T4 syndrome

- A clinical pattern that involves paresthesia and pain with or without symptoms into the neck
or head
- Prone to >35 years of age
- MOI: - insidious
o After the start of new job
o Change of work practice
o Taking up a new hobby
o Jobs that involve forward stooping and bending or sedentary positions
- S/Sx: - paresthesia in all 5 fingers, in whole hand, forearm and hand.
o Hand feels hot or cold, and arm may feel heavy, swollen
o Pain- crushing, bursting, like tight band
o “cap” type headache
- PE: -posterior to ant. Accessory mobilization at the T4 segment reproduces the pt
symptopms
- Palpation of rib angles may elicit symptoms
- Trophic changes: red/purple temp: hot/cold
- (+) neurodynamic test of upper limb
- REHAB: manual therapy
o Postural retraining