HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS		QUICK SEARCH:   [advanced] Author: Keyword(s): Year:  Vol:  Page:

This Article Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Services Similar articles in this journal Alert me to new issues of the journal Download to citation manager Citing Articles Citing Articles via Google Scholar Google Scholar Articles by Rempel, D. Articles by Loomer, P. Search for Related Content PubMed Articles by Rempel, D. Articles by Loomer, P.

The writers confuse the term musculoskeletal disorder (MSD) with carpal tunnel syndrome (CTS). Musculoskeletal disorders are conditions not just of nerves, but also of other structural tissues such as tendons, ligaments and muscles. In this context, the term "disorder" has been defined as "alterations in an individual’s usual sense of wellness or ability to function ... and may or may not be associated with well-recognized anatomic pathology."¹

Most workers who experience recurring pain in their hands or arms want treatments and work-place interventions that will reduce their pain, so that they can function effectively. The fact that the pain cannot be labeled with a specific diagnosis in some people does not lessen its importance. The inability to apply a specific diagnosis may be due to the use of narrow diagnostic criteria or the early presentation of a disorder. Furthermore, from the perspective of designing appropriate ergonomic interventions, the difference between someone with pain only and someone with pain and physical signs is probably not very important.

The work-related risk factors for arm and hand pain, tendon disorders and CTS are similar and include high grip force, sustained awkward postures, repetitive motions and vibration.¹ Contrary to the writers’ assertion, tendonitis among dental professionals is not due solely to awkward postures. Their cited reference² does not support their assertion.

Whether or not the risk of CTS is increased by dental work is not well-addressed by the studies that the writers cite, and a thorough treatment of the topic should be done in a different forum. That said, we do not want JADA’s readers to think that CTS is the most prevalent MSD among dental professionals. CTS is the best known and may be the most disabling MSD,³ but tendon disorders are a more common problem among dental professionals.²

The Simmer-Beck and colleagues article⁴ is a good companion piece to our study. They evaluated the effect of dental mirror handle diameter, weight and surface texture on forearm muscle activity. Unfortunately, we were unable to predict the future; the electronic release of the Simmer-Beck paper occurred after our article had been accepted for publication in December 2005.

	REFERENCES

TOP REFERENCES

1. National Research Council, Institute of Medicine. Musculoskeletal disorders and the workplace: Low back and upper extremities. Washington: National Academy Press; 2001.
   
   
2. Werner RA, Hamann C, Franzblau A, Rodgers PA. Prevalence of carpal tunnel syndrome and upper extremity tendinitis among dental hygienists. J Dent Hyg 2002; 76(2):126–32.[Medline]
   
   
3. Daniell WE, Fulton-Kehoe D, Chiou LA, Franklin GM. Work-related carpal tunnel syndrome in Washington State workers’ compensation: temporal trends, clinical practice, and disability. Am J Ind Med 2005;48(4):259–69.[Medline]
   
   
4. Simmer-Beck M, Bray KK, Branson B, Glaros A, Weeks J. Comparison of muscle activity associated with structural differences in dental hygiene mirrors. J Dent Hyg 2006;80(1):8. Epub 2006 Jan 1.[Medline]
   
   

This Article Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Services Similar articles in this journal Alert me to new issues of the journal Download to citation manager Citing Articles Citing Articles via Google Scholar Google Scholar Articles by Rempel, D. Articles by Loomer, P. Search for Related Content PubMed Articles by Rempel, D. Articles by Loomer, P.