Thoracic Spondylosis, a complex degenerative condition affecting the discs, vertebral bodies, and/or facet joints of the thoracic spine, requires a comprehensive treatment approach. A proven method for managing this condition is through chiropractic care.

Understanding Thoracic Spondylosis

Thoracic Spondylosis is a broad term which describes dynamic, interdependent degenerative changes that occur in the spinal region in response to stress and time123. Despite the commonality of these degenerative changes, particularly in the thoracic spine, the pain associated with them is relatively uncommon, accounting for only 2% of all spinal degeneration-related complaints45.

The Degenerative Cascade

The degenerative process in the spine, described as a “degenerative cascade” by Kirkaldy-Willis and Benard6, begins with repetitive micro-traumas that cause small circumferential annular tears. These initial “sprains” may or may not be painful, depending on the degree of innervation of the annular lamellae6.

As the degeneration progresses, the disc thins from cumulative stressors and by the loss of its normal viscoelastic properties over time7. This results in the body laying down additional bone in the form of osteophytes on the anterior and lateral vertebral body margins7.

Symptoms of Thoracic Spondylosis

Symptoms related to thoracic degeneration usually manifest insidiously, without a history of significant trauma8. The continuum of symptoms begins with axial complaints and sometimes advances to “radicular” as the degree of neurologic involvement increases8.

Clinical Findings and Diagnostic Tools

Clinical findings may include painful or limited thoracic range of motion9. Radiographic findings associated with spondylosis include loss of disc height, joint space narrowing, osteophytosis, subchondral sclerosis, vacuum phenomenon, and cyst formation10.

MRI is warranted when conservative care fails to improve symptoms after three to six weeks and in any case of progressive neurologic deficit10.

The Role of Chiropractic Care in Managing Thoracic Spondylosis

Chiropractic care is a proven method for managing thoracic spondylosis. It aims to relieve inflammation, reduce compressive forces, and restore normal mechanics11.

A primary risk factor for the development & progression of degeneration is joint dysfunction12, and chiropractic manipulation can restore joint function13.

Efficacy of Spinal Manipulative Therapy (SMT)

While studies evaluating the value of SMT for thoracic spondylosis are sparse, spinal manipulation has proven beneficial in the treatment of chronic back pain1415 and other thoracic spine complaints161718.

Contraindications to Spinal Manipulation

Though spinal manipulation can be hugely beneficial, there are instances where it may be contraindicated19. Severe degeneration is a contraindication to high velocity, low amplitude (HVLA) manipulation19.

Other Treatment Options

In addition to manipulation, other treatment options may include myofascial release, stretching, self-mobilization on a foam roller, ball, or other apparatus2021, and exercises to correct for the presence of upper crossed syndrome, lower crossed syndrome or paradoxical breathing22.

Medical Co-Management

Medical co-management may include prescription of Cox-2 inhibitors or muscle relaxants, facet blocks, thoracic epidural steroid injections, and in severe or recalcitrant cases, surgical intervention.


Thoracic Spondylosis is a complex degenerative condition that requires a comprehensive treatment approach. Chiropractic care, as practiced by professionals such as Dr. Noah Volz in Ashland, OR, offers a proven method for managing this condition and relieving the associated pain.


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