T4 Syndrome is a condition where dysfunction in the upper thoracic spine (usually around the T4 vertebra) causes symptoms in the arms, hands, upper back, and sometimes the head. It’s believed to be caused by irritation of the nerves or joints in the upper-mid back, which can affect how the nervous system sends signals to the upper limbs. Even though the problem is in the spine, most people feel symptoms in their arms or hands, not necessarily where the source is.

An analogy…

Think of your spine like a power board. If one of the plugs (a spinal joint or nerve) is slightly loose or faulty, it can cause flickering or faulty power (strange symptoms) further down the line, in this case, your arms or hands.

What causes T4 syndrome?

T4 Syndrome is thought to be caused by joint dysfunction or poor mobility in the thoracic spine, especially around the T2–T7 levels. When these joints become stiff or irritated, often from poor posture, repetitive strain, or prolonged slouching, they can affect the sympathetic nervous system, which controls things like circulation and nerve sensitivity. This results in odd nerve-related symptoms in the upper limbs, even though the actual issue is in the spine.

What are the signs and symptoms of T4 syndrome?

• Heaviness, numbness, or tingling in one or both arms or hands
• Pins and needles in fingers
• Feeling of a “glove-like” distribution of symptoms
• Upper back stiffness or aching, especially between the shoulder blades
• Symptoms may come and go, or be worse at night or after sitting
• Occasionally includes headaches, dizziness, or neck pain
• Often not linked to specific injury or trauma

What tests are used to diagnose T4 syndrome?

Physical examination and history: Helps rule out other causes (like disc bulge)

Palpation: Feeling for stiffness and tenderness in the T2–T7 joints

Neurological screening: To check reflexes, sensation, and strength

Thoracic mobility testing: Identifies restricted movement in the spine

How long does T4 syndrome take to heal?

With the right treatment, symptoms of T4 Syndrome often improve within 2–6 weeks, but full recovery may take longer if symptoms have been present for a long time. Consistent posture correction and mobility work are key to long-term improvement.

How does T4 syndrome happen?

• Prolonged sitting or slouched posture
• Repetitive upper body movements
• Lack of thoracic spine mobility
• Muscle imbalances between the front and back of the body
• Stress or shallow breathing habits

What treatment can help T4 syndrome?

• Thoracic joint mobilisation or manipulation
• Soft tissue massage and dry needling
• Postural education and ergonomic setup
• Thoracic mobility exercises
• Strengthening for the upper back and core
• Breathing techniques
• Clinical Pilates or guided rehab
• Stress and relaxation strategies if symptoms are aggravated by tension

What exercises or stretches can I do for T4 syndrome?

• Thoracic extensions over a foam roller
• Wall angels
• Cat-cow or thread-the-needle
• Chin tucks and shoulder blade squeezes

What products can help with T4 syndrome?

• Trigger Ball
• KT Pilates Band Pack