Does gastrointestinal endoscopists suffer from procedure-related musculoskeletal symptoms?

Work-related musculoskeletal disorder (MSD) is common among individuals whose job requires repetitive isometric maneuvers or awkward body positions. However, the prevalence of MSD among endoscopists is not well known. There are neither detailed descriptions nor analyses of the severity of the symptoms, risk factors, and management in eastern countries.

A research article to be published on July 21, 2008 in the World Journal of Gastroenterology addresses this question. The survey led by Prof. Lee from Samsung Medical Center of Sungkyunkwan University in Korea investigated 55 endoscopists practicing in 4 general hospitals and 2 health promotion centers. Data about age, gender, duration of practicing endoscopy, underlying musculoskeletal disease, and postures and habits during endoscopy were collected.

Forty-nine (89.1%) endoscopists reported musculoskeletal pain on at least one anatomic location.

Forty endoscopists (72.7%) had pain at more than one anatomic location. Thirty-seven endoscopists (67.3%) had pain at rest. Twenty-six (47.3%) endoscopists had severe musculoskeletal pain defined as a visual analogue score larger than 5.5. Factors related to the development of severe pain were (1) standing position during the upper endoscopy, (2) specific posture/habit during the endoscopic procedure, and (3) multiple symptomatic areas. In this study, the experience level of endoscopists was not related to the prevalence of musculoskeletal pain, the number of symptomatic areas, and severity of the most painful regions. However, they found the different distribution of the symptomatic areas. Finger pain was more common in beginners, whereas shoulder pain was more common in experienced endoscopists, suggesting multiple ergonomic mechanisms of symptom development. The exact reason of this difference is unclear, but muscles and/or joints frequently used during the endoscopic procedure may be different by the endoscopic experience.

They also found that sixteen percent of symptomatic endoscopists have modified their practice or decreased the number of endoscopic examinations. Only a few symptomatic endoscopists have sought the professional consultation of related specialists. Measures for the prevention and the adequate management of the endoscopy-related musculoskeletal symptoms are necessary.

Source: World Journal of Gastroenterology