Comparison of spine structure, mobility, and competency in dentists with and without low back pain

Abstract

Dental practices can cause musculoskeletal pain and dysfunction due to cumulative microtrauma and inappropriate working positions (1). The prevalence of musculoskeletal pain in dentists was declared between 64% and 93% (2). The prevalence of low back pain in dentists was reported as 47.6% as the most common musculoskeletal dysfunction (3,4). Is there a difference in spine structure, mobility, and competency of dentists with low back pain compared to those without low back pain? In the study, 65 dentists with low back pain (40 females, 25 males, age: 25.57±2.83 years, weight: 67.64±13.20 kg, height: 171.72±8.46 cm, BMI, 22.75±3.25 kg/m2) and 57 pain-free matched control group (30 females, 27 males, age: 26.36±3.94 years, weight: 69.05±13.00 kg, height: 170.53±7.78 cm, BMI, 23.64±3.52 kg/m2) were included. Spine structure, mobility, and competency in the sagittal and frontal planes were evaluated with the Valedo®Shape device (Idiag, Fehraltorf, Switzerland). Parameters were obtained in degrees: thoracic, lumbar, sacral/hip angle, and trunk inclination angle (angle between straight line from T1 to S1 and vertical line). After the spinous processes of the spine were marked as reference points, the Valedo®Shape device was moved down by the evaluator over all the spinous processes starting from the C7 spinous process to approximately the S3 spinous process. The response of the spine to loading was evaluated using weight for competency measurement. After measuring before the weight, the participant was asked to wait for 30 seconds with the weights in hand, and the measurement was repeated (6). The normality distributions of the data were determined by the Shapiro-Wilk test. In the comparison of the data, the independent sample t-test was used in those with normal distribution, and the Mann-Whitney U test was used for those that were not normally distributed. In patients with low back pain, in the sagittal plane, the inclination angle decreased (p=0.045), there was a shift in the sacral angle with loading (p=0.037). In the sagittal and frontal planes, there was no significant difference in thoracic region angles (p=0.292;0.074) and in the lumbar region angles (p=0.369; p=0.781). In participants with low back pain, the angle of inclination decreased in the sagittal plane and a lateral shift response occurred in the sacrum with loading. It is known that the angles of the lumbopelvic region are directly related to the curvature of the spine and compensatory mechanisms against spinal deformities in the sagittal plane in this region (7). In a previous study, a shift in the inclination angle was reported by dentists with low back pain (8). The changes in the spine in dentists may be seen in the occurrence of low back pain. This should be considered for the assessment and treatment of low back pain.