Promoting Longevity in Surgical Careers: A Narrative Review and Fitness Program to Reduce Occupational Pain.
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IMPORTANCE: Many surgeons experience work-related musculoskeletal disorders (MSD) throughout their career. Incorporating evidence-based strategies to prevent and manage MSDs would benefit both trainees and those in practice. The present narrative review seeks to evaluate the effectiveness of current strategies to manage and prevent musculoskeletal (MSK) occupational pain among surgeons and trainees. OBSERVATIONS: Eleven studies were identified. Included studies covered 3 broad interventions: ergonomics (n = 5), intraoperative breaks/pauses (n = 7), and physical fitness (n = 1). Intraoperative breaks demonstrated improved pain, fatigue, stress, and a decrease in intraoperative errors without increasing overall surgical time. Residents that were specifically instructed in ergonomics exhibited better posture and decreased musculoskeletal (MSK) symptoms and recommended incorporating this information into their curriculum. In a program combining ergonomics, microbreaks, and stretching, 85% of residents experienced reduced discomfort, and 93% felt this training would help them "perform better in the operating room". Overall, the surgical physical fitness programs reduced surgery/occupational-related pain and increased performance measures in the OR. The study participants also found the interventions valuable and were able to use learned principles in practice. CONCLUSIONS AND RELEVANCE: The existing body of literature supports the positive impact of fitness programs in preventing and managing occupational-related pain. We propose the implementation of a comprehensive program that integrates education, intraoperative breaks, ergonomic adjustment, and physical fitness, with initiation during the first year of surgical residency. To facilitate practical integration, we propose a pilot program that may be integrated into the regular surgical work week, encompassing recommendations from the reviewed studies. Future research is recommended to explore aspects such as program effectiveness, feasibility, mental health impacts, and gender-specific differences.
