Back and neck pain in dentistry: A new reality

Iveta Ramonaite, Dental Tribune International

Wed. 21 February 2024

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Timothy Caruso is a physical therapist with over 30 years of experience, specialising in manual therapy, orthopaedics and ergonomics. In this interview with Dental Tribune International, he offers insights into the common yet often overlooked issue of cervical and lumbar pain among dental professionals. He also addresses the profound impact that chronic pain can have on both the personal and professional lives of dentists, potentially leading to career shortening or even disability, and discusses some preventive measures that can be integrated into daily practice without sacrificing work efficiency.

Mr Caruso, can you share how common back and neck pain are among dental professionals? What factors contribute to cervical and lumbar pain in dentistry?
Depending on the source of information, the range of prevalence of back and neck pain has been stated as somewhere between 50% and 80%. Back and neck complaints are nearly evenly split, and this has held up over the past few decades. In the past year, 84% of dentists reported pain or discomfort while working, according to a survey conducted by the American Dental Association (ADA). The neck, lower back, shoulders and upper back were the most common sites of discomfort.

Factors that most often contribute to pain and discomfort are poor lighting, incorrect practitioner posture, the use of magnification loupes and having limited access to the oral cavity.

How can chronic pain impact the personal and professional lives of dental practitioners?
Initially, there may be increased fatigue, stiffness and aches throughout the body. Over time, this may lead to more chronic pain, musculoskeletal disorders and limitations in employing certain techniques and undertaking certain procedures. In a worst-case scenario, chronic pain can lead to the shortening of one’s career or to disability.

Timothy Caruso is a member of the FDI World Dental Federation Ergonomic Task Team. (Image: Timothy Caruso)

Why are strength and flexibility important for dental professionals? Can you recommend exercises or routines to improve strength and flexibility?
Assuming a balanced posture and working in this posture during the working day can be a huge help, and so is getting a good, restful sleep at night to recharge the body for the following day.

Some general stretches are a good start to improve practitioners’ strength and flexibility. More enthusiastic dental professionals should consider doing yoga, swimming and Pilates. The ADA website has some excellent resources on offer to improve physical health and ergonomics for dental professionals.

What treatment options specific to dental professionals are currently available for managing cervical and lumbar pain?
Seeking out a trained professional in the care of back and neck pain is a great place to start. Dental professionals should always exhaust conservative treatments before considering surgical intervention unless there are emergency circumstances. The McKenzie Institute is a good resource for that. After entering your zip code, it will provide a list of trained clinicians in your area.

Without compromising work efficiency, what preventive measures can dental professionals take to avoid the onset of neck and back pain?
Dental professionals should monitor their working posture throughout the day. They should incorporate chairside stretches during the working day as well as do regular exercise, take rest breaks, and balance difficult and easy patients and procedures. Additionally, dental professionals can adapt the work environment to support better posture and reduce strain by improving the ergonomic set-up of the operatory and being mindful of maintaining dental ergonomics throughout the day.

How do you envision the advancement of ergonomics in dentistry?
Now, more than ever, we are working harder than we have done in the past. The expense of running a practice and the constraints of insurance and reimbursement create a new reality, perhaps a new survival of the fittest.

Would you like to add anything else?
I will be at the 2024 Chicago Dental Society Midwinter Meeting next Thursday and Friday and would be happy to answer any questions dental professionals may have, either on-site or via email.

Editorial note:

Timothy Caruso gave two lectures at the 2024 Chicago Dental Society Midwinter Meeting, titled “Treating back and neck pain in modern dentistry: A survival guide for the rest of your career” and “Posture, pain and productivity in modern dentistry”.