Mar
13

Got Lower Back Pain? Most People Do, Especially Dentists!

As a result of spending most of their day leaning over patients, lack of correct sitting posture, and core strength, it’s easy to understand why dentists (and chairside staff) have posture problems and chronic lower back pain. But take heart, you’re not alone, lower back pain is among the top job related disabilities claimed in the United States.

The problem, more often than not, is that the symptoms of chronic lower back pain are treated rather than the real problem itself. To truly understand this chronic pain, it’s important to look above and below the lower back.

Our body is a stack of joints, each joint provides either mobility or stability, in regard to overall body movement. When your joints are functioning properly, the result is efficient movement and a healthy body. But when a joint isn’t performing its function properly, another joint is forced to compensate for the under-performing joint. The compensation most often occurs directly above and/or below the joint that isn’t functioning properly.  As a result, in many cases, this also leads to pain or injury in the compensating joint(s).

So, with the above in mind, let’s look at the joints above and below the lower back (lumbar spine), to find relief and better understand their function.

  • The lumbar spine’s main joint function is stability. It’s comprised of 5 vertebrae that are significantly bigger than the others in the vertebral column, they’re NOT built for flexing, extending, or rotating. Any sort of core training that you perform should be focused on stabilization instead of movement.
  • The thoracic spine and hips are designed for mobility. The 12 vertebrae of the thoracic spine, located above the lumbar spine, attach to the rib cage and are smaller and are capable of more movement than the lumbar spine.
  • The ball and socket of the hip joint is located below the lumbar spine and has a great capacity for multi-directional movement.

When the hips and thoracic spine don’t move well, the lumbar spine compensates and moves instead, which leads to pain and/or injury.

What’s the best way achieve a healthier pain-free back? Improve your hip and thoracic spine mobility, while performing core strength training to stabilize the lumbar spine.

Correct Sitting Position — According to the Cleveland Clinic, correct sitting position includes all of the following:

  • Sit up with your back straight and your shoulders back. Your buttocks should touch the back of your chair.
  • All three normal back curves should be present while sitting. A small, rolled-up towel or a lumbar roll can be used to help you maintain the normal curves in your back.

Here’s how to find a good sitting position when you’re not using a back support or lumbar roll:

  • Sit at the end of your chair and slouch completely.
  • Draw yourself up and accentuate the curve of your back as far as possible. Hold for a few seconds.
  • Release the position slightly (about 10 degrees). This is a good sitting posture.
  • Distribute your body weight evenly on both hips.
  • Bend your knees at a right angle; Keep your knees even with or slightly higher than your hips (use a foot rest or stool if necessary); Your legs should not be crossed.
  • Keep your feet flat on the floor.
  • Try to avoid sitting in the same position for more than 30 minutes.
  • At work, adjust your chair height and work station so you can sit up close to your work and tilt it up at you. Rest your elbows and arms on your chair or desk, keeping your shoulders relaxed.
  • When sitting in a chair that rolls and pivots, don’t twist at the waist while sitting. Instead, turn your whole body.
  • When standing up from the sitting position, move to the front of the seat of your chair. Stand up by straightening your legs. Avoid bending forward at your waist. Immediately stretch your back by doing 10 standing back-bends.

Improve Your Abdominal Strength — According to About.com’s Sports Medicine, “getting great abs takes more than just ab exercises; you’ll need proper nutrition and a well-balanced exercise routine to go with these ab-focused exercises.”

Perform several (3-5) abdominal exercises 3-5 times a week. Start with exercises and repetitions that are comfortable for your fitness level and as you improve increase the number of repetitions. You do not need to do all the exercises; simply select those that work well for you and vary your routine.

  • Bicycle Crunch Exercise
  • Captain’s Chair Exercise
  • Ab Crunch on an Exercise Ball
  • Vertical Leg Crunch
  • Long Arm Crunch
  • Reverse Crunch
  • Plank (Hover) Exercise
  • Traditional (Basic) Abdominal Crunch
  • Half Curl
  • Crossover Crunch
  • Seated Oblique Twists with Medicine Ball
  • Oblique Crunch
  • Alternating Superman’s
  • V-Sit Exercise
  • Oblique Twist with Medicine Ball

Core Strength Training — According to strength and conditioning coach Brian Utley (The Athlete’s Insider), “abdominal training contributes to a stronger core, but hardly completes the job when you consider that there are actually 29 muscles that make up the core musculature.”

Here are the Mayo Clinic’s at home (or in-office) core strength exercises:

  • Bridge
  • Single Leg Abdominal Press
  • Single-Leg Abdominal Press Variations
  • Double-Leg Abdominal Press
  • Double-Leg Abdominal Press
  • Segmental Rotation
  • Quadruped
  • Modified Plank
  • Modified Plank Variations
  • Side Plank
  • Superman

This article was adapted and expanded from the article, “How Core Strength Training Can Help Dentists with Lower Back Pain,” written by Brian Utley, CSCS, PES. If you enjoyed this article and want more information on back pain, core training, and exercise, please visit Brian’s blog at www.theathletesinsider.com.

About Matt Swenson

Matt Swenson is the man behind Your Dental Edge. With more than nine years of dental implant, biologics, and endodontic sales, marketing, education, and product management experience – plus 12 years as a marketing agency owner, Best Buy corporate art director, and hospital marketing manager – Swenson brings a unique blend of technical dental knowledge and business savvy to Your Dental Edge.

Comments

  1. Thanks for suggesting on a Twitter post that we look at your blog. This is a good article with explanations about the causes of back trouble with dental professionals, and a list of strengthening exercises for the back and body. We also find it helpful to have periodic visits with our favorite chiropractor. Though few of us make time for it, massage therapy is also valuable for keeping a healthy and strong back for the dental profession.

  2. Edward Logan says:

    Great information from both of you. Weight control is very important as well. Routine exercise helps with this of course.

  3. Kurt Klemm PT Cert MDT CEAS says:

    Interesting article on the postural component of the problem in dentistry and other occupations.

    Posture actually means position, most of which in dentistry is well within the normal physiological ROM of the spine. Research suggests that laborers—hard physical workers—who are allowed to vary their position have less problems than more sedentary workers like dentists who maintain a position, even though the work is seemingly less demanding.

    The spine was actually made to move—many structures rely on movement for nutrition—so varying one’s position is a good thing. I invite you to consider the idea that what’s missing in dentistry (and other areas) is support in the desired working position, as the position itself is easily within the normal ROM of the spine.

    You are correct that the hips can and should contribute to the incline position necessary to visualize the worksite—that incline is actually a natural forward lean most people do and avoid “hunching over”. If suported at the trunk in this forward lean position, the head and shoulders are closer to the work area and the upper extremities are free to move about to perform any task. Support allows muscle relaxation and avoids the problems seen with even minimal but constant muscle effort. Myofascial Pain Syndrom and trigger points are soft tissue dysfunctions we often experienced by dentists/hygienists and others. Dental practitioners tell us that especially by the end of the work day/week they are leaning on an elbow or whatever they can, in an effort to get support and allow muscle rest.

    As a certified spine therapist I’d like to share more with you and I appreciate your efforts to improve the problem of widespread pain and dysfunction in dentistry.

    Sincerely,
    Kurt Klemm PT Cert MDT CEAS

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