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Musculoskeletal Pain in Surgeons on Operating Days
Alexandria Panuccio1, Thomas Webb2, Yilan Jiangliu1
1Department of Surgery, Kaiser Permanente Los Angeles Medical Center, Los Angeles, CA, USA.
Abstract:
Work-related musculoskeletal (MSK) pain is frequent in surgeons, but factors associated with it are not well studied.
Methods:
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).
Results:
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).
Conclusion:
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.
Insights
Surgeon workload significantly increases musculoskeletal pain across most body regions during operating days. Addressing workload and optimizing surgical approaches can help reduce surgeon pain.
Area of Science:
- Occupational Health
- Surgical Outcomes
- Musculoskeletal Disorders
Background:
- Work-related musculoskeletal (MSK) pain is prevalent among surgeons.
- Factors contributing to MSK pain in surgeons are not well understood.
Purpose of the Study:
- To investigate the association between workload, surgical factors, and MSK pain in surgeons.
- To identify key contributors to MSK pain experienced by surgeons during operating days.
Main Methods:
- Surveys collected data on surgeon demographics, exercise, workload (NASA-TLX), and pain scores.
- Operating room registry provided data on case length and surgical approach (robotic, laparoscopic/endoscopic).
- Statistical analysis examined the independent association of variables with pain scores in 12 body regions.
Main Results:
- Increased workload (NASA-TLX) correlated with increased pain in multiple body regions, including neck, hands, back, hips, legs, and feet.
- Longer operative case lengths were associated with increased neck and upper back pain.
- Robotic surgery was linked to increased wrist and lower back pain, while laparoscopic/endoscopic surgery was associated with upper back pain.
Conclusions:
- Surgeon workload is the primary driver of MSK pain during surgical procedures.
- Surgical case length and approach also contribute to MSK pain in specific body regions.
- Implementing targeted ergonomic interventions may alleviate the burden of MSK pain for surgeons.
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