Ergonomic injuries and their complications: prevention and treatment

Abstract

Ergonomic hazards are prevalent in otolaryngology and head and neck surgery, with nearly 80% of otolaryngologists reporting work-related musculoskeletal discomfort (WRMD). These issues arise due to the specialized equipment used in patient care, such as endoscopes, microscopes, and loupes, which require prolonged and varied postures that strain the body. WRMD, including pain, stiffness, and fatigue, can persist throughout an otolaryngologist's career, affecting performance, quality of life, and patient safety. A lack of ergonomic training contributes to the high prevalence of WRMD, which begins during early training and often persists without intervention. Several factors increase the risk of WRMD, including the surgical position (sitting vs standing), longer procedure times, and the use of endoscopic tools. Prevention measures like ergonomic education during medical training, adjustments to workstation setups, and targeted interventions using assessment tools such as RULA can help mitigate these risks. However, there is a need for comprehensive guidelines and research into effective remediation methods. Treatment strategies include improving ergonomic practices in the operating room, clinic, and wards, using adjustable equipment, and integrating micro-breaks. While some surgeons benefit from robotic-assisted surgeries, which reduce WRMD, these methods may introduce other ergonomic challenges. Additionally, alternative treatments such as acupuncture, massage, and physical therapy can help alleviate symptoms. Overall, addressing ergonomic hazards through early education, better equipment, and improved practices can reduce WRMD and improve both surgeon well-being and patient outcomes.