Can’t sleep. Can’t bend over. Can’t walk through stores. Can’t stand to make dinner. Can’t clean my house. Can’t pick up my children/grandchildren. Can’t drive for very long. Can’t put on pants normally. Can’t sit through a movie. Can’t play golf. Can’t exercise. Can’t take a shower. Can’t carry grocery bags. Can’t travel. Can’t work. Can’t take it anymore.
Every one of these can’ts represents someone who I have treated who has experienced the debilitating consequences of back pain.
If you are practicing dentistry, you may be able to identify with some of those statements. Dental professionals are very susceptible to various musculoskeletal disorders. (Hayes M, 2009) Among the most common symptoms listed by dental professionals is back pain, along with headaches, neck and shoulder pain, wrist and hand pain and fatigue. (Puriene A, 2008)
I have spent considerable time on discussing neck pain and fatigue as well as providing strategies to decrease pain. So now it is time to delve into back pain.
The truth is that there are many factors have been shown to also contribute to back pain including but not limited to:
Gender, Age, Stress, Anatomy, Vibrations from tools
However, poor posture and muscle imbalances are still considered significant indicators of whether or not back pain will develop. So, let’s take a look at these two fundamental issues.
No discussion about pain in dentistry would be complete with addressing posture. Subsequent blogs will provide strategies to improve posture and pain. But first, let’s explore some research about how inadequate postures contributes to back pain..
Studies of common working postures of dentists reveal that 90.69% demonstrated postures that could lead to back pain. (Marshall ED, 1997) So maybe all we need to do to remedy back pain related to dentistry is as to correct posture.
Sounds simple. But it’s not. Why?
Because dentist have been shown to have be poor judges of their own postures. A cross sectional study of dentists in Nepal found that 73.5% of those interviewed believed they practiced correct posturing during work even though it was observed that they did not. (Shresth BP, 2008)
There is a problem with recognizing incorrect positions and implementing corrective strategies. Even though dental professionals have ergonomic and educational resources available to them, it is not so easy to practice.
But let’s consider the ultimate problem with inadequate posturing. That is the resulting weakness in specific muscle groups. That weakness can lead to risk of further injury and pain. I discuss this in depth with regards to the muscles of the neck at jbenedictdpt.weebly.com. The principles are exactly the same and are applicable to almost all musculoskeletal dysfunctions.
Creating balance between the muscles is essential to avoid and improve pain from inadequate postures.
Want to test to see how strong your back muscles are? There are two easy to perform tests that I use in the clinic to determine strength of erector spinae and posterior hip strength. Both are required to properly assess potential areas of treatment.
Please read all of the instructions and be careful. Never stay in painful position.
1.Trunk Extensor Test:
Do not perform if in severe pain. This test is likely to increase pain. If you choose to perform it, make sure that you are ready to address results with usual pain relieving techniques.
2. Hip Extensor Test:
This test may also cause increased pain, but is less likely as it is not placing direct stress on the structures of the lumbar.
How did you do? If you found weakness in either your trunk or hips, there is good news. You can fix that! Your body is amazing. It was meant to move and be strong. Unfortunately, (or fortunately) there is no medication that can do for you what exercise does. Especially specific exercises used as treatments.
Each of the opening statements have been uttered in my office over and over by patients who have suffered with back pain. Can’ts do not need to define the work and personal lives of dental professionals. The field is physically, mentally and emotionally demanding, yes. But back pain is not the price you have to pay in order to help others stay healthy. It is possible to turn your can’ts into CANS.
Hayes M, C. D. (2009, 08). A systematic review of musculoskeletal disorders among dental professionals. International Journal of Dental Hygeine, 7(3), 159-165.
Marshall ED, D. L. (1997). Musculoskeletal symptoms in New South Wales dentists. Australian Dental Journal, 42(4), 240-246.
Puriene A, A. J. (2008). Self-reported occupational health issues among Lithuanian dentists. Industrial Health, 46(4), 369-374.
Shresth BP, S. G. (2008). Work related complaints among dentists. Journal Of The Nepal Medical Association, 47(107), 77-81.