Twisted Vertebrae — What is Spinal Rotation?

A woman in the supine position twists her spine by bringing her knees to one side.
Supine spinal twist. cirkoglu

The phrase "twisted spine" may conjure up all sorts of unsavory things in your imagination: Hunchbacks, broken bones, injury risks or an urgent need to see your chiropractor. But let's unpack this term just a bit, to allay your fears and help you address your pain in an appropriate for you kind of way. 

Twisted Spine - How Capable is Your Back, and How Capable Should It Be?

The spine can do several movements, of which twisting is one.

The others include bending or rounding forward, tilting sideways (often powered by the same muscles that twist the spine) and extending or arching backwards.

And the spine is made of 26 interconnected bones, called vertebrae. When you perform the above-mentioned movements, it's actually each individual vertebrae that set the direction for the entire column. You might think of the vertebra as underpinnings or structure for spinal motion.

Although the well-being of your back relies to a great extent on your ability to perform all the movements (again, bending, tilting, twisting and arching,) limits exist as to how far you should go. This is especially true with twisting — rotated or twisted vertebrae, especially in conjunction with forward bending, as when lifting heavy objects without minding the rules of good body mechanics —  is associated with back injuries like strain and herniated disc.

Twisting the Vertebrae, or Intro to Spinal Rotation

Rotation is a basic spinal movement in which you turn the spinal column around itself (called turning around the axis, with the axis being the spine.) When you twist your spine, it also bends to the side as a secondary part of that action. This is due to the way the vertebra fit together.

The internal oblique abdominals and the external oblique abdominals are the muscles primarily responsible for powering spinal rotation in the lower back.

Age and Spinal Rotation

Most people, especially as they age, accumulate tension in the obliques and other trunk muscles. This tension is largely attributable to sedentary behavior, by the way. The problem is, by reducing trunk range of motion,  this accumulated ab tension diminishes our ability to twist our spines, as well.

Being sedentary may also lead to weak muscles, which, in turn, may decrease support for any spinal movement, including twisting. Muscle weakness is another thing that may decrease overall trunk stability.

Spinal Rotation and Scoliosis

Scoliosis is often called a lateral curve of the spine, suggesting displacement off to the side of some of the vertebra. While this may seem true upon visual inspection, a more careful examination may reveal that an abnormal vertebral rotation underlies this side-to-side displacement. Treatment for scoliosis is often focused on decreasing the degree of the vertebral rotation. As far as curative activities for scoliosis is concerned, consult with your doctor and/or physical therapist for guidelines.


Don’t Risk Your Back -- The Dangers of Over Rotating

Many people over rotate their spines during the work-intensive winter (shoveling snow) as well as summer months (think gardening and home construction projects.)   Unfortunately, they often pay for it with a back injury.

Generally speaking, workers who over-rotate while digging a garden or shoveling snow have either not learned how to safely shovel (or perform similar tasks) or  they aren't willing to make the extra effort to step around before letting go of the shovel's contents. In other words, rotating your spine in order to dump a shovelful of snow or garden dirt behind you may seem easier while you’re in the throes of your project, but overall, this is much riskier for your back than simply taking a few steps around and flipping the shovel down instead.

In a 1997 review of studies, the Centers for Disease Control concluded that lifting heavy objects with your back twisted (as well as other awkward work postures) is indeed a risk factor for work-related injury.

How to Develop Your Spinal Rotation

Perhaps the best way to achieve optimal rotation of your spine is to do your back exercises daily.

A good back exercise program will consist of movements in every direction the spine moves, including rotation. Yoga is great for this because it places emphasis on developing flexibility and strength in all directions. (Pilates does the same.) 

But rotation may irritate some back problems, such as herniated disc. If you have a condition, talk to your doctor or physical therapist about how you can safely rotate your spine or move in any of the other directions as you exercise.

A good injury prevention exercise program will also work your hip and pelvic muscles, too.


Bernard, B., P., MD, MPH. Musculoskeletal Disorders and Workplace Factors: A Critical Review of Epidemiologic Evidence for Work-Related Musculoskeletal Disorders of the Neck, Upper Extremity, and Low Back. U.S. Department of Health and Human Services. Public Health Service. Centers for Disease Control and Prevention. National Institute for Occupational Safety and Health. July 1997.