According to a systematic review and meta-analysis , Surgeons and medical interventionalists are at high risk for work-related musculoskeletal disorders , with rates comparable to construction workers. The study findings were published in the JAMA Surgery .
The lead author Bernard Lee explained many work-related musculoskeletal disorders depend on positioning, and result from standing in awkward, static positions for long periods of time, often with heavy equipment worn on the head, or heavy gowns worn on the body.
Long hours spent performing repetitive movements and less-than-ideal instrument design can also add to the wear and tear on surgeons' bodies. Such problems can cause some surgeons to cut back on procedures, take time off from work for rehabilitation or surgery , and even shorten careers.
Some studies suggest a higher prevalence of work-related musculoskeletal disorders among surgeons and interventionalists than among coal miners, manufacturing laborers, and physical therapists. Others have reported that up to 80% of at-risk physicians may experience significant work-related pain.
However, most of the data is limited or anecdotal. To provide more evidence, Dr Lee and colleagues searched four databases and two clinical trials for studies on work-related musculoskeletal disorders in surgeons and medical interventionalists.
The analysis included 21 articles published in English or Spanish in 23 different countries between 1974 and 2016 and encompassed data from 5828 physicians . Participants were 78.5% male (mean age, 46.0 years), had been in practice for roughly 12.8 years, and spent about 14.4 hours per week performing procedures.
Pooled crude prevalence estimates showed that the most common work-related musculoskeletal disorder was degenerative lumbar spine disease, with an overall career prevalence (OCP) of 19% (95% confidence interval [CI], 13% – 27%).
Other common disorders included degenerative cervical spine disease (OCP, 17%: 95% CI, 12% – 25%), rotator cuff injury (OCP, 18%; 95% CI, 13% – 25%), and carpal tunnel syndrome ( OCP, 9%; 95% CI, 5% -16%).
Results also showed that the overall prevalence of neck, shoulder, back, or upper extremity pain in the last 12 months ranged from 21% to 60%, although results varied depending on how studies assessed pain.
Among physicians who experienced work-related musculoskeletal disorders, 12% (95% CI, 7% – 18%) needed to take a leave of absence, had to modify or restrict their practice, or entered early retirement. Twelve specialties in eight countries reported the need for ergonomics education.
The results point to the need for evidence-based ergonomics programs for surgeons and interventionalists. Such programs should be integrated with other types of wellness programs designed to prevent burnout, attrition, and suicide. First and foremost, however, is the need for awareness and frank discussion about the problem.