Articles, Dentistry

Correcting and preventing back problems

Are you stretching your back every now and then? How relaxed are your arms and shoulders? Or do you feel pain in your neck after a work day? A large number of people sit for long periods at work, at home and in their free time. According to Tim Hutchful from the British Chiropractic Association, people who spend a significant amount of time in a poor sitting position put twice as much weight on their spine compared to when they are standing.

Studies clearly show that dental professionals have increased risk of musculoskeletal symptoms. Most commonly these problems appear in the area of neck, shoulders and lower back (Kerosuo et al, 2000; Ayers et al, 2009; Razan et al, 2011). Especially for dental care professionals the posture becomes the most important occupational hazard, because many dental procedures require abnormal sitting postures for many hours using repetitive motions (Razan et al, 2011). In a large Lithuanian study it was shown that work tasks in dental care can cause severe health problems varying from fatigue and headaches to musculoskeletal complaints such as hand problems and back pain (Puriene et al, 2008).

The right and wrong posture

On the base of the studies it would seem that in order to prevent musculoskeletal problems, one has to concentrate on getting into the right working positions and adopting optimal working methods. The traditional sitting posture (Figure 1) is widely recognised as one of the greatest hazards for sedentary workers (Corlett, 2008). In contrast, when sitting in a riding like position (Figure 2), you are always in the upright posture and, as a result the forces transmitted through certain parts of your spine are reduced compared to when sitting in a normal chair. This sitting position also has positive effects on one’s neck, shoulder and back muscles.

Figure 1: Traditional sitting

Figure 2: Riding-like sitting

In a riding position you can maintain the healthy, ideal spinal posture, lumbar curve and upright position where your thighs can slope downward at 135°. Studies show that this posture reduces posterior spinal disc pressure and reduces back pain and musculoskeletal symptoms (Mandal 2003; Corlett 2008). In addition, in this posture, individuals report feeling healthier and more energetic. This may be because your breathing is deeper and your blood circulation is better in a more upright position. 

Dental care professionals

For dental care professionals it is important to have a well-designed work environment that allows you to move around with your stool and access different instruments quickly and efficiently. According to physiotherapist Marie Jalkanen, when sitting on a saddle chair, which has easy rolling castors and a swing-mechanism, one can easily reach to things and activate the core muscles at the same time. Further to the benefits from the divided saddle chair sitting on one can also keep the pelvis rotated more anteriorly and downwards that helps maintain the ideal lumbar curve (Keegan 1953 in Corlett 2008). In contrast, on undivided saddle chairs the pressure gets too high in the pelvic area and as a result people tend to slouch.

In dental care it is important that you get a good visibility into the mouth and this is possible on a divided saddle chair because you can lean forward with a straight back. ‘As you can see from the main image with the divided saddle chair, you can also work at a close distance when your legs are sloped under the hoisted chair. This treatment position facilitates an optimal position for your arms and enables you to relax your shoulders and upper back,’ says physiotherapist Marie. 

With regards to dental care there are also a variety of accessories, which can be attached to a divided saddle chair, which will also facilitate your working posture. According to Marie’s knowledge of dental care and human anatomy and physiology, this riding-like sitting is becoming the most common way to work in dental care in Scandinavia and this method of working decreases back and neck problems for dental care professionals. 

Final words

When a workday includes many hours of sitting and working in static postures, one should change positions regularly (moving around the patient and standing in between procedures). However, it is important to assume a riding-like, upright position where your thighs are angled downwards in relation to your body. This can significantly minimise the risks on the spinal health of sedentary workers (Corlett 2008).  

For a list of references contact sebastian.evans@fmc.co.uk.

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