Sure they’re trendy, touted as ergonomic and featured on high-end chairs. But why, exactly, would you want to invest your valuable dollars in a chair with armrests?

The answer: comfort and injury prevention. Studies support the use of armrests in the prevention of neck and shoulder pain. Armrests have been shown to decrease muscle activity in dental professionals’ neck and shoulders, especially in the upper trapezius. In dentists, the use of armrest can significantly reduce tension in the upper trapezius muscle, especially on a person’s dominants side, i.e., the arm that handles the handpiece.  Hygienists, on the other hand, receive more benefit on the mirror-side or retracting hand. Traditionally, armrests tend to be more popular among dentists than hygienists, since dentists tend to stay in one position longer than hygienists.  

So which style of armrest is right for you? Armrests should be highly adjustable and support the operator in a wide range of positions. There are several styles of armrests on the market today:  fixed, movable armrests, swiveling, pivoting and telescoping armrests. Different styles tend to be more appropriate for different team members.

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Fig. 2

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Fig. 4

Fig.5

Because dentists tend to work in one position longer than hygienists, fixed, movable armrests (Fig 1) are preferred by many dentists, especially endodontists. This type of armrest system is highly adjustable in many directions: width, height, forward/backward, and the armrest itself tilts for optimal hand positioning. Once the desired position is found, the knobs can be tightened to secure the settings (Fig 1).  Dentists often find they like the retracting, or mirror-side arm slightly higher and further forward than the right on this type of chair.  

   Swiveling armrests (Fig 2) move freely with the operator, which many operators, especially hygienists, find favorable.  The only drawback may be if the armrests swivel too freely, the operator cannot find it when they need it. The telescoping/hydraulic armrest moves in/out and forward/backward with the operator and can be set at a specific height (Fig 3).  

    A pivoting movable armrest (Fig 4) uses a small circular pad on the armrest, which can be moved with the operator.  A nice feature is that the resistance can be increased or decreased according to the operator’s liking.  

Another problem encounterd by some is fiberoptic lighting cables may become entangled in armrests.  One solution is to place sticky-backed cable guides on the backrest of the chair.  Other problems include hitting the patient in the head with the armrest.  This is simply a ‘spacial awareness’ problem that is usually resolved within the first couple of weeks of use.

Proper height adjustment of the armrest is essential in preventing neck/shoulder problems.  Adjusting the armrests too high can actually worsen neck pain, as it puts the levator scapulae muscle on slack and can cause neck stiffness and pain at the crook of the neck and shoulder.  Adjust the armrests too low, and you lose the ergonomic benefits of the armrests. Proper width adjustment (between armrests) is also important, since armrests set too far apart will cause you to have to abduct your arms.  

If you have a confined operatory space and find it difficult to maneuver a chair with armrests around the patient, you may want to consider a unilateral armrest fixed to a counter (Fig 5). Dentists who operate with the left arm resting have been shown to have less pain than those who do not.  These are available in a variety of heights to adjust to multiple users and situations.

To be clear, armrests are not an automatic solution for all operators with neck pain.  Depending upon the etiology of your pain, taking the arm weight off your neck and shoulders may or may not reduce your symptoms.  In consultations, I perform a specific physical therapy test to determine if individuals with neck pain would benefit from armrests.  You should trial a chair for at least one week in your operatory before buying one to determine if it benefits you and can be easily maneuvered in your operatory.

Although they may take some getting used to, the rewards of using armrests can be great in the reduction of neck and shoulder pain in dentists. I highly recommend that dentists consider a chair with armrests in at least one operatory. You can even alternate between a chair with armrests and a traditional or saddle-style type stool in another operatory to prevent overworking one area of the body.  However you choose to do it, it pays to give your muscles a rest!