World Doctor's Day: 7 tips for dentists, surgeons to prevent back pain

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Most of us do not quite enjoy our periodic visits to the doctor as sympathy often lies fairly and squarely with the patient. However, what many people fail to appreciate is that these situations place considerable musculoskeletal demands on health professionals, such as dentists and surgeons while they are treating us in an attempt to improve the quality of our lives. The cause of this lies in the fact that, for a patient, medical visits typically involve sitting in a comfortable reclined position, while the dentist often has to bend to perform the oral work.

In the case of a surgeon, while the patient is usually unconscious or supine, the medical professional must contort their own body in order to perform the surgery. In fact, there exist vast similarities in the work of dentists and surgeons as both professions involve working in a standing posture and prolonged stooping over a reclined or supine patient. Besides, the similarities also involve the fact that a variety of hand equipments must be used by both professionals in a delicate manner. Both professions also involve working for extended periods of time, typically less than an hour per patient for a dentist and considerably longer than an hour for a surgeon.

The prevalence of work-related musculoskeletal disorders among surgeons published in a JAMA survey analyzed a 12-month prevalence of specific pain types in doctors. Following were the findings:

Neck pain - 60% (No. of doctors surveyed - 1921)
Shoulder pain - 52% (No. of doctors surveyed - 1360)
Back pain - 49% (No. of doctors surveyed - 2254)
Upper extremity pain 35% (No. of doctors surveyed - 1343)

Dr. Garima Anandani, senior spine specialist and clinical director of the QI Spine Clinic at a recent POP talk at Nair Hospital shared her concern regarding the fact that 70% of the dentists suffered from back pain due to their work. She stated that "Awkward working posture, repetitive slant and prolonged standing leaves dentists to be very vulnerable. This damages the muscles, joints, bones, ligaments, tendons, nerves, and blood vessels leading to pain and fatigue.

"Surgeons are at risk of developing neck and back pain as they work long hours, along with standing in awkward positions for a long period of time, while they hold human life in their hands," she added.

The 3 main risk factors leading to this kind of occupational back pain in dentists and surgeons involve poor lifestyle choices, postural faults leading to muscle strains being placed on the backs as bending or twisting is a huge factor in the profession, and lack of physical activity which causes weight gain leading to stress on the spinal column.

This National Doctor's Day, here are a few tips for doctors to prevent occupational back pain:

Ergonomic recommendations in minimizing the risks of back injuries among medical professionals primarily focus on improving working posture, lifestyle choices, and equipment design. These include:

• Managing time: Avoid long appointments whenever possible, or distribute these while the inclusion of frequent, short rest breaks in which you change posture and relax the upper extremities.
• Postural Vigilance: Medical professionals need to be mindful of their posture, maintaining a direct line of sight while also sitting and standing in proper alignment. This will help prevent the additional strain placed on the back as bending or twisting is a huge factor in this profession. Alternating between sitting and standing to reduce postural fatigue and maximize postural variety is also helpful in reducing static muscle fatigue.
• Safe reaching arm movements - Keep the elbows and upper arms close to the body avoiding a raise that causes tension in the shoulders when working. Also, ensure that hand postures do not get deviated as this could lead to wrist problems. Also, avoid having to reach awkwardly to equipment while also working close to the patient. The pieces of equipment used most frequently must be kept within a distance of about 20 inches (50 cm). Ask assistants to help move equipment into this zone.
• Use of Comfortable Equipment - Medical professionals must use equipment that isn't too heavy and can be used without assuming an awkward upper body posture. Ergonomically designed equipment helps minimize stresses on the upper extremities and the back. The use of microscopes in the form of loupes helps maintain proper ergonomics, while procedures can be performed with greater magnification.
• Use Support - When sitting or standing, doctors must not lean forward or stoop in an unsupported posture for prolonged periods. Sitting up straight or reclining slightly in a chair with good back support, while also using a good footrest if necessary helps prevent back pain. While standing for prolonged periods try to find something to help you lean against.
• Eat healthily and Stay Hydrated: Our spinal discs need water to remain hydrated and flexible. While doctors often tend to neglect themselves due to the concern of the responsibilities they face, they forget to drink enough water and often also forget to eat, or many times do not make healthy choices. Include foods such as nuts, dairy, beans, berries and dark leafy greens for a healthy spine.
• Physical exercise: Additional pounds onto the midsections and hips places an incredible amount of stress on the spinal column. Doctors must make time for exercise to maintain a healthy weight and also to strengthen the muscles that help stabilize the cores, thereby helping stabilize the spine. Besides, a lack of exercise could lead to the avoidance of excessive weight gain so to reduce the pressure on the vertebrae. However, before starting any exercise schedule, consult a spine specialist.

In case of an existing back condition, one must be sure to visit a spine specialist. Accurate analysis of the spine can be acquired by advanced spine function tests more effective than basic MRI's or X-Rays like that of the Digital Spine Analysis (DSA). Through the results of this test, pain management and targeted mechanical and medical treatment of the affected area can be performed to attain functional recovery.

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