Repetitive strain injury (RSI) describes a number of musculoskeletal conditions, most of which are occupational in origin. It often affects the limbs but can also affect the spine causing referred pain and making diagnosis difficult. Symptoms include numbness, tingling, sharp pain, dull ache, weakness and loss of grip. RSI is very common among the dental profession with an estimated 27 per cent of dentists having to retire prematurely because of it.

However, this is not really surprising when you think about the grossly distorted postures that members of the dental team have to adopt to reach those awkward spots, coupled with repetition of tasks that may require a bit of force.

Overuse of any part of the body combined with poor posture, twisting, cold, vibration or stress, is a risk factor for RSI, and while the environment plays a great part, secondary factors such as stress, high workload and poor overall health and posture are likely to figure into the equation too.

Avoiding RSI

Simple adjustments can make all the difference to the health of the dental team and should help prevent pain becoming a part of everyday life. Adopt the best posture by doing the following:

  • For dentists, the upper arms and elbows should be in light contact with the sides and the hands and fingers should be at mid-chest height. For nurses, the arms can be extended rather more forward keeping the top of the upper arm in contact with the body

  • Nurses should sit with their eye level four inches higher than that of the dentist

  • The patient's head must be at the top of the headrest

  • Dentist and nurse should sit as close to the patient as possible

Chartered physiotherapist, Chris Keevil from 3 Way Physiotherapy in Reading, says: 'Day to day activities can put undue strain on joints, ligaments, tendons and muscles. This strain causes inflammation which can become chronic and debilitating if simple actions are not taken. Avoid actions that are repetitive and do something else between patients or tasks. Do not stay in the same position for more than 20 minutes without a break. Get up, walk around or stretch for a few seconds to adjust your position. Soon, doing these things will become second nature.'

Go for a walk at lunchtime and try the simple stretches shown below at regular intervals. Avoid activities outside of work that increase the strain on joints and muscles (such as sitting for hours at your home PC) and, of course, it pays to eat healthily, drink two litres of water a day and exercise regularly if you can.

Treatment

If you think you are experiencing the symptoms of RSI, see your GP. Should you need treatment, a multidisciplinary approach may suit you. Conventional therapies include:

  • Physiotherapy - using heat, electric current, manipulation and exercise

  • Medication - involving nonsteroidal anti-inflammatory drugs, aspirin, antidepressants and muscle relaxants

  • Immobilisation - where splints can alleviate pain in the hands and arms

  • Steroids - cortisone injections to give short-term pain relief

  • Surgery

  • Chiropractic and osteopathy - especially for neck and back pain

  • Massage - to relax soft tissue

Complementary therapies include:

  • Alexander technique - to promote good posture

  • Pilates - to build strength and improve flexibility

  • Yoga - helps with fitness, flexibility and stretching

  • Tai chi - a Chinese martial art that helps with posture and meditation

  • Acupuncture - helps pain by applying pressure with tiny needles to specific points on the body

'Practice Essentials', a pack containing laminated health and safety information for dental practices, is now available for £15 (members) /££20 (non-members) from BDA Shop.