Upper Back Pain From T4 Syndrome – Everything You Need To Know

T4 Syndrome causes pain in the upper back. And as it worsens, that pain may cause problems in the neck, shoulder, arm all the way to the hand and fingertips. It happens more often than is diagnosed making it a sneaky condition that is often overlooked by healthcare professionals.

In this video, I’m going to explain to you everything you need to know about upper back pain caused by T4 syndrome. Let me tell you about the symptoms of T4 syndrome. Usually there’s sharp stabbing pain right in the middle of the upper back right in this area, they call it T4 syndrome because this part of the spine where the ribs attach, is called the thoracic spine starts with a T.

So all the vertebrae all the bones in the spine here are labeled T one T two, T three T four. And this doesn’t always happen or right at T four, it could be T three T four T two T three, t 45, t five t six, it just was named as T4 syndrome because it generally happens in this area, that the pain is usually directly in the middle of that’s where it should be because the ligaments that are right over these pokey parts of the spine here get stretched out and irritated and so it’s painful to touch even, but then there’s a deeper pain.

And that’s usually because the disc gets overstretched and injured as well. There are discs between the vertebrae here, just like there’s discs in the neck, and in the lower back, there’s disc between the bones of the thoracic spine too, and the disc in the area gets overstretched and injured.

And there’s a special part of the nervous system of the nerves, called the sympathetic nervous system. That sympathetic nervous system, the majority of it that lives close to the spine lies just in front of the ribs where they attach to the vertebrae here. So if a disc of the thoracic spine becomes injured, they can irritate the nerves have the sympathetic nervous system.

And the sympathetic nervous system controls things like pain, sweating, blood flow, which can influence your body temperature, and a bunch of other things that are rarely talked about. As a result of this, if the sympathetic nervous system gets involved, because of the T four syndrome problem, then it can send weird sensations down into your neck or shoulder all the way into your arm and hand.

One of the common sensations it’s odd that people will say they have is they feel clammy in their palm or in their hand, or they feel that one hand is a different temperature may be hot or cold compared to their other hand, the sympathetic nervous system can also control breathing rate and heart rate.

So another experience that I see people go through is they’ll feel like they get an increased heart rate or they start to breathe slightly different when the pain flares up in the middle part of their back, of course, there’s going to be numbness, tingling, and pain sensations that go down into the hand.

And so if this happens on the left side, patients sometimes think that they’re having a heart attack. In fact, about half the patients that we see here in the clinic that end up having tea for syndrome have been to their doctor, sometimes even the emergency room to get screened ouT4 symptoms of a heart attack. And once they get their heart screen and their lung screen and other problems screened.

If they’re told that everything’s normal, then the doctors are usually saying that your heart’s good. I don’t know what else it could be, but it’s not your heart. But the patients of course, are left with the symptoms, you know, the searing back pain right here.

Some, some will describe it as an icepick like somebody’s stabbing them right in the middle of the back, they’ll still have those symptoms along with the symptoms that go into their arm and hand and they’re left with you know what I do next. Not many healthcare professionals know about this.

Now, let me tell you about the cause of T four syndrome. This is really importanT4 you to understand. In T four syndrome, there’s two muscle imbalances that are coming together to cause that excessive motion that’s injuring the ligaments and the discs of the spine here. The first is a muscle imbalance up top here at the base of the neck where the shrugging muscles, the upper trapezius muscles are too weak.

And when they get too weak, the shoulders pull the muscles down, they stretch out the muscles and because those muscles attached to the neck bones and the head here, it adds a lot of compression to the upper part of the back or the lower neck here, the base of the neck kind of the junction between the neck and the back.

The joints here when they get compressed, they get stiff and stuck. So there’s less motion that happens here. Many people even get that that hump or that bump the buffalo hump that it’s called a dowagers hump in the medical field, and that means it’s very stiff and it’s been chronically in a bad position for a long time.

That stiffness then causes extra motion to happen a little bit lower below that where the T4 syndrome problem happens. The second muscle imbalance is coming from the lower abdominals. When the lower abdominals are weak. It causes the back muscles the lower back muscles to become overused and so they get too dominant.

It’s too strong back here on the backside of the spine. And when those back muscles start to get big, they start to get thicker than they start to compress the spine here, which adds to the stiffness in the area. And it makes the joints get stuck, the muscles get stuck as well.

When those two muscle imbalances are present in this part of the spine here and then down here in this part of the spine, then by default, the middle part right here is going to move excessively, and something’s going to get stretched out too much, it tends to be in the T four area at the disc and the ligaments.

Now let me tell you about how T four syndrome is diagnosed, when people visit their doctor for this back pain, this upper back pain, the doctor is going to reflexively thing to check the heart and the lungs. And this is good that doing their due diligence to make sure that you don’t have a problem with one of your essential organs with you don’t have a good heart or lungs, you’re not going to be around for very long.

So once you check out your heart and lungs, if everything checks out fine, then they’ll tell you it’s not that they may do an x ray as well to see if any bones in the area are fractured or broken. You can’t have hairline fractures that can cause this kind of problem. And the older you are, the more likely you are to get fractures of the spine.

If your X rays fine, then they’re not going to really know what to do next are probably going to refer you out to a specialist orthopedist, doctor, like a spine surgeon, or maybe even a physical therapy at that time. And up to this point, if you see the physical therapist or the surgeon, the spine doctor, you’re lucky if anyone mentions that you have T fours syndrome, we’re going to bring it up.

