Don’t let Dentistry cause you pain!
in Your Health
Dentists commonly experience musculoskeletal pain during the course of their careers. While the occasional back ache or neck ache is not a cause for alarm, if regularly occurring pain or discomfort is ignored, the cumulative physiological damage can lead to an injury or a career-ending disability!
A significant number of today’s dentists experience musculoskeletal pain and are at risk of developing serious Musculoskeletal Disorders (MSD’s).
In order for you to develop and implement a comprehensive approach to minimize the risks of a work-related injury, a thorough understanding of the underlying physiological mechanisms leading to these problems is necessary.
When dentists sit, pain occurs not only in their backs, but also their necks,shoulders and arms. On the other hand, dentists who primarily stand experience low back pain as well as neurocirculatory disease including varicose veins, postural defects and flatfoot.
The common risk factors causing musculoskeletal disorders in dentists who practice in standing or sitting postures are:
• Prolonged static postures
• Personal working habits
• Repetitive movements
• Poor positioning (forward bending, twisting particularly)
• Poor job design
• Poor physical fitness
Other factors include:
• Poor nutrition
• Sub-optimal lighting
Generally, causes of musculoskeletal pain and disorders common to dentists are multifactorial.
There is a relationship demonstrated between prolonged, static (motionless) muscle contractions and muscle ischemia or necrosis.
Weak postural muscles of the trunk and shoulder may lead to poor operator posture.As muscles adapt by lengthening or shortening to accommodate these postures, amuscle imbalance may result, leading to structural damage and pain.
Just as dentists need to be knowledgeable about the mechanisms contributing to oralpathology so they can effectively treat and prevent the progression of symptoms, they also must understand the mechanisms that contribute to MSDs so they can make informed choices regarding ergonomic equipment, exercise and lifestyle. Having this knowledge is key in preventing and managing work-related musculoskeletal problems in clinical dentistry.
Common Musculoskeletal Disorders
The most common MSDs that occur in dentistry include chronic low back pain. This pain often refers into the hip, buttock or down one or both legs. The pain may be caused bymuscle strains or trigger points, instability of the spinal vertebra due to weak postural muscles, hypomobile spinal facet joints, or spinal disc disease including herniation.
Neck pain - stiffness and muscle spasms in the cervical musculature, often referring pain between the shoulder blades or the occiput. When adjacent cervical nerve roots become inflamed numbness and/or tingling may occur in the arm or hand. Forward head postures may precede this syndrome, precipitating muscle imbalances, ischemia, trigger points, or cervical disc degeneration or herniation.
Tendon Disorders of the Upper Limb - Due to the repetitive tasks involved in dentistry the tendons of the hand, wrist and elbow may become painful when lifting and operating apparatus. Such conditions often begin as a dull ache and should not be ignored as they may lead to chronic discomfort.
Sub-Acromial Impingement Syndrome - This condition is characterised by pain in the shoulder on overhead reaching, sustained arm elevation or sleeping on the affected arm. Incorrect body mechanics and a rounded shoulder posture in the operatory can lead to the impingement.
Initially, dentists experience aches & pains at the end of the day. These symptoms ease with movement but are aggravated by prolonged positions . Early symptoms can usually be resolved with simple measures.
If symptoms progress i.e. radiation of pain & begin to limit activity it is suggested that individuals seek professional advice in the management of such a condition, before symptoms progress any further. Unfortunately surgery is not uncommon, particularly when symptoms are not prevented or addressed at an earlier stage.Musculoskeletal Disorders have resulted in lowered productivity in the dentistry profession due to missed work or in a career ending.
Prevention of Musculoskeletal disorders
Preventing MSK disorders in dentistry requires individuals looking at their
• Clinical work habits
• Good postural positioning (operators should strive to maintain a neutral, balanced posture
• Good use of ergonomic equipment
• Frequent short stretch breaks
• Regular strengthening exercise
• Seek professional advice as appropriate
Please feel free to visit www.connectphc.co.uk if you would like to know more about prevention & treatment of Musculoskeletal Disorders, Physiotherapy, Ergonomics Advice &Training Programs. Alternatively you can contact Connect’s head office on 0191 250 4586 in regards to the variety of services we deliver.
Kathryn Gough MCSP HPC
Occupational Physiotherapy Services
Connect Physical Health