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Thoracolumbar Spine ROM Norms

Reference values for back flexion, extension, side-bending and rotation, and how to measure them.

⚠️ For clinicians

This page is a measurement reference for physical therapists, occupational therapists, students and other clinicians. Patients with joint pain or stiffness should be examined by a licensed clinician.

Thoracolumbar Spine range of motion values from the CDC Normal Joint Range of Motion Study (where it measured this joint), the most-quoted reference values, and our clinicians’ goniometry steps for each motion. All values are in degrees.

On this page

Reference values at a glance

MotionAAOS reference valueVA rating schedule
Flexion—90°[1]
Extension—30°[1]
Lateral flexion (each side)—30°[1]
Rotation (each side)—30°[1]

The CDC study did not measure the spine, and we could not verify an AAOS value for the thoracolumbar spine from a source we could check, so this page lists only the VA rating schedule. The VA adds the six motions into a “combined range of motion,” with 240° as normal; its numbers are written for disability rating and are the maximum it counts, not average values. Trunk measurements mix hip and pelvic motion with spinal motion, so method matters more here than at most joints.

AAOS and VA numbers are single reference values, not averages. A dash means we could not verify a value from a source we could check, so we left it out.

Goniometry guide[2]

Our clinicians’ step-by-step method for each motion. Use the same position, landmarks and instrument every time you retest.

Flexion and extension

Patient position
Standing, feet hip-width apart, knees straight.
Stabilize
Watch the knees and pelvis; for lumbar-only motion use two inclinometers, one at the thoracolumbar junction and one on the sacrum, and subtract.
Axis (fulcrum)
With a goniometer: lateral trunk at the level of the iliac crest.
Stationary arm
Vertical (perpendicular to the floor).
Moving arm
Along the mid-axillary line toward the axilla.
Watch for
Knee bending, hips driving the motion, leaning to one side. A goniometer records trunk plus hip motion; name the method you used.
Typical end-feel
Firm.

Lateral flexion

Patient position
Standing, feet hip-width apart.
Stabilize
Keep both heels down and the trunk out of flexion or rotation.
Axis (fulcrum)
Over the posterior S1 spinous process.
Stationary arm
Vertical (perpendicular to the floor).
Moving arm
Along the spinous processes toward C7.
Watch for
Bending forward or twisting, lifting the opposite heel, knee bending.
Typical end-feel
Firm.

Rotation

Patient position
Sitting on a stool, feet flat, to block pelvic rotation.
Stabilize
Keep the pelvis still.
Axis (fulcrum)
Center of the top of the head.
Stationary arm
Parallel to a line between the iliac crests.
Moving arm
Parallel to a line between the acromion processes.
Watch for
Pelvis turning, side-bending, the head turning separately from the trunk.
Typical end-feel
Firm.

Measurement notes

  • Active or passive: say which you measured. The CDC values are passive.
  • Record the method: position, instrument and anything that changed (pain, guarding, a different start position) so the next measurement is comparable.

Other joints

Sources, review and disclosures

Graded citations

How we grade sources. A = population study of healthy people with published methods (CDC). B = widely used consensus reference values, as reported in a textbook or peer-reviewed paper; these are single “normal” numbers, not measured averages. C = U.S. government rating standard written for disability evaluation, not as clinical norms. D = expert clinical opinion.

  1. Grade C U.S. Department of Veterans Affairs. Schedule for Rating Disabilities, 38 CFR §4.71a, General Rating Formula for Diseases and Injuries of the Spine, Note (2). ecfr.gov (38 CFR 4.71a)
  2. Grade D Holsman Physical Therapy clinical guidance. Goniometry steps, common errors and end-feels written in our own words by Holsman physical therapists and reviewed by Dr. Richard Holsman, PT, DPT, NCS. Expert opinion, not a research source.

Reviewer

Reviewed by Dr. Richard Holsman, PT, DPT, NCS (Board-Certified Clinical Specialist in Neurologic Physical Therapy), founder of Holsman Physical Therapy. Last reviewed: November 13, 2026.

Change log

  • November 13, 2026: Page published. All CDC values checked against the CDC page and Soucie et al. (2011); reference values checked against the cited sources.

Review policy

We re-check every number on this page against its source at least once a year, and sooner if a source is updated or a reader reports a problem. Changes are listed in the change log with the date. To report an error, contact us.

Licensing

Source: CDC. The CDC normative values are a U.S. government work in the public domain (CDC Stacks marks the study’s data documents “Public Domain”), used under CDC’s Use of Agency Materials terms. The values are shown as published, and the original material is available on CDC’s website at no charge. Our use of CDC material and links to CDC do not imply endorsement by CDC, HHS or the U.S. Government. The VA values come from a federal regulation (38 CFR), also public domain. AAOS values are cited as individual numbers with credit to the publication that reports them; no table layout or text is copied. The goniometry guide is original text by Holsman Physical Therapy.

Conflict of interest and advertising

This page is published by Holsman Physical Therapy and Wellness, P.C., which runs outpatient and in-home therapy practices; that is our only commercial interest. The page carries no advertising, no sponsorship and no affiliate links, and we received no payment from any source for it. We do not sell goniometers or apps. Holsman Physical Therapy is not affiliated with the CDC, the VA, the AAOS, or the authors and publishers cited, and they do not endorse this website.

For clinician education. Norms vary; interpret with clinical judgment. Range of motion differs with age, sex, body type, activity, measurement position, instrument, and whether motion is active or passive. A value outside a reference range is not a diagnosis. Compare with the uninvolved side, retest with the same method, and read the number alongside the patient’s symptoms and function.

Common Questions

What is normal back flexion?

The VA rating schedule uses 90 degrees of thoracolumbar flexion as normal, 30 degrees of extension, and 30 degrees each for side-bending and rotation. These are rating values, not averages from healthy people.

Why is there no CDC or AAOS chart for the back?

The CDC study measured only the shoulder, elbow, hip, knee and ankle, and we could not verify an AAOS thoracolumbar value from a source we could check, so we show only the VA values.

Referring a Patient?

Holsman physical therapists see patients at clinics across North Jersey, the Bronx and Brooklyn, plus in-home visits.

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