T4 Syndrome

In the upper back there are 12 vertebrae numbered from T1 to T12, each of which is crucial to moving the spine. The discs and joints at T4 are particularly prone to injury when the spinal column makes certain excessive or unnatural motions. This can lead to injury in the local nerves, and subsequent numbness or pain in the arms or back known as T4 syndrome.


Pain spread throughout one or both arms, especially in the upper arm. This is often accompanied by extended feelings of numbness or the tingling of pins and needles. Sometimes pain is also present in the back, neck, the ribs, shoulder blades or chest. Generally one side of the body is affected but this does vary. The injury will typically hurt at the moment it is sustained during activity, though conversely you may not feel anything significant until the next day. You should also be prepared for movement-limiting stiffness in the back and muscle spasms. Symptoms may worsen when performing activities involving the spine or outstretched hands, such as bending, driving or even sitting.


T4 syndrome is usually caused by excessive strain on the spine, particularly due to twisting or bending motions or strenuous lifting. This can happen as the result of a sudden movement during any sport involving high speed turns or frequent bending of the back, such as basketball or gymnastics. The injury may also be provoked over time as the result of repetitive improper movements or be related to long-term poor posture.

Medical Attention

Consult a doctor, who should be able to diagnose the condition using a physical exam or other simple tests. They will advise you about physiotherapy for your back and any other appropriate treatment.


Taking sufficient rest while the injury heals is crucial for a quick and successful recovery. This means avoiding the activity that caused the injury and any others which could potentially exacerbate the condition until the pain has disappeared. To maintain fitness you may wish to attempt exercise that is light on spinal pressure and arm movement. In the days after sustaining the injury, applying ice to the affected areas regularly should help to reduce pain and any swelling. Anti-inflammatory medication may also be beneficial, though always check with a doctor.

Sitting should be kept to a minimum, and when you do sit you must maintain a straight spine to reduce the risk of worsening the injury. It is important to stretch and strengthen your back and arm muscles at an early stage (the timeframe depends on the severity of the condition); a physical therapist can recommend suitable techniques that will maintain flexibility without causing pain.

Returning to Activity

A small number of cases require additional treatment, but T4 syndrome regularly heals completely within 2 months. Many sufferers cease to feel pain after only 2 or 3 weeks, but this is not an accurate indicator of full recovery and exercise should be undertaken with caution until a doctor confirms that the injury poses no further threat.

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