Signs and Symptoms of Musculoskeletal Disorders
Dental hygienists are susceptible to musculoskeletal pain, especially in the neck, shoulder, and hand/wrist regions. It is believed that awkward, prolonged working posture—such as bending, reaching, and standing—contribute to these conditions.
Dental hygienists are susceptible to musculoskeletal pain, especially in the neck, shoulder, and hand/wrist regions. It is believed that awkward, prolonged working posture—such as bending, reaching, and standing—contribute to these conditions. Like other health care professionals, dental hygienists experience psychological stress and anxiety at work. Studies suggest that the psychological stress experienced by dental hygienists is related to musculoskeletal symptoms. Studies on oral health professionals found that 58% of dentists have experienced headaches and dental hygienists may also be susceptible to tension headaches due to the nature of their work.
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Muscle Pain
Muscle pain, or myalgia, is a common condition that affects most people at some point. It can vary from mild aches to severe, incapacitating muscle spasms. A muscle spasm is an involuntary contraction of one or more muscles. Muscle spasms are frequently referred to as “muscle cramps,” which may be related to dehydration, poor circulation, or lack of minerals in the diet. However, muscle spasms are also the result of overuse and excessive strain of the muscle unit. The prolonged standing and awkward reaching postures commonly performed by dental hygienists, for example, may result in muscle tension in the spine and neck areas.
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Tendonitis
Tendonitis occurs when there is inflammation of the muscle tendon, or the muscle’s attachment to the bone. It often happens after excessive, repetitive motions such as gardening, painting, and playing tennis. It is common in the upper extremities, especially the base of the thumb, elbow, and shoulder; although it affects the lower extremities, as well. Tendonitis is frequently included in descriptions of cumulative trauma disorders, also known as repetitive strain injuries, which are the largest cause of occupational disease in the United States. Repetitive upper extremity motions routinely performed by dental hygienists may predispose this group to inflammatory conditions.
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Bursitis
Bursitis is inflammation of the bursae, or the fluid-filled sacks in the body designed to reduce friction. Trauma to the area or excessive motion can lead to increased amounts of fluid in the bursae, causing pain. Bursitis is common in the elbow, shoulder, and hips. The inflamed bursae often can be palpated as a fluid-filled sack, thus distinguishing it from tendonitis. As the bursae is not directly in series with contractile tissue, the pain may not be reproduced with muscle contraction or stretching. However, the area is typically extremely sensitive to touch and these criteria help a trained clinician reach an accurate diagnosis.
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Arthritis
Osteoarthritis results from an erosion of the normal cartilage within a joint, reducing the joint space available for normal motion. Common symptoms include morning stiffness or stiffness after prolonged rest, and pain and swelling in the joints after use. There is no specific cause of osteoarthritis; however, genetics, obesity, injury, and overuse may be contributing factors. The repetitive movements involved with dental hygiene practice may make these professionals more susceptible.
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Fibromyalgia
Fibromyalgia is a condition that can result in widespread chronic pain that frequently presents as musculoskeletal symptoms. It is not a specific disease but rather a group of symptoms that also include memory problems, fatigue, and mood changes. Unlike osteoarthritis, it does not lead to joint or muscle damage. Fibromyalgia affects nearly 4 million Americans most of whom are women between the ages of 40 and 75. Fibromyalgia is diagnosed when a certain identifiable pattern of symptoms is present, when pain has lasted at least 3 months, and when no other medical diagnosis explains these symptoms.
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Take Action
First, some serious medical conditions present as musculoskeletal pain. It is vital that individuals identify certain “red and yellow flags” that may help distinguish between typical musculoskeletal pain syndromes and serious pathology. The following are red/yellow flags that may signify more serious pathology than musculoskeletal injury: severe unremitting pain; pain unaffected by medicine or position; severe night pain; severe pain with no history of injury; severe muscle spasm; incontinence; prolonged fever; ringing in the ears; dizziness; blurred vision; sensitivity to light; abnormal sweating; generalized and unexplained weakness; and elevated heart rate not associated with activity.
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Seeking Assistance
When dental hygienists determine the threshold has been met to seek medical assistance for musculoskeletal pain, they have multiple options. For example, they may seek help from a family physician, occupational health physician, orthopedic surgeon, nurse practitioner, physician assistant, chiropractor, massage therapist, or physical therapist. These professionals have varying levels of training and areas of expertise. In rural areas, nurse practitioners and physician assistants may be more accessible.
