02/04/2026
"Unlike that C1 vertebra or the sacrum, the T4 vertebra doesn’t have a fun and fancy name. It does have a syndrome named after it, though! “T4 Syndrome” is often considered a diagnosis of exclusion, but has symptoms, such as upper back pain, pins and needles (paresthesia) into the arms and hand and headaches.
The pain is right between the upper part of the shoulder blades and when the muscles in the upper back are reacting to compression on the T4 nerve root, it can spread up the neck and cause headaches. Along with motor and sensory nerves, the autonomic nervous system can also be affected, specifically, the sympathetic nervous system which is our fight or flight. As a result, it can cause symptoms that mimic a heart condition (make sure if you’re having symptoms that might indicate cardiovascular issues, you get your heart checked.) It can cause pain and numbness down the arm and up the neck into the jaw and can have pain with breathing. It also can cause heart palpitations, sweating and unexplained anxiety, again, if you're having symptoms that could indicate cardiovascular issues, get your heart checked out first. It also tends to be worse at night, affecting sleep.
It is almost always an injury to chronic microtrauma: poor posture but can also be brought on by improper heavy lifting. It can feel like it is a very serious issue while in the throes of it, but often can be treated effectively through chiropractic or physical therapy." - Dr. Erick Thompson