raised object about the height of a foot stool. Before you lift something heavy, decide where you’ll place it and how you’ll get it from A to B. Bend at your knees, not your back, so that your legs do the lifting. Carry objects close to your body at about waist level. If possible, set the object down on a surface between shoulder and knee height to avoid lifting objects over your head or bending over too far. Don’t twist at your waist. Instead turn by pivoting your feet. Be careful moving heavy things when you become tired, Tiredness can cause you to move more awkwardly than normal. Heavy loads are the greatest risk to your spine, so know your limitations. Don’t attempt to lift something that is beyond your normal ability.

 Try the following measures:

o    Cold or ice packs. Initially using cold packs may be able to reduce inflammation and relieve discomfort. Wrap an ice pack in a thin towel and apply to the painful areas for 15 to 20 minutes at least 7 times a daily.

o    Stretching. Stretching exercises for your low back can help you feel better and may help relieve nerve root compression. Avoid or sudden movements and twisting during the stretch and try to hold the stretch as long as possible. Around 40 seconds per stretch if possible.

o    Medications.

        Pain killers (analgesics) fall into two categories those that reduce pain and inflammation and those that only treat pain. Nonsteroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen, and acetaminophen (Tylenol,) will be helpful for sciatica. Although they provide real relief, both types of medication have a limit to how much pain they can reduce. If you have moderate to severe pain, exceeding the recommended dosage will not provide any additional benefits. In addition NSAIDs can cause side effects such as nausea, stomach bleeding or ulcers, and acetaminophen can cause liver problems.

If you’re using these medications, you should talk to your GP so that you can be monitored for any arising problems. Periodically reassess whether you still need drug treatment or not. Exercise, stretching, massage and other none drug treatments can often provide the same benefits without side effect. 

Regular exercise. 

It may seem counterintuitive to exercise when you’re in pain, but regular exercise is one of the best ways to combat chronic discomfort. Exercise prompts your body to release endorphins chemicals that prevent pain signals from reaching your brain. Exercise in moderation. In the early stages of sciatica, swimming or other low-impact exercise such as an exercising bicycle will help you stay active without worsening your symptoms. Later, as you improve and the pain becomes less combining aerobic activity with strength training and core stability exercises that improve the strength of your back muscles can help limit the effects of degenerative changes in your spine.

Start out slowly and progress to at least 45 minutes every day. This may prevent further injury.

Cold laser Therapy/Treatment.

Low Level Cold Laser Therapy (LLLT) is a Handheld, non invasive, light-emitting medical device which is used over different areas of the body. It provides an unmatched advantage in the treatment of conditions such as Athletic and sports injuries;

Chronic Neck and Back pain.

Back Pain and injuries.

Lower back Pain.

Slipped disc.

Prolapsed disc.

Herniated disc.

Bulging disc.

Sciatica. 

Trapped Nerves.

Stiff Back.

Knee and Foot Pain
Shoulder Injury
Carpal Tunnel Syndrome
Arthritic pain relief, Muscle Spasm
Relief of Muscle and Joint Pain
Skin infections, including cold sores
Relief of Stiffness, the Promotion of Muscle Relaxation, and Cell Restoration

Wound Management  including Skin Ulcers, Pressure Sores and Burns

Soft Tissue Injuries including Sprains and Strains, Tendonitis and Haematomas.

Joint Disorders and Conditions including Arthritic pain relief and Tenosynovitis

Chronic pain including Trigeminal Neuralgia and Chronic Neck and Back pain.

Cold Laser Therapy is used at our clinic for pain relief and treatment of ligament and tendon injuries, muscle sprains by reducing pain and accelerating the healing process.

For further in depth information on “Back Pain, lower back pain”  “Conditions”  “Treatments” and “Cold Laser Therapy”. Please go to top left corner.