Clinical Assisting- Chapter 25

musculoskeletal disorders:

• headaches, neck, shoulder pain, back pain, and carpal tunnel syndrome (CTS: a wrist injury) account for many disabling and potentially career ending musculoskeletal disorders among dental professionals

• work habits, posture, and equipment and instrument design can contribute to these work-related disorders

work related musculoskeletal disorders: include

• back pain

• joint pain

• neck and shoulder pain

• hand/wrist pain

• headaches

ergonomics in dental office:

• members of the team usually preform their work in a seated position, often w excessive motions and unbalanced posture

• early onset of pain- should alert you to an imbalance: if ignored it can lead to more serious issues

important for assistants to understand:

• how to implement ergonomics changes and methods

3 interrelated factors that contribute to increased risk of job-related injury:

• posture

• repetition

• force

frequent reaching, twisting, and working w the arms in awkward positions can cause:

• strains and sprains

strains:

• extreme stretching of muscles or ligaments

sprains:

• usually involve a sudden twisting or wrenching of a joint w resulting stretching or tearing of ligaments

shoulder problems can be caused by:

• repeatedly reaching behind the body for instruments or supplies

to help prevent CTD’s:

• periodic breaks and alternation of difficult procedures w less stressful procedures are recommended

one common CTD is:

• CTS

what can significantly increase the risk of cumulative trauma disorders:

• repetitive motion

• over flexion

• extension of the wrist

what does CTD’s stand for:

• cumulative trauma disorders

carpal tunnel is:

• an anatomic area of the hand/wrist

first symptoms of carpal tunnel: (CTS)

• a painful tingling in one or both hands

• decreased ability and power to squeeze objects or make a tight fist may follow

carpal tunnel syndrome:

• with improper motion, the tendons swell, exerting pressure on the median nerve

what are other causes of carpel tunnel:

• other repetitive hand and wrist movements:

• knitting

• gardening

• keyboard

the use of ambidextrous gloves:

• can exert excessive tension on the hypothenar eminence by forcing the hand to work against the vertical alignment of the glove form

right-left gloves:

• that are properly sized support the hand in natural position,

• which properly positions the thumb, index finger, middle finger

stretching and strengthening muscles:

• that support the back and neck, and those used in the forearm, wrist, and hand will help them remain strong and healthy

• you can engage in stretching- periodically throughout the workday

• before beginning- check with physician, mostly if you experience pain w any movements

hand exercises:

• resting hands frequently is believed to be one of the most important factors in preventing CTS

eye exercises:

• to relieve eyestrain caused by focusing intensely at 1 depth of vision for long periods- look up from the task and focus your eyes at a distance for approximately 20 seconds

• practice this frequently throughout the day to use your full range of vision and lessen eyestrain

back exercises:

• to release back, neck, and shoulder stresses- try full back release

• let the head roll forward slowly and allow the arms and head to fall between the knees; hold for a few seconds, then rise slowly by contracting the stomach muscles and rolling up. bring the head up last

neck exersices:

• try head rotations for neck stiffness

• they involve tilting the head from right to left, as well as forward and backwards, w/o forcing the motion beyond your range of comfort

shoulder exercises:

• shoulder shrugging

  • used to stretch shoulder muscles that may be stresses by holding oral evacuators, instruments, and telephone handsets

  • pull shoulders up toward the ears, then roll them backward and forward in a circular motion

posture effects:

• the ability of the assistant to reach for, hold, and use equipment

• influences- how long the assistant can perform a task w/o suffering adverse health affects

• overtime, any position will lead to fatiguing and may lead to lower back pain

• consider- alternating assisting at chairside w others to give variety

posture: how to position

• neutral position by sitting upright w weight evenly distributed

• legs- separated and feet flat on the chair footrest

• back- pressed against the back of the chair for lumbar support

• hips- tilted forward to rotate the pelvis backward, properly aligned resembles a gentle S

• spine- properly aligned, the ears, shoulders, and hips are in straight vertical alignment, providing balance, support, and equal distribution of weight

posture: deviate from neutral position

• ex. leaning forward, twisting, overbending the back, reaching

• can lead to- aches, pains, numbness, tingling

• ideally- sitting/standing should be alternated whenever possible