T4 syndrome

Upper thoracic dysfunction associated with arm symptoms and headaches.

Overview

T4 syndrome refers to upper thoracic joint dysfunction linked with diffuse arm symptoms, hand stiffness and sometimes headaches. The mechanism is debated, but it commonly responds to thoracic mobility and manual therapy.

Symptoms

  • Vague arm or hand tingling and heaviness
  • Upper back stiffness around the shoulder blades
  • Headaches in some cases
  • Symptoms not following a single nerve path

Causes

  • Upper thoracic joint dysfunction
  • Sustained postures
  • Stress and muscle tension

Treatment

  • Thoracic mobility and manual therapy
  • Posture and ergonomic advice
  • Strengthening of the upper back
  • Reassurance and graded activity