T4 Syndrome: Causes, Symptoms & Physiotherapy Guide
What is T4 Syndrome?
T4 Syndrome is a condition that arises due to dysfunction of the T4 vertebra in the thoracic spine. It commonly causes upper back pain, headaches, and symptoms radiating into the arms or hands. This condition is often related to posture or mechanical stress on the upper thoracic spine.
Causes of T4 Syndrome
- Poor posture, especially prolonged forward head posture
- Repetitive stress on the upper thoracic spine
- Prolonged computer or desk work
- Trauma or injury to thoracic vertebrae
- Muscle imbalance or tightness
Signs and Symptoms
- Upper back or shoulder pain
- Headaches (especially in the morning)
- Paresthesia (numbness or tingling) in arms or hands
- Heaviness or cold sensations in upper extremities
- Restricted thoracic spine mobility
Diagnosis
Diagnosis of T4 Syndrome is usually clinical, based on history and physical examination. It involves excluding other serious conditions such as cervical radiculopathy or thoracic outlet syndrome. Imaging like X-rays or MRI may be done to rule out structural issues.
Physiotherapy Management
- Postural correction and education
- Thoracic spine mobilizations and manipulations
- Myofascial release techniques
- Strengthening of back and scapular stabilizing muscles
- Stretching of pectoral muscles
- Home exercise program to improve flexibility and posture
Precautions
- Avoid prolonged sitting or poor posture
- Use ergonomic setups while working on computer or desk
- Perform regular stretching and strengthening exercises
- Maintain spinal alignment during daily activities
FAQs About T4 Syndrome
T4 Syndrome is a condition involving dysfunction of the T4 vertebra that leads to upper back pain and neurological symptoms in the upper limbs.
It is mainly caused by poor posture, repetitive stress, and mechanical dysfunction of the upper thoracic spine.
Yes, morning headaches are a common symptom associated with T4 Syndrome.
Yes, physiotherapy focusing on posture correction, mobilization, and strengthening is highly effective.
Recovery varies, but most patients improve with 4–6 weeks of consistent therapy.
Not always. Imaging is used to rule out other causes of symptoms.
Improper exercises may worsen symptoms. Follow a physiotherapist’s program strictly.
Pectoral stretches, thoracic extensions, and upper trapezius stretches are useful.
Yes, until symptoms are controlled. Avoid strenuous activities during flare-ups.
No, with correct management it can resolve completely.
Yes, if posture and lifestyle changes aren’t maintained.
Initial relief may be gained, but guided physiotherapy is essential for long-term results.
NSAIDs may reduce pain but don’t treat the root cause.
Excellent with early diagnosis and proper therapy.
Yes, bilateral symptoms are possible depending on severity.