External vs. Internal Spinal Interference: How Fixation May Affect Nerves, Movement, and Cerebrospinal Fluid

By
Dr. Masoud Shamaeizadeh, DC
Soft Touch Chiropractic
Porter Ranch, CA
When people think about spinal problems, they often think only about neck pain, back pain, stiffness, or a pinched nerve. But the relationship between the spine and nervous system is more complex.
At Soft Touch Chiropractic, one useful way to explain this relationship is to divide spinal dysfunction into two broad patterns: external interference and internal interference.

• External interference involves altered spinal or rib mechanics that may irritate or place mechanical stress on nerves as they travel away from the spinal cord.
• Internal interference refers to restrictions around the skull, upper cervical spine, spinal canal, and sacrum that may influence normal movement and the environment surrounding the central nervous system, including cerebrospinal fluid (CSF) dynamics.

This framework can help patients understand why we evaluate more than simply the location where pain is felt.

What Is External Interference?The spinal cord is protected inside the vertebral column. Peripheral nerves leave the spinal column through openings between the vertebrae and travel throughout the body.
If a spinal segment or rib becomes restricted, rotated, or mechanically dysfunctional, the surrounding joints, muscles, connective tissues, and nerves may be affected.
Examples can include:
Cervical Fixation or Joint DysfunctionRestriction or altered mechanics in the neck may be associated with:

• Neck pain
• Muscle tightness
• Reduced range of motion
• Headaches in some patients
• Shoulder or arm symptoms when nerve structures are involved

Thoracic Fixation or RotationThe thoracic vertebrae are closely connected with the ribs. Therefore, thoracic dysfunction can also affect rib movement.
Possible symptoms include:

• Mid-back pain
• Stiffness
• Muscle imbalance
• Restricted rib movement
• Discomfort with breathing or rotation
• Irritation of nearby nerve structures

Rib Rotation or FixationThe ribs are not stationary structures. They move with breathing and trunk movement.
Abnormal rib mechanics may contribute to:

• Localized rib or mid-back pain
• Muscle spasm
• Pain during deep breathing
• Restricted thoracic movement

Lumbar FixationRestriction or dysfunction in the lumbar spine may contribute to:

• Low back pain
• Muscle tightness
• Limited mobility
• Hip or buttock discomfort
• Leg symptoms when peripheral nerve structures are irritated

EXTERNAL INTERFERENCE FLOW
Cervical Fixation
↓
Thoracic Fixation / Rotation
↓
Rib Rotation or Restricted Motion
↓
Lumbar Fixation
↓
Altered Joint + Muscle Mechanics
↓
Possible Irritation of Peripheral or Autonomic Nerve Structures
↓
Pain • Stiffness • Muscle Spasm • Altered Function

What Is Internal Interference?
​There is another concept that deserves attention: the internal environment surrounding the brain and spinal cord.
The brain and spinal cord form the central nervous system (CNS). They are surrounded by protective membranes and cerebrospinal fluid.
Cerebrospinal fluid performs several important functions. It helps cushion the brain and spinal cord, participates in nutrient and waste exchange, and contributes to maintaining the chemical environment required for normal nervous-system function.
From a biomechanical perspective, special attention may be given to areas such as:

• The skull
• The atlas (C1)
• Upper cervical spine
• Other cervical vertebrae
• Spinal canal
• Sacrum

Restrictions in these regions may change normal spinal mechanics. Researchers are also studying how posture, movement, breathing, sleep, vascular pulsation, and other physiological factors relate to CSF movement and waste clearance.
It is important, however, to distinguish this emerging area of research from established clinical fact: The key concept is not disease—it is function. We describe spinal interference in two categories: external interference and internal interference. External interference focuses on how spinal or rib fixation may affect the mechanical environment around peripheral and autonomic nerves. Internal interference focuses on how restrictions involving the skull, atlas, cervical spine, or sacrum may influence the mechanical environment surrounding the central nervous system and cerebrospinal fluid (CSF). The purpose of this discussion is not to claim that spinal fixation causes a specific disease, but to examine how these mechanical restrictions may influence normal movement, nervous-system function, and overall physiological function.
Why Cerebrospinal Fluid Is Important Cerebrospinal fluid is much more than simply “water around the brain.”
CSF helps:

• Cushion the brain and spinal cord
• Maintain the environment surrounding the central nervous system
• Transport certain nutrients and signaling substances
• Participate in waste exchange and clearance
• Protect delicate neurological structures

The brain also has a waste-clearance pathway commonly discussed as the glymphatic system, which is especially active during sleep.
Because of these important functions, maintaining healthy sleep, movement, circulation, hydration, breathing, and overall neurological health is important.

