What is T4 Syndrome (Back Pain Problem)


What is T4 Syndrome (back pain problem)? Symptoms, Diagnosis and its significance?

The upper back (thoracic spine) comprises of 12 bones known as vertebrae. There are 12 thoracic vertebrae named T1 to T12 from the top of the upper back to the bottom of the upper back. During certain movements of the spine, stretching or compressive forces are placed on the facet joints and discs at the T4 level. If these forces are excessive and beyond what the joints can withstand, injury to the facet joints or discs may occur, this results in irritation or damage to the adjacent nerves at the T4 level and the patient experiences diffuse arm pain, pins and needles or numbness in the upper arm this leads to T4 syndrome.

Signs and symptoms of T4 syndrome

  • Diffuse arm pain
  • Sensory symptoms such as pins and needles or numbness in the upper arm.
  • Pain in the upper back and occasionally in neck
  • Symptoms may develop suddenly during the causative activity.
  • Symptoms are typically felt in one arm or on one side of the upper back although occasionally both sides may be affected.
  • Pain may also be referred into the shoulder blade, ribs and chest.
  • Muscle spasm, stiffness and restricted spinal movement

Aggravating factors

  • Twisting
  • Lifting
  • Arching backwards
  • Bending forwards or sideways
  • Sitting for prolonged periods of time
  • Coughing or sneezing

How to diagnose T4 syndrome:

A thorough examination from a physiotherapist is usually sufficient to diagnose T4 syndrome. MRI or CT scan may be needed to confirm diagnosis.

Risk Factors

  • Poor posture
  • Thoracic spine stiffness
  • Sedentary lifestyle
  • Poor core stability
  • Muscle weakness or tightness
  • Inappropriate lifting technique
  • Prolong sitting,
  • Repeated bending,
  • Activities involving the use of hands in front of the body

Physiotherapy for T4 syndrome

  • Myofascial release
  • Manual therapy to thoracic spine
  • Electrotherapy
  • Postural correction
  • Taping
  • Dry needling
  • Ergonomics
  • Life style modification
  • Pilates
  • Strengthening exercises 

Check out these links for relevant information: Neurological physiotherapy, Pain management,

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