Shoulder Stiffness and Pain

Identifying the etiology of your pain is crucial to developing a plan to eliminate or control causing factors. Enlist others to periodically observe your posture throughout the day at work and home to determine when you raise your shoulder or abduct your arm (arm away from body). You are aware of your posture throughout the workday and note that you lift your right shoulder periodically. Being aware of your posture is one step in determining the cause of improper body mechanics. Keep a pad chairside to note what area you are working on and if you are stressed when you raise your right shoulder. If you find that you tend to raise your shoulder when working on a specific area you want to assess your positioning to lower your shoulder. The height and the occlusal plane of the patient may need to be adjusted to attain proper body mechanics. Optimal sitting position should be balanced on the "sit bones" or ischial tuberosities of your pelvis with a slight anterior tilt (declined position) to maintain the natural lordosis/curve of the spine. Your thighs should fit under the patient’s chair without hindrance; if this cannot be accomplished, extend the headrest to fit freely beneath the patient’s headrest. You may also want to try alternating standing and sitting. Some clinicians find it easier to maintain proper body mechanics if they stand while instrumenting certain areas. You can make some changes in your work routine to include stretching exercises, implementing stress management techniques and changing your working position. Taking frequent mini-breaks to lean backwards in your chair and stretch or changing position can be beneficial. Adjust your work schedule to alternate difficult and easy cases throughout the day so that you don’t have 3-4 difficult cases consecutively. Properly fitted magnification can help maintain proper working distance and neutral posture. Keep current with vision examinations and prescriptions for glasses and loupes. Also take into consideration other life activities and your posture. While driving you want to adjust your seat height so that your shoulders are relaxed. Activities at home and outside should be assessed as well. Computer work heights should be adjusted for neutral posture. Consider the height of working counters and use a step stool if the working surface cannot be lowered. The body needs rest in between activities; try to take breaks throughout the entire day to stretch and relax. Routine exercise and relaxation techniques are beneficial in reducing stress and muscular pain. Keep a log of activities that cause shoulder pain. This log can be used to assess what is contributing to the shoulder pain and lymphatic congestion. The lymphatic congestion that is occurring causes the pressure, stiffness, and pain in the shoulder and can progress to the neck area leading to headaches. A medical consultation is advisable and may be needed. The consolation can help to determine the cause of lymph congestion and if an increase in massage therapy sessions and other alternative techniques are warranted.