What is T4 Syndrome?

T4 Syndrome describes pinching of, or irritation to the nerves surrounding a particular facet joint of the spine. The T4 level is part of 12 vertebra making up the upper spine. Symptoms include the referral of pain and / or numbness to the upper limbs and hands. 


  • Repetitive bending, lifting or twisting
  • Overuse
  • Poor posture 


  • Arm pain
  • Nerve pain e.g. pins and needles or numbness affecting one or both sides of the upper limb
  • Neck or back pain 
  • Headache 
  • Weakness 
  • Aching and stiffness
  • Chest, ribcage and shoulder pain and stiffness 

Symptoms are often worsened by lifting and twisting movements, sitting for long periods and driving. Coughing and sneezing can also aggravate symptoms. 

T4 Syndrome can be diagnosed by a Physiotherapist. At Jonathan Clark Physiotherapy, our therapists offer advice and a wide variety of treatments to help you manage your symptoms. 

Treatment often includes the advocation of rest, anti-inflammatory medication and postural management. Your therapist may suggest an ergonomic assessment at work as well as activity modification measures to help you get back on track! We can also provide mobilisations, trigger point release and tailored stretching programmes to help increase your flexibility and ease of movement.