VANCOUVER, British Columbia — More than half of gastrointestinal Endoscopists reported that they have experienced musculoskeletal Injuries related to their practice, researchers said here.

In a systematic review and meta-analysis of 21 published studies, 62% of endoscopists surveyed said they have had various injuries including low back Pain, neck pain, thumb pain, hand pain, shoulder pain, carpal tunnel syndrome, and de Quervain’s tenosynovitis, reported Azizullah Beran, MBBS, a gastroenterology fellow at Indiana University School of Medicine in Indianapolis, during the American College of Gastroenterology annual meeting.

“No one talks about this, but it is pretty common among endoscopists,” Beran told MedPage Today at his poster presentation.

Injuries that occur doing the endoscopies are not just minor aches and pains, he noted. About 5.6% of the endoscopists required surgery to correct these musculoskeletal injuries, and 13.2% reported requiring time off from work due to the injuries.

Across the studies, 2,523 endoscopists received some ergonomic training, but even in this group, about 25% experienced musculoskeletal injuries. Beran noted that the longer one works as an endoscopist, the more likely they were to experience these injuries: 47.9% of fellows in gastroenterology experienced injuries, while about 76% of interventional endoscopists reported these complaints.

“Given musculoskeletal injury high prevalence and significant health burden among gastrointestinal endoscopists, ergonomic endoscopic instrument re-design is critical,” Beran said. “Implementing standardized ergonomic curricula in endoscopy training is essential.”

“Further research to inform such an evidence-based ergonomic curriculum is paramount to mitigate musculoskeletal injury risk, especially considering the imminent shortage of gastroenterologists and increasing production volume,” he added.

Endoscopists who developed shoulder injuries often found ways to avoid these injuries on their own by learning different ways to rotate their shoulder while performing the endoscopy to avoid stress on the joints, he noted.

Commenting on the study, Hazem Abosheaishaa, MD, an internal medicine resident at the Icahn School of Medicine at Mount Sinai in New York City, told MedPage Today that “this is an important study and it needs to be reported, so that these injuries might be avoided among endoscopists in training. We need to come up with recommendations for them.”

He pointed out that some endoscopists try to avoid lower back pain and neck pain by sitting down while performing the procedures.

For this study, Beran and colleagues searched PubMed, Embase, and Web of Science databases from their inceptions through March 2023 for studies reporting musculoskeletal injuries among endoscopists.

Of the 5,407 endoscopists included in the studies, 37.7% said they experienced low back pain, 37.2% said they had neck pain, 34.2% experienced thumb pain, 32.2% said they had hand pain, and 30.1% complained about shoulder pain. Carpal tunnel syndrome and de Quervain’s tenosynovitis were each diagnosed in 10%.

Musculoskeletal injury prevalence was 73% among female endoscopists compared with 63.2% among men (P=0.0003). Musculoskeletal injuries occurred less often in academic institutions compared with non-academic settings (48.5% vs 59.5%), but this difference did not reach statistical significance.

Of the endoscopists who reported injuries, 37.7% reported using pain medications, 25% reported undergoing physical therapy, 11% reported splinting, and 8.5% reported steroid injections.