Are you protecting your posture from injury?

Isabel Johnston considers the impact of musculoskeletal injuries on the dental profession and what prevention and protection can be done.


Many dental professionals spend most of their working day in static, awkward positions, in the face of high work pressures with little time for breaks. A study conducted by Cinar-Medini showed that over half of health professionals with back pain, including dentists, had incorrect working postures1.

Dentists are at high risk for neck and back pain2 with data showing 70% of dental professionals reporting incidences of back pain.

“While mechanical back pain and lower back pain is fairly typical health complaint in the dental profession, there are also often other noticeable musculoskeletal issues with smaller joints, such as wrists and neck. This is due to the repetitive nature of the work, as well as the posture that you need to keep and maintain for prolonged periods of time,” says Dr Jonathan Carnell, Chief Medical Officer at Dentists’ Provident.

Dr Jonathan Carnell, Chief Medical Officer

Dr Jonathan Carnell, Chief Medical Officer

Having worked as a GP for more than 20 years, he says musculoskeletal issues are very common and can be exacerbated by waiting times for physiotherapy combined with lack of self-help and prevention.

What the claims show

In 2023 musculoskeletal disorders were the highest reason for claims at Dentists’ Provident, a leading income protection provider for the dental profession. In total 23% of claims paid last year were due to musculoskeletal disorders – and in the first six months of 2024 this proportion has increased to 26% of total new claims.

Many examples of claims are from dentists as young as in their 20s and 30s who have had to take months off work due to issues with their lower back. Others have been unable to practice for years because of back pain and repeated musculoskeletal issues.

“Musculoskeletal pain continues to be a common issue for our members who lose their capacity to work. Like many other health conditions, the earlier you can identify the issue and find way to manage it the better. Our claims experience shows that failure to seek early intervention for symptoms can often lead to a stage where it becomes a chronic or recurrent condition,” says Paul Roberts, Head of Claims at Dentists’ Provident.

In such a physical profession, what can be done to help prevent these injuries?

Workstation adjustments

One of the first thing to look at is how you practice. The surgery set-up is key and ensuring all manual handling training and procedures are followed.

“Really think about the position of the chair, the patient and the angles you are working at. Sometimes there are going to be procedures with awkward positions that are unavoidable but try to minimise that and spread out those appointments to avoid continuous strain.

Remind yourself regularly of good posture, make sure you use good techniques and maximise the ergonomic equipment available including chairs and desks. Remember to reassess the whole workstation before your first patient of the day, especially when sharing clinics with other colleagues. A key issue is that we often don’t take the time to re-adjust equipment to our individual needs making their benefits redundant,” says Dr Jonathan Carnell.

Incorporating regular breaks – at least every 30-40 minutes and between patients, to get up, stretch and move around giving the musculoskeletal system a little flex and rest.

Don’t ignore initial pains

Dentistry is a repetitive environment and often chronic positioning leads to musculoskeletal injuries – rather than a one-off accident.

“Often it starts small. Maybe at certain points in the day your neck is a bit sore, and you ignore it and don’t really think about why. And then the next day, they do the same thing again. You may notice you are fine when not practicing, so it’s obviously a work trigger, but it’s not being addressed. It almost doesn’t matter how old or otherwise fit you are – if that posture is not corrected, it’s not going to get better. Addressing any niggles or pains early on, rather than ignoring them, is key to avoiding long-term problems and work absences down the line,” says Dr Carnell.

Exercises and self-help

Exercise is commonly advised as one of the best ways to help prevent and manage most back and musculoskeletal injuries. Incorporating activities like walking, swimming, yoga or Pilates can help strengthen your core and maintain healthy musculoskeletal function3.

Regular exercises can be done at home or during working hours, with many useful examples and self-help videos that can be found on the NHS website and from the Backcare charity, including:

Useful exercises

MSK useful exercises

If you find that any of the exercises exacerbates your back pain, try another one or seek advice from your GP or health professional. You should, however, expect some minor discomfort after starting an exercise programme, since your body may not be used to the movement or exercise.

Avoiding recurring injuries

Back pain is one of the biggest causes of work absences, accounting for more than 12 million days lost every year4. According to Dr Carnell if you have an existing or previous back or other musculoskeletal problem, you are more than likely to have a recurrent issue down the line.

“When you have recovered from an injury, it’s important to look at what caused the pain that led to work absence. There is a lot of evidence to say that history repeats itself once you’ve had one injury unless you do make some of these preventive changes. Don’t merely return to the same set-up, but use preventive methods such as work environment adjustments, good posture and regular breaks and exercise to avoid the injury recurring,” he says.

Whatever stage you are at in your career, take the time to think about whether you have a preventive approach to your physical health and wellbeing, and that you try to spot early signs of discomfort or pain. If you look after yourself and protect what is important now, you could be set for a long, fulfilling and pain-free career.

 

References
  1. https://pubmed.ncbi.nlm.nih.gov/27858698/
  2. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4616098/
  3. https://backcare.org.uk/wp-content/uploads/2020/02/901-Exercises-for-back-pain.pdf
  4. https://www.unison.org.uk/get-help/knowledge/health-and-safety/back-pain

 

Any workouts, movements, and progressions provided in this article are for educational purposes only and are not to be interpreted as a medical treatment plan or recommended course of action. Exercise is not without its risks, and any exercise programme may result in injury. To reduce the risk of injury, before beginning any exercise programme, please consult an appropriate healthcare professional for advice and safety precautions. Any exercises and/or advice presented are in no way intended as a substitute for a proper medical consultation. We disclaim any liability for and in connection with the information in this article. As with any exercise programme, if at any point you begin to feel faint, dizzy, or have physical discomfort, you should stop immediately and consult a medical practitioner. 

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