T4 SYNDROME: THE PAIN IN NECK THAT IS OFTEN MISDIAGNOSED

Abstract

It has been ascertained that musculoskeletal issues arising from the upper thoracic spine are often incorrectly diagnosed
as cervical in nature, by both the therapists and the medical professionals equally. This may be due to the reason that the
lower cervical and upper thoracic vertebrae are closely linked with regards to cervical movements, predominantly, flexion,
and extension. Symptoms from the upper thoracic spine can also bring up pain in the arm and forearm, thus, mimic a heart
attack1.
One such condition of upper thoracic spine is of T4 vertebra - the T4 syndrome. In 1994, Evans P, discussed the basic science
behind the genesis of T4 syndrome and argued that, the term upper thoracic disorder might be a more accurate term, in view
of the fact that, the condition generally ranges between T1 to T72. However, it is generally referred to as T4 or T3 syndrome3. If
we examine the vertebral column, the compressive load at T1 is about 9% of body weight, increasing to 33% at T8 and 47% at
T124. In between each one of these vertebrae, lie the facet joints and discs, which help in maintaining the weight and directing
the movement among the individual vertebrae. When either of these joints gets injured, damage in turn can be imposed on
the nerves