Determining the Source of Pain
I have been practicing dental hygiene for 11 years and am right-hand dominant. I try routinely to sit properly, adjust my body throughout the day, and use magnification, yet I suffer from right shoulder stiffness and sometimes pain by the end of 4 days of treating patients. I receive massage therapy at least once a month with specific work done to alleviate the pain in my right shoulder. What else can I do to relieve this pain and prevent it from recurring?
Identifying the etiology of the pain is crucial to developing a plan to eliminate or control the causative factors. Enlist colleagues and friends/family members to periodically observe your posture both at work and home to determine when you raise your shoulder or abduct your arm (move the arm away from the body). Remaining aware of your posture is one step toward determining the cause of improper body mechanics.
Keep a notepad chairside to record what position you’re in and if you are stressed when you raise your right shoulder. If you find that you 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. An optimal sitting position is balanced on the “sit bones,” or ischial tuberosities of the 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, adjust your stool so that it fits 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 include stretching exercises, stress management techniques, and position changes into your work routine. Taking frequent mini-breaks to lean backward in your chair and stretch or change position can be beneficial. Adjust your work schedule to alternate difficult and easy cases throughout the day. Properly fitted magnification can help you maintain proper working distance and neutral posture. Receive regular vision examinations and keep prescriptions for glasses and loupes up-to-date.
Your activities outside of the office should also be considered. While driving, adjust your seat height and steering wheel so that your shoulders are relaxed. Computer work areas should be adjusted to support neutral posture. Consider the height of working counters, and use a step stool if the surface cannot be lowered. The body needs to rest between activities; 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 to assess what is contributing to the discomfort and lymphatic congestion, which causes pressure, stiffness, and pain in the shoulders. These problems can progress to the neck area, resulting in headaches. A medical consultation is advised to determine the cause of lymphatic congestion and whether an increase in massage therapy sessions or the implementation of another technique is warranted.