The Skull–Atlas–Spine–Sacrum ConnectionThink of the central nervous system as a continuous structure.
BRAIN / SKULL
↓
ATLAS (C1)
↓
CERVICAL SPINE
↓
THORACIC SPINE
↓
LUMBAR SPINE
↓
SACRUM
The brain transitions into the spinal cord at the base of the skull. The spinal cord then travels downward through the spinal canal.
This is one reason a chiropractic examination should not necessarily focus only on the painful area.
A patient complaining of low back pain may also have thoracic restriction, pelvic imbalance, muscle asymmetry, or cervical dysfunction. Likewise, someone with neck discomfort may have postural or mechanical problems extending farther down the spine.

External vs. Internal Interference — The Big Picture External Interference and Internal Interference Concept
Cervical fixationSkull/upper cervical restriction
Thoracic fixationAtlas/C1 restriction
Rib rotationCervical mechanical restriction
Lumbar fixationSacral restriction
Altered joint mechanicsAltered mechanics around the CNS
Muscle imbalancePotential influence on normal movement surrounding the spinal canal
Peripheral nerve irritation may occurCSF dynamics are considered as part of CNS physiology
Pain, stiffness, or radiating symptoms may occurSymptoms such as headache, neck pain, fatigue, or brain fog require evaluation because they have many possible causes
Could These Problems Cause Brain Fog, Fatigue, or Headaches?
Symptoms such as:

• Brain fog
• Fatigue
• Poor concentration
• Headaches
• Neck pain
• Back pain
• Stress and tension
• Difficulty focusing
• Anxiety or mood changes

can occur for many different reasons.
Musculoskeletal pain and chronic tension can certainly affect sleep, concentration, physical activity, and quality of life. However, symptoms such as persistent fatigue, cognitive changes, severe headaches, anxiety, or depression should not automatically be attributed to spinal fixation or CSF dysfunction.
A proper examination is important, and some symptoms require evaluation by an appropriate medical professional.

---

Why We Look Beyond the PainOne of the biggest mistakes in musculoskeletal healthcare is concentrating exclusively on where it hurts.
Pain is important, but it does not always identify the entire mechanical problem.
For example:
Muscle Imbalance
↓
Abnormal Pull on a Vertebra or Rib
↓
Joint Restriction / Altered Mechanics
↓
Additional Muscle Guarding
↓
Reduced Movement
↓
Pain and Dysfunction
If treatment addresses only the pain but ignores the mechanical pattern contributing to it, the underlying dysfunction may remain.
That is why an examination may include posture, spinal motion, muscle balance, rib mechanics, neurological findings, and other appropriate tests.

The Goal of Chiropractic CareAt Soft Touch Chiropractic in Porter Ranch, our goal is not simply to “crack” the spine.
We evaluate how the vertebrae, ribs, muscles, joints, and nervous system work together.
Depending on examination findings, care may be directed toward:

• Improving restricted spinal movement
• Addressing joint fixation
• Improving rib and thoracic mobility
• Reducing muscle imbalance
• Decreasing mechanical irritation
• Improving flexibility and range of motion
• Supporting better overall spinal function

Treatment recommendations should always be individualized according to the patient's examination and clinical needs.

Your Spine Is More Than a Stack of BonesYour spine is a dynamic structure surrounding and protecting one of the body's most important systems—the central nervous system.
The vertebrae, ribs, muscles, joints, spinal cord, peripheral nerves, and cerebrospinal fluid are anatomically and physiologically interconnected, although the exact effects of specific spinal restrictions on CSF flow and systemic health continue to be studied.
That is why chiropractic care should be based on a complete examination rather than symptoms alone.
If you are experiencing recurring neck pain, back pain, stiffness, headaches, restricted movement, or symptoms that may involve a nerve, consider having your spine properly evaluated.
Schedule an Evaluation
​Soft Touch Chiropractic
Porter Ranch, California
Dr. Masoud Shamaeizadeh, DC
Call: 818-831-0100
A thorough evaluation can help determine whether spinal or rib dysfunction is contributing to your symptoms and whether chiropractic care is appropriate for you.

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