The Hidden Strain: Musculoskeletal Disorders Among Surgeons in High-Volume Operating Theaters

Rohan Lal¹, Kavita Rana², Neel Joshi³, Anjali Rajan⁴, Farhan Sheikh⁵

Abstract

Background: Surgeons face prolonged physical demands and static postures during procedures, yet musculoskeletal disorders (MSDs) remain an underreported occupational hazard. This study investigates the prevalence, anatomical distribution, and risk factors associated with musculoskeletal disorders (MSDs) among surgeons in high-volume surgical units.
Methods: A cross-sectional survey was conducted across six tertiary hospitals in India between 2023 and 2024. A total of 412 surgeons from general surgery, orthopaedics, ENT, and gynaecology completed a validated musculoskeletal health questionnaire (Nordic Musculoskeletal Questionnaire) and ergonomic assessment. Variables included weekly operating hours, surgical speciality, posture rating, use of magnification tools, and fitness habits. Prevalence rates were calculated, and multivariate logistic regression was used to identify independent risk factors.
Results: Overall, 74.5% of surgeons reported at least one MSD in the past 12 months. The most commonly affected regions were the neck (42.7%), lower back (38.3%), and shoulders (26.4%). Female surgeons were more likely to report neck pain (OR = 1.82, p = 0.03), and operating more than 30 hours/week was associated with increased lower back pain (OR = 2.19, p < 0.001). Surgeons using loupes or microscopes without adjustable supports had a significantly higher risk of shoulder discomfort (OR = 2.06, p = 0.005). Only 18% of respondents had received formal ergonomic training.
Conclusion: MSDs are highly prevalent among surgeons, with work-related postural strain being a major contributor. Immediate action, including ergonomic redesign of operating rooms and mandatory ergonomic education, is essential to preserve surgeon health and performance in high-demand surgical settings