Blog Update


T4 syndrome is a medical condition affecting the joints within the thoracic vertebrae of the spinal column, causing pain, paresthesia, reduced mobility and discomfort.

At Esther’s place well-being hub, we specialize in T4 syndrome to empower recuperation or recovery, improve spinal loading and reduce pain.

Within the thoracic spine, there are 12 vertebrae which facilitate spinal movement and provide support. The vertebrae joints comprises of the vertebral discs and facet joints; and a dysfunction, general wear and tear or traumatic injury to these bones can compress, pinch or irritate the nearby nerves, causing pain and discomfort to the back. This pain is usually felt in the upper body, typically down the arms, in the head, neck and chest area (inner portion of the sternum). The nerve compression or joint dysfunction at the 4th thoracic vertebra causes T4 syndrome.

T4 syndrome is somehow referred to as “diagnosis of exclusion” because it is only diagnosed when presentation and symptoms do not match with other spinal conditions. T4 syndrome is relatively uncommon condition, and its diagnosis is even rarer due to the complexities and other potential sources of pain in the back which needs to be ruled out.

Causes of T4 syndrome

  • poor posture
  • heavy lifting or strenuous activity
  • hypermobility
  • sudden movement which may overload or overextend the spin
  • change in routines which involve novel movement
  • underlying thoracic dysfunction

Symptoms of T4 syndrome

As a diagnosis of exclusion, T4 syndrome is mainly identified through pain presentation, pattern and response to muscle relaxants and other medications. Associates between the clinical presentation and the specific range of restricted movements is important. Some symptoms includes:

  • Back pain which worsens with applied pressure/ when palpated (touched), at night and with movements involving the thoracic spine (ie. Sitting, lying on a bed)
  • soreness, tenderness or numbness in the back
  • Tingling or pins and needles sensation
  • Poor reflexes or sensory problems
  • Difficulty with movement
  • Reduced range of motion
  • Gait, posture and balance issues
  • Pain at the upper back and chest area simultaneously.


If you have any of the listed symptoms, it is important to have it assessed by a physical therapist or physiotherapist. The therapist will then be able to rule out any other conditions. They may also refer you for a scan (CT scan, MRI or X-ray).


At Esther’s Place Well-Being Hub, we design a therapeutic modality to best fit your recovery goals through:

  • Stretching exercises
  • strengthening, conditioning and balance techniques
  • restoring range of movement
  • massage (soft tissue mobilizations)
  • TENS treatment
  • Ultrasound therapy
  • Shockwave therapy
  • Heat therapy (infrared treatment)
  • Taping
  • Graded exposure to load program
  • Home exercise and self-management techniques

At Esther’s Place well-Being Hub, your physical therapist may also advise you on thermal or cryotherapy (heat and ice application) and rest. Additionally, they might recommend for the use of spinal support (braces) or therapeutic pillow which is already available at the center.

A Sound Mind in a Sound Body

At Esthers Place, we are committed to providing our clients with the highest quality care and support.

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