Unfortunately, that is almost sure the problem. The back cylinders burn valves because of the exhaust crossover heat. I you tear it down to fix it, you definitely want to remove both heads and have both heads checked and the valves ground. It is a big job, I don't think I would recommend most non-mechanics do it. I just finished mine in November and it's a pain, and I am a full time mechanic.
It also is fairly expensive, if you have the machine shop adjust the valves, you are looking at about $600 just for the machine shop. If you adjust the valves yourself you can save a couple hundred, but will probably have to spend a hundred for valve shims.
If you try to do it yourself, you will probably get very frustrated halfway through, it is not a fun job. Hate to be the bearer of bad news, but that's the way it is. I'm not recommending any particular course of action, just telling you my experience.


1997 T100 extracab, 3.4L, 5-speed, 169K, 4x4. Love the truck, never buy anything but toyota, I tried it once, most miserable six months of my life.