And even if they do bring it up, they’re probably not going to know how to properly treat this and all this stuff that I just explained about the muscle imbalances. It’s rare to find anybody who knows what I’m talking about. The reason for that is that this is poorly researched in the medical literature.

And so because of that it’s not taught in health care schools, and much less how to treat it and what’s successful and what’s not, it just hasn’t been researched. If you go to your orthopedic doctor, they’re probably going to do more tests like an MRI or a CT scan.

And then they may offer you pain medication like you know, ones that you take by mouth, possibly even an injected pain medication to try to get you some relief because this problem can get quite severe to where it’s constant pain, but even keeps you from sleeping at night and definitely doesn’t let you get comfortable. People that have T4 syndrome, they’re always shifting around when it gets really bad. They’re trying to find a comfortable position and they’ll lean forward, lean back lean in the armrests, they’re leaning and shifting in different ways will stand up.

They’re just uncomfortable all the time, because of this stabbing back pain right in the center of the spine. So doctors are looking to just bring some comfort to their patient by offering them what they know to offer which is pain medications. They usually say you’re not a surgical candidate.

There’s no surgery for this that I’ve ever heard of. And so they won’t offer that. At that point, an orthopedic surgeon is going to tell you they can’t help you much beyond just offering you pain medications and injections that may send you off to physical therapy. Now let’s talk about the common treatment options for T4 syndrome.

I’ve already talked about pain medications and injections that may be offered to you if you’ve got T4 syndrome, surgery is likely not ever going to be offered for this condition because there’s nothing wrong on the MRI. There’s nothing wrong with a CT scan, X rays look fine your heart your lungs are typically okay.

They may put you on a medication if you have like high blood pressure or some cholesterol problem, but that won’t be related to the pain that you’re having in your back. So at this point, most doctors will punt though they’ll refer you to physical therapy. Now in physical therapy. Physical Therapists generally don’t know about this as a specialist diagnosis.

But what they’ll do in an effort to help you out as best as they can with what they know is they’ll have you exhaustively exercise muscles in the area and exhaustively stretch parts of the body in the area. So they may have you doing stretches where you lean back all the way lean back over a ball stretch this way stretch that way stretch your arms out in different directions stretch out against a wall, stretch your neck this way, turn your head this way and then do exercises for the muscles that are right back there.

This is one that you got to watch ouT4 because the part of the body that hurts here and T4 syndrome, the muscles that are there are the rhomboids the lower track muscles and the levator. SCAP often gets blamed too for this because it’s close by exercising those muscles tends to make the problem worse in the long run because it makes those muscles in the area thicker, which adds more compression to the T four area.

So don’t be surprised if you’ve done therapy for this problem already. You did those kinds of exercises and stretches. If you’re slightly worse as time goes on. You’ve got to know that you’ve just got to back off of doing those exercises. Sometimes physical therapists will also try to pop the joints in the area.

You may even visit a chiropractor trying to get that that popping sensation because it may feel like it just needs to pop people often say that with the force syndrome Sometimes people will say if you can just pop it, it’ll bring me some relief. And I just need some comforT4 a moment. But what you’ll find is that even chiropractors won’t be able to pop joints in that specific area. Now, this part of the spine above where I told you it gets stuck and download, the other place where it gets stuck, may pop loose, and that’s actually beneficial for the short term.

But this area in the middle is probably not going to pop. In fact, it’s usually flatter in this part of the area, because the spine bones are kind of shifting forward, you’re losing your curvature here in T four syndrome, that happens very often.

So trying to pop joints in this area is typically not productive, because the disc and the ligaments already loose, and you’re trying to force extra motion through there, you’re just going to overstretch things. Without a proper diagnosis of T4 syndrome and an understanding of what causes it, you’re going to have difficulty in resolving this problem for the long term.

And the reality is, is that it’s very possible to get rid of this problem 100% As long as you do the right treatment, let me tell you about the right treatment. Next, let’s talk about how to solve the root problem of T4 syndrome.

So I’ve already mentioned to you that there’s a muscle imbalance up here that’s causing too much compression, which leads to stiffness in the vertebrae and the bones up here. And a similar thing happening down here, there’s too much muscle buildup because of muscles that are weaker on the front that are causing compression and stiffness to the joints down here that causes that extra motion to happen here in the middle of the spine.

That these muscle imbalances tend to happen to desk workers, people that are working on computers all the time, because the muscles up here they get weak or the upper tract muscles, the shrugging muscles, you just don’t get a whole lot of shrugging or overhead reaching activity if you work a desk job, and then the muscles down here.

These back muscles in this part of the spine get overdeveloped because they’re working extra to compensate for the weakness that’s in the abdominals, especially the lower abdominals below the belly button.

Those muscles also don’t get much activity if you work a desk job. So gaining strength in the upper trapezius muscles, the shrugging muscles and the lower abdominal muscles below the belly button. Getting those muscles to burn and get stronger over time is what will resolve T4 syndrome for the long term.

As you gain strengthen those muscles, you should put less and less compression through the parts of the spine that get stuck. And that creates more of a uniform motion throughout the spine, which takes away the excessive motion right here in the middle, where T4 syndrome happens.

Now in the short term, it may be beneficial to do things like a subtle slouch motion, because that alleviates the pressure right here. And even hanging like hanging from a pull up bar can take a lot of pressure off and bring some good relief.

But if you’re not working on the root muscle imbalances, then those things the slouch and the hanging are only going to bring you short term relief, it’s going to come right back because you need to get stronger in those weaker muscles.

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