Background <p>Thoracic spine fractures (TSF) are increasing in prevalence. It is unclear which physiotherapy interventions are most effective for pain, physical function, and quality of life in people with TSF.</p> Objective <p>To investigate the effectiveness of physiotherapy interventions on pain, physical function, and quality of life in patients with TSF.</p> Data Sources <p>Academic Search Complete; CINAHL Ultimate; MEDLINE Complete; SPORT Discus, ProQuest, Science Direct, PubMed, and Cochrane were searched from inception to 2024.</p> Study Selection/Eligibility Criteria <p>Randomised controlled trials (RCTs) published in English, that investigated the effectiveness of any physiotherapy management techniques on pain, physical function, and Quality of life, for diagnosed adult TSF were included.</p> Study Appraisal and Synthesis Methods <p>Two reviewers independently screened and extracted the data of interest from the included studies using a standardized data collection form in Covidence. Outcome measures were synthesized using standard mean differences and meta-analysis was completed for primary outcomes (pain and physical function). GRADE tool was used to assess the quality of evidence for each outcome of interest.</p> Results <p>Six RCTs were included in the review. Evidence of very low certainty indicated that rigid bracing was associated with modest reductions in pain and improvements in physical function compared to conservative treatments. Findings for quality of life were inconsistent and limited by heterogeneity in outcome measures and follow-up periods.</p> Conclusion <p>Although rigid bracing shows potential short-term benefits for pain and functional improvement, the current evidence is insufficient to draw conclusions. Variability in study design, small sample sizes, and low methodological quality highlight the need for well-designed RCTs to establish evidence-based physiotherapy approaches for TSF management.</p>