Pain in the Neck: The Hidden Cost of Poor Posture in Operating Theatres

25 April 2024

Posture is unlikely to be at the front of a surgeon’s mind as they operate, but studies show that many surgeons retire early or have to undergo spinal surgery because of poor posture in the operating theatre. There appears to be a systemic lack of awareness around musculoskeletal disorders in surgical staff, despite the impact both on surgeons’ lives and the hospitals in which they work. Something needs to change.

This is far from a new revelation: an article from 2017 highlighted the issue, and a study by junior doctor Rohan Bassi, presented at the British Association of Plastic, Reconstructive and Aesthetic Surgeons (BAPRAS) 2023 annual conference further cemented the concerns. In fact, the study showed that in just one hospital trust, MSK disorders accounted for a staggering 727 absences over a single year. The study recorded that surgeons felt discomfort just 60 minutes into an operation, and one in seven reported that this pain affected both their concentration and performance. So why are we not taking this seriously? To use the age-old oxygen mask aeroplane analogy: if you don’t keep yourself well, how are you placed to help others? We must work out how to move forward into an environment in which surgeons look after their own wellbeing as well as that of the patient.

The key lies in ergonomics. A 2022 paper published in The Bulletin of the Royal College of Surgeons of England explored whether implementing solutions that challenged the one-size-fits-all approach to surgical tools could be the answer. Consultant vascular surgeon Ginny Bowbrick is cited in the paper, having undergone major spinal surgery suspected to be because of the loupes she wears for surgery and the awkward posture required to ‘peer into holes’.

An ergonomically sound working environment can mitigate the physical impact of operating, as shown in this article in the British Journal of Surgery. Shoes, stockings, loupes, lead aprons, room set-up, operating table positioning, monitor placement, and anti-fatigue mats were all reviewed with a view to creating a ‘safe and efficient workplace’.^{^[1]} A review across all Trusts would be a (less painful) step in the right direction, and implementing informative posters in the operating theatre - as per Rohan Bassi’s findings - as well as stretch breaks, and adaptation of equipment and working environment, ergonomics education for trainees and faculty, and an acceptance that surgeons must begin to look after their wellbeing, is all in order.

CBS’s clinical psychologist in residence, Richard Sherry, who specialises in high-pressure environments, says:

“The problem is both an environmental and a human factor, both of which play a crucial role in surgeon wellbeing. We already know that chronic pain has a profound effect on sleep which, in turn can lead to concentration issues, potentially leading to mistakes. Mistakes in a surgical environment can have life-changing consequences to the patient as well as the surgeon and surgical team. If that happens, this can have a catastrophic impact on the surgeon’s mental health, an impact that, in the past, at its worst has led to suicide. Something as simple as re-ordering an environment to create a comfortable and safer workspace for all can mitigate such dangerous risks. Surgeons spend thousands of hours in particular positions over their working lives; if in any doubt about the compatibility between the surgeon and their working environment, adjustments must be made.”

CBS is committed to the physical and psychological wellbeing of its members and their families. CBS members have access to discounted gym memberships at over 400 locations in the UK, as well as multi-activity memberships with MoveGB, and savings of up to 55% on some of the UK’s most popular home work-out subscriptions.

^{^[1]} https://www.bjsacademy.com/surgical-ergonomics-how-and-where-to-start

Read other news articles