Musculoskeletal Pain in Surgeons on Operating Days

Work-related musculoskeletal (MSK) pain is frequent in surgeons, but factors associated with it are not well studied.

Repeat surveys were sent to general and subspecialty surgeons in the evening of their operating room (OR) days in one month. Age, sex, BMI, weekly exercise, NASA Task Load Index (NASA-TLX: a composite measure of workload), and pain scores were collected. Operating room case length and approach were collected from a registry. All variables were analyzed for their independent association with mean pain score changes in 12 body regions (with 95% CI).

There were 29 surgeons who performed a total of 537 operative cases on 228 OR days. Increases in NASA-TLX by 100 were associated with increased pain in neck +0.23 (0.10-0.35), hands/fingers +0.22 (0.11-0.33), upper back +0.22 (0.10-0.34), lower back +0.31 (0.18-0.44), buttocks +0.07 (0.02-0.13), hips +0.10 (0.03-0.18), legs +0.14 (0.06-0.21), and feet +0.15 (0.05-0.24). Longer total case length increased pain in neck and upper back (+0.15 and +0.13 for every increase in 4 hours, respectively). An OR day with higher proportion of robotic time was associated with increased pain in wrists +0.32 (0.10-0.54) and lower back +0.36 (0.02-0.70). Higher proportion of lap/endo time was associated with increased pain in upper back +0.33 (0.08-0.58).

Workload was the strongest contributor to musculoskeletal pain during operating days, with associations seen across most body regions. Case length and approach contributed to pain in a smaller number of regions. Targeted ergonomic strategies may reduce the burden of MSK pain among surgeons.