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T4 Syndrome

What is T4 Syndrome?

T4 syndrome occurs when the T4 vertebrate in the spine is damaged and causes pain in the arm. The vertebrae bones which make up the spine are named T1 to T12 from top to bottom. Between each of these vertebrae lie the facet joints and discs which help support the weight and control the movement between the individual vertebrae. When either of these joints become damaged or injured, damage in turn can be inflicted on the nerves which surround the joints. The most common area for this injury lies in the T4 vertebrate due to the nature of its position whilst performing certain movements. When the nerves become damaged and the patient experiences arm pain as a result this is known as T4 Syndrome.


  • Excessive bending, lifting and twisting
  • Overuse injury
  • Poor posture


  • Arm pain and nerve symptoms i.e. pins and needles, numbness
  • Sudden or gradual onset of pain in the back and neck
  • Pain when resuming activity
  • Weakness, aching and stiffness in the area
  • Pain may be felt in the chest, rib cage or shoulder blade


  • RICE method (Rest, Ice, Compression, Elevation)
  • Physiotherapy
  • Posture evaluation
  • Postural back brace

T4 Syndrome Diagnosis

In order to diagnose T4 syndrome, a doctor or physiotherapist will give an examination of the area and often an X-ray or MRI scan will be undergone in order to confirm the diagnosis and also to rule out any further complications.

Where Is The T4 Vertebra?

The T4 vertebra is the fourth thoracic vertebra in the spine. There are twelve in total, the fourth is located in the upper back.

Further Info

The most common cause of T4 syndrome is overuse injury and it usually seen in patients who perform excessive amounts of bending, lifting and twisting movements seen in sports such as gymnastics and pole dancing. T4 syndrome however can also occur due to impact or pressure to the spine causing damage to happen suddenly. This injury is also common in patients who have a poor posture over a period of time for example sitting at your office chair without effective back support. When a patient sustains T4 syndrome sprain they will begin to feel pain and often sensory symptoms such as pins and needles or numbness in their arm as a result of nerve damage. Patients are also likely to feel a pain in the back and often the neck which becomes more apparent over time as activity is resumed and the back is put under more strain. In the case of sudden impact, the pain may come on suddenly at the point of injury. Patients are also likely to feel pain and stiffness in joint even after activity is halted which will become more apparent first thing in the morning. In more severe cases, individuals may also feel pain in the rib cage, chest and shoulder blade. In order to treat T4 Syndrome, rest is crucial in order to allow the injury time to heal and to prevent any further activity which could cause damage or discomfort to the injury. Applying ice to the injury is an important aspect of healing as it will reduce any swelling and inflammation as well as providing cooling pain relief to the injury. Using the RICE method (Rest, Ice, Compression and Elevation) is beneficial for the first 72 hours of the injury occurring as it will reduce swelling to the area and by keeping the injury elevated blood flow is restricted which can prevent further inflammation. Anti-inflammatory medications can also be taken in order to reduce swelling as well as relieving pain or achiness from the injury. When the injury has begun healing and you are advised by a physiotherapist or doctor, it is important for the patient to undergo a rehabilitation program such as strengthening and stretching exercises which will keep the area strong and make it easier to return to sports once the injury has fully recovered. These exercises should not be carried out if the patient feels pain in the area and the advice of a physiotherapist should always be sought in order to obtain an exercise regime suitable for the individual. If the injury has occurred as a result of poor posture or is a reoccurring injury, the patient may find it beneficial to re-evaluate their back posture as well as their technique if sustained whilst lifting and bending. This may put a stop to any bad habits which have caused the injury in the first place and prevent it from happening in the future. The patient may also choose to use a postural brace to correct any poor posture issues.