Working Through the Pain: Surgical Culture and Musculoskeletal Injury

Document Type


Publication Title

Current Surgery Reports


Purpose of Review

Ergonomic injury occurs in all surgeons in varying degrees and at different times in their career. These occupational injuries are the result of suboptimal ergonomic conditions in the operating room, lack of appropriate ergonomic training and resources, failure to monitor and report ergonomic injuries, and the increasing paradigm of productivity which encourages surgeons to push through physical discomfort.

Recent Findings

Occupational injuries in surgery can be prevented or decreased through education and institutional commitment. Surgeons, surgical educators, and administrators responsible for the design and maintenance of operating rooms must learn that a culture that ignores pain may result in poor work environments, significant injury, and premature attrition of surgeons. Ergonomics in the operating room, specifically awkward surgeon positioning, inappropriate table height, incorrect monitor placement, and poorly fitted instrumentation are directly responsible for musculoskeletal injuries in surgeons. These injuries are under-reported due to biases ingrained in surgical culture, lack of resources to support injured surgeons, and fear of workplace repercussions.


Ergonomic injury in the operating room is a significant but under-reported issue which is often career limiting, can lead to excessive cost for institutions, and may affect patient safety and outcomes. Preventing and limiting ergonomic injuries in the operating room is possible, but requires robust educational programs, support for research to better understand the etiology, prevention, and treatment of these injuries, non-punitive reporting mechanisms, and support for injured surgeons.



Publication Date



surgical culture, surgical ergonomics, work-related musculoskeletal injury, ergonomic guidelines, injury reporting, gender stigma