Thoracic spondylosis: causes, treatments, and exercises

The middle part of your back, known as the thoracic spine, plays a crucial role in supporting your upper body and, along with your rib cage, protecting your heart and lungs. Your spine is strong and resilient, but it’s normal for changes to happen over time that might lead to occasional discomfort or stiffness. This includes spondylosis, or age-related arthritis of the spine.

While the term might sound concerning, thoracic spondylosis is common with age, says Laura Plankis, PT, DPT, a physical therapist at Hinge Health. In fact, as many as 90% of people age 60 and older have it. Most people don’t even know they have thoracic spondylosis because it often doesn’t cause any symptoms. But if your mid-back is feeling stiff or tight, conservative treatments such as targeted exercises and stretches can help increase your spine mobility and alleviate pain.  

Here’s a closer look at thoracic spondylosis, including causes, symptoms, and how to treat it, especially with exercises recommended by Hinge Health physical therapists.

What is thoracic spondylosis?

Thoracic spondylosis is a condition where the middle part of the spine experiences normal age-related changes that can affect the joints, discs, cartilage, and vertebrae (bones). These changes might lead to some stiffness or discomfort, but they are usually just part of how your body adapts over time, Dr. Plankis says.

What causes thoracic spondylosis? 

Age increases your risk of thoracic spondylosis, says Dr. Plankis. Other factors include:

• Genetics. If a close family member — like a parent or sibling — has thoracic spondylosis, you may be more at risk of developing it as well, says Dr. Plankis.

• Past injury. A fall or accident that injured your discs, joints, and ligaments can make you more prone to thoracic spondylosis, says Dr. Plankis. Past injuries can contribute to tension or stiffness in the area, making the spine more prone to changes. 

• Sedentary lifestyle. Staying active can help protect your thoracic spine. “Regular exercise supports spinal health by boosting blood flow and slowing age-related changes,” says Dr. Plankis.

• Smoking. Research has shown that smoking tobacco can speed up spondylosis, as it restricts blood flow to the spine, leading to inflammation.  

• Nutritional deficiencies. Low calcium and vitamin D levels can make you more susceptible to spondylosis, including thoracic spondylosis, as these nutrients are crucial for bone health.

Thoracic spondylosis symptoms

If you develop thoracic spondylosis, you may notice the following:

• Back and neck pain

• Stiffness, especially in the middle of your back

• Limited range of motion (difficulty bending or twisting your back)

• A creaky or clicking sound in your back when you move

As the condition progresses, the discs that cushion your spine can shift and put more pressure on nearby nerves.

These dynamic stretches and strengthening moves can help improve mobility in your spine, ease tension, and reduce pain from thoracic spondylosis. Try doing these exercises daily to make everyday movements, such as reaching, bending, and lifting easier.

The information contained in these videos is intended to be used for educational purposes only and does not constitute medical advice or treatment for any specific condition. Hinge Health is not your healthcare provider and is not responsible for any injury sustained or exacerbated by your use of or participation in these exercises. Please consult with your healthcare provider with any questions you may have about your medical condition or treatment.

Treatments for thoracic spondylosis

Thoracic spondylosis can make you feel stiff and achy, which can cause pain. Often, conservative treatments can help relieve tension and reduce discomfort, says Dr. Plankis. These include:

• Try physical therapy and targeted exercises. Targeted exercises can help break up tension and improve range of motion in your spine, so you can move easier. You can do exercise therapy at home or work with a physical therapist who can guide you through movements tailored to your needs. You can see a physical therapist in person or use a program like Hinge Health, where you may access a PT via telehealth/video visit.

• Get active. When your back feels off, it’s understandable you’d be hesitant to work out. But movement is medicine. Staying still may intensify your symptoms, says Dr. Plankis. Regular activity can promote relief by enhancing blood flow and delivering healing nutrients to the area. Find activities you enjoy, like walking, swimming, or biking, to help you feel better and make exercise fun.

• Apply heat or ice. While either may help you feel better, heat may be especially helpful since it relaxes tight muscles that contribute to thoracic spondylosis discomfort, says Dr. Plankis. But consider trying both methods to see which one feels best for you. 

• Take over-the-counter (OTC) medication. Pain relievers such as ibuprofen (Advil, Motrin), naproxen (Aleve), and acetaminophen (Tylenol) can be helpful for back discomfort. It’s important to make sure that you are safely able to take these medications, based on your medical history.

• Complementary treatments. Talk to your provider if you’re interested in trying alternative treatments for back pain relief, such as massage, acupuncture, or chiropractic care. Research suggests chiropractic care can help relieve pain and stiffness associated with thoracic spondylosis. For this type of treatment, also known as spinal manipulation, chiropractors use their hands to apply pressure to bones and joints to improve alignment in the body for better function and less pain.

• TENS therapy. TENS, or transcutaneous electrical nerve stimulation, uses gentle electrical impulses to interact with your nervous system and help reduce pain associated with conditions like thoracic spondylosis. One option is the wearable device Enso, available through Hinge Health. It’s small, wireless, and portable. 

PT tip: Take movement breaks

Sitting in one position for too long can make anyone’s back feel stiff, ‌but even more so if you have a condition like thoracic spondylosis. “To manage discomfort and improve your mobility, try to move your back in different positions,” says Dr. Plankis. Taking movement snack breaks every 30 minutes or so to stand up and walk, or do one of the exercises listed above, can help. Another option: while sitting, take a moment to arch your back to relieve tension, says Dr. Plankis.

How Hinge Health can help you

If you have joint or muscle pain that makes it hard to move, you can get the relief you’ve been looking for with Hinge Health’s online exercise therapy program.

The best part: You don’t have to leave your home because our program is digital. That means you can easily get the care you need through our app when and where it works for you.

Through our program, you’ll have access to therapeutic exercises and stretches for your condition. Additionally, you’ll have a personal care team to guide, support, and tailor our program to you.

See if you qualify for Hinge Health and confirm free coverage through your employer or benefit plan here.

This article and its contents are provided for educational and informational purposes only and do not constitute medical advice or professional services specific to you or your medical condition.

References 

1. Ravindra, V. M., Godzik, J., Guan, J., Dailey, A. T., Schmidt, M. H., Bisson, E. F., Hood, R., & Ray, W. Z. (2015). Prevalence of Vitamin D Deficiency in Patients Undergoing Elective Spine Surgery: A Cross-Sectional Analysis. World Neurosurgery, 83(6), 1114–1119. doi: 10.1016/j.wneu.2014.12.031

2. Harrop, J. S., Naroji, S., Maltenfort, M., Anderson, D. G., Albert, T., Ratliff, J. K., Ponnappan, R. K., Rihn, J. A., Smith, H. E., Hilibrand, A., Sharan, A. D., & Vaccaro, A. (2010). Cervical Myelopathy. Spine, 35(6), 620–624. doi: 10.1097/brs.0b013e3181b723af

3. Khurana, V. G. (2021). Adverse impact of smoking on the spine and spinal surgery. Surgical Neurology International, 12, 118. doi: 10.25259/sni_6_2021

4. Fujita, T. (1998). Degenerative joint disease: An example of calcium paradox. Journal of Bone and Mineral Metabolism, 16(4), 195–205. doi: 10.1007/s007740050046

5. Fedorchuk, C., Himel, B., & Lightstone, D. F. (2022). Improved Pain and Quality of Life with Corrected Thoracic and Lumbosacral Spondylolisthesis Subluxations Using CBP®: A Case Study and 1-Year Follow-Up. Journal of Radiology Case Reports, 16(2), 21–38. doi: 10.3941/jrcr.v16i2.4413