T4 Syndrome


T4 syndrome is a condition that causes pain and altered sensations into the arms and hands. These altered sensations come from a dysfunction of the thoracic spine causing referral patterns of pain from both the zygophythosel joints and the intervertebral discs. The restrictions through the thoracic spine are thought to cause dysfunction of the sympathetic nervous system which causes pain through the arms and hands. Although the pain can affect both sides of the body it is much more common to affect only one side. It is a condition that affects people between the ages of 30 and 50, and is far more common in women than men.
Predisposing factors of T4 syndrome include:

  • Poor posture.
  • Thoracic stiffness.
  • Sedentary lifestyle.
  • Muscle weakness or tightness.
  • Poor core stability.
  • Jobs that require a lot of bending forwards and sustained poor postures such as an electrician or an assembly line worker.


Signs and symptoms of T4 syndrome:

  • Altered sensation into the hands in a glove like distribution.
  • Can cause neck pain and headaches.
  • Hands feeling tingling, numb or swollen.
  • Heaviness in the arms.
  • Stiffness of the thoracic spine (between the shoulder blades).
  • Possible discolouration of the hands, they may feel hot or cold to touch.
  • Pain may be described as crushing or like a tight band.


Physiotherapy treatment of T4 syndrome includes:

  • Postural education.
  • Restoring movement to any stiff joints, especially T4.
  • Stretching of any tight postural muscles.
  • Exercises to restore movement so you can make progress at home yourself.
  • Strengthening of the core and scapula.