Sex-based differences in musculoskeletal pain among surgeons: an international survey

Introduction: Musculoskeletal (MSK) injury is a known occupational risk for surgeons. Few studies have focused on the impact of sex in MSK injuries, despite differences in physical characteristics that may influence MSK pain occurrence. The increasing number of female surgeons urges investigation on ergonomic challenges faced by this group. The aim of the survey was to evaluate incidence and impact of MSK pain among surgeons to assess sex-based differences in the occurrence of MSK pain. Methods: A survey comprised of demographic/practice-related questions, validated scales for work-related MSK pain assessment and effect of health impairment on quality of life (QoL) was electronically distributed. Primary outcome was MSK pain incidence across sex evaluated with comparative and logistic regression analysis. Results: 1162 surgeons completed the survey (48.02% females, 51.98% males). Significant differences across demographic factors were identified whereas surgical platforms used were similar across sexes. Female surgeons reported higher frequency of MSK pain (p =  < 0.0001), and significant difference in MSK pain location. Higher burden of MSK pain in females was noted, with higher rates of "numbness", "pain" and "ache" and less often "none" with respect to the male group (p = 0.020). Higher MSK pain frequency was associated with depression-like feelings, painkiller use and work absence (p =  < 0.0001). Conclusions: There are striking sex-based differences in work-related MSK pain across surgeons. Female surgeons experience more MSK pain than males and suffer of subsequent impacts on routine work, function, and QoL. These results highlight the need to promote appropriate surgical ergonomics in the operating room for the expanding population of female surgeons.