- by Vanessa Milot, Registered Physiotherapist
Last week a patient came to the clinic reporting numbness and tingling in her hands every morning when she woke up. The tingling resolved within a few minutes but would occasionally return during the day particularly if she was driving or sitting at her computer. She had no recent injuries, but reported mild pain and stiffness between her shoulder blades and in her neck. During the assessment I noticed that two of the joints in her upper back weren’t moving very well and she had a sizeable muscle spasm next to this area. It became clear that she had T4 syndrome which is common injury that is often misdiagnosed due to its non-specific symptoms.
What is T4 syndrome? The spine is divided into three main sections: cervical spine (neck), thoracic spine (upper back), and lumbar spine (low back). The thoracic spine, also known as the T-spine, is comprised of 12 vertebral bones. These bones are connected to one another by a central disc and two facet joints on either side. Together, these joints allow both stability and movement in the upper back. Excessive sudden loading or repetitive movements placing stress on the spine can lead to injury or dysfunction in one or more of these joints. Nerves lie in very close proximity to these joints and, if aggravated, can lead to paresthesia (numbness and tingling), muscle spasm or pain. T4 syndrome is named as such because the joints at and around the 4th thoracic vertebrae are particularly vulnerable to stress and thereby injury.
Some symptoms of T4 syndrome include glove-like paresthesia (hands falling asleep), pain or stiffness in the neck or upper back, headaches, numbness in the face, and weakness and pain in one or both arms and shoulders. It is important to get these symptoms assessed by a health care professional because many injuries and illnesses often have a similar presentation of symptoms. It is the responsibility of your doctor or Physiotherapist to determine a proper diagnosis.
What is the treatment for T4 syndrome? Physiotherapy treatment, as well as home stretching and exercise, can help to resolve these symptoms. Here is a quick home exercise. If you have access to a foam roller, try lying on your back with the roll perpendicular to your spine. Let your body relax over the roll and gently bend and extend your knees so the roller glides up and down your upper back. It should feel like a deep tissue massage.
Physiotherapy treatment for T4 syndrome can accelerate the healing process, ensure optimal recovery, and reduce chances of re-occurrence. Treatment may include: education regarding posture, exercise and activity modification, mobilization or manipulation of the neck and back, massage, dry needling, electrotherapy (e.g. ultrasound, IFC) and assistance with safe return to work and daily activity.
If you think you have T4 syndrome it is important to get it treated early to maximize recovery and minimize suffering!
This is provided as general information only and is not intended to be relied upon as medical advice. Vanessa Milot is a Registered Physiotherapist and Associate of Sun City Physiotherapy. She can be contacted at Sun City Physiotherapy’s Glenmore clinic by calling 250.762.6313, or via email at Glenmore@suncityphysiotherapy.com
