As a dentist, there’s a strong possibility that you may have already experienced back discomfort or even back pain, which can have an effect on your practising life.
In your day-to-day working life, from examinations and treatments to desk-bound tasks carried out in front of a computer screen, your posture is regularly distorted and prolonged periods can be spent holding the body in one position. As a result, chronic lower back conditions, excruciating muscle spasms and long term disorders affecting the neck, shoulders, back and even the limbs are all too common. They can strike at any time, whatever your age.
To those who recover relatively quickly, back pain episodes can be annoying, uncomfortable and may necessitate a little time off work. Others might suffer the impact for the rest of their lives, resulting in substantial loss of earnings and, for the unfortunate few, the untimely end of their careers.
Musculoskeletal claims
Dentists’ Provident claims experience analysis shows that during 2012 some 26 per cent of male claims paid and 35 per cent of female claims paid were for musculoskeletal issues such as general back pain, lumber problems, sciatica, herniated disc, spondylitis and prolapsed invertebral discs, not to mention the referred pain that can appear in other parts of the body.
“It’s no surprise that lower back pain is one of the most common musculoskeletal issues for dentists,” explains Bryan Gross, head of claims and underwriting at Dentists’ Provident. “But shoulders, necks, hands and wrists are also areas where dentists experience problems due to the demands of their work. We regularly hear accounts of rapid onset back pain – one day you’re sitting happily in surgery, caring for a patient; the next day the pain hits and you’re barely able to move.”
Recent Dentists’ Provident claims have included a 26 year old clinician whose back pain left him unable to work for over three months and a 38 year old dentist with musculoskeletal problems that prevented her from practising for two years. Of course it isn’t only the pain itself that needs to be dealt with, you also need to think about the effect being unable to work has on your family, colleagues, business, patients and the progress of your dental career.
Maintenance programme
David Jones, head of member services at Dentists’ Provident, believes that dentists have a good awareness of the need to maintain their spinal health. “It’s encouraging to hear from our members of the on-going maintenance and preventive measures they take. Some are more traditional activities, like simply exercising regularly or going to yoga and Pilates classes to strengthen the core muscles and maintain flexibility. But we also have members who tell us that they regularly visit a physiotherapist, osteopath or chiropractor for preventive reasons. Therapists from those disciplines employ therapeutic exercise or manipulation techniques to try to prevent back or neck problems occurring in the future.”
To stay healthy you might create your own ‘back maintenance’ programme for your future health by choosing preventive measures which are appropriate to you. There are many different approaches you might take, both traditional and alternative, and it may take some time and a little experimentation to discover what works best for you and your lifestyle.
David continued “Another potential preventive measure is The Alexander Technique. Some members tell us that by learning this technique they have learned how to re-establish the natural relationship between their head, neck and back.”
Antonella Cavallone is a qualified teacher and member of the Society of Teachers of The Alexander Technique (STAT) who has worked with a wide range of healthcare professionals. “People whose routine daily tasks involve the overuse of particular parts of the body, such as when leaning forward to examine patients, create excessive tension in the neck and lumbar spine. The way a dentist sits on their stool and overarches the lumbar spine can lead to postural imbalances, mal-coordination and eventually pain. With The Alexander Technique we teach such professionals to recognise poor quality of movement and replace it with more natural, better balanced actions, such as bending from the hips instead of the upper back.”
Antonella suggests inviting an Alexander Technique teacher to come to your practice, so that several dentists and members of the team can learn at the same time, and directly address the issues specific to their roles.
Workplace adjustments
In the workplace itself it’s worth putting some serious thought into the positioning of your patients in relation to your own seat, as well as your seat’s height and tilt and its position in relation to your equipment, all of which can contribute to poor posture or awkward movements. With the range of products on the market, a great deal of time and money can be spent on the chair you install for your patients, with comfort, height and headrest adjustment all high priorities. But it is you who spends the most time seated in the surgery, and the same consideration may not always be given to choosing an appropriately ergonomic seat in the name of your long term health.
Because dental work involves extreme precision, the body is naturally held very rigid for extended periods, with the arms often unsupported. The tension it causes in the neck can lead to a range of associated pains both in the upper and lower back. There are a number of chairs that are specifically designed to combat this by placing the pelvis in its neutral position, supporting the spine and enabling it to maintain its natural ‘S’ curve. The Bambach Saddle Seat is one such chair.
“Ordinary flat seats put pressure on the discs in your spine,” explains Chris Langham, Bambach’s managing director. “The Saddle Seat works by supporting the body in an upright position, so it’s impossible to slouch. There are a great many benefits from sitting in this position, particularly relieving stress on the spine. The seat also has the ability to adapt to each individual’s stature.” This is supported by research carried out at the university of Birmingham indicating that a dentist's posture is improved when sitting on a Bambach Saddle Seat.
Taking the time to review your current seating and looking at an ergonomically designed option could ultimately play a significant part in keeping your career on track. As around 80 per cent of dentists suffer back pain during their career and of those who retire prematurey, 30 percent do so because of persistent back pain, so there is undoubtedly plenty you can do to minimise the chances of it happening to you. Isn’t it time to invest in a healthy back for your future?
References available on request.