Aching for Change: Musculoskeletal Pain in the Operating Theatre Amongst Surgical Trainees

Work-related injuries are common among surgeons with up to 70 % being found to report difficulties. Given the extension expected to career longevity for current trainees, injury prevention is more important than ever. However, ergonomics education for surgical trainees in the UK is deficient. We aimed to gauge whether current trainees in Kent, Surrey and Sussex (KSS) experience pain whilst operating and what strategies, if any, they utilise.

A questionnaire was distributed to trainees in the KSS School of Surgery collecting data on pain related to operating and pain management strategies. Participants discussed their experiences of operating-related pain in a focus group.

75 trainees across the KSS region responded. Mean age was 32 years (range 26-42) and median training level was ST4. General surgery (n = 22), orthopaedics (n = 19) and urology (n = 13) were the most prevalent specialties. All trainees reported musculoskeletal pain attributed to operating, with 36 % (n = 27) experiencing pain "frequently" or "always". 69 % (n = 52) found this pain "sometimes", "frequently" or "always" distracted them whilst operating. The most common sites for pain were the lower back (73 %), neck (49.3 %), upper back (38.7 %) and shoulders (37.3 %). No participants had received formal ergonomics training and the majority (86.7 %) had not discussed pain with their supervisors. The focus group identified a culture of enduring pain without complaint and a reluctance to discuss it with mentors.

Musculoskeletal pain from operating was found to be a common issue in this cohort with the majority reporting distraction while operating. Ergonomics is not currently addressed by any formal training programmes and we have recommended a regional training initiative for trainees in KSS to address and prevent musculoskeletal injuries.