Surgeons' Operating Positions and Development of Musculoskeletal Pain: A Cross-Sectional Study in Tanzania

Background : Surgeons experience a significant burden of musculoskeletal pain (MSP) stemming from awkward postures, prolonged static positions, and repetitive movements. Poor ergonomics worsen these risks, impacting their well-being and performance. This study investigates the relationship between operating positions and MSP, highlighting the necessity for targeted interventions. Methods : A prospective cross-sectional study was conducted from August to December 2024. An electronic questionnaire was distributed to surgeons from various specialties in Tanzanian hospitals. The questionnaire gathered data on experiences with musculoskeletal pain, its causes, and effects. Results : A total of 171 surgeons with a mean age of 42.3 years (SD ± 8.7) and a Body Mass Index (BMI) of 25.4 (SD ± 3.2) participated. The prevalence of musculoskeletal pain was 68% (95% CI: 60.5%–75.5%), with the lower back (66.4%, 95% CI: 59.1%–73.7%) and neck (45.7%, 95% CI: 38.2%–53.2%) being the most commonly affected areas. MSP was more prevalent among general (71.1%) and orthopedic surgeons (66.3%) than among urologic and ENT specialists, with statistical significance noted across specialties (p < 0.05). Prolonged standing (>4 hours) was strongly associated with lower back pain (71.4%, p = 0.0008, Cramer’s V = 0.32), and forward neck flexion (>30°) was significantly correlated with neck pain (75.5%, p = 0.0015, Cramer’s V = 0.28). Arm elevation >90° was associated with shoulder pain (79.5%, p = 0.0024, Cramer’s V = 0.30), and repetitive motions were linked to the upper back (56.3%, p = 0.0049, Cramer’s V = 0.25) and shoulder pain (50.0%). Surgeons with less than 10 years of experience reported significantly higher MSP rates than those with longer careers (p < 0.05). A sedentary lifestyle was associated with an increased risk of shoulder pain (OR = 8.7, 95% CI: 2.99–25.29; p = 0.0001). Conclusion : Musculoskeletal pain (MSP) is a significant occupational health burden among Tanzanian surgeons. This study's findings show the need for ergonomic interventions to mitigate MSP. Policymakers should prioritize workplace ergonomics in hospital guidelines; surgical training programs should incorporate ergonomic education to reduce long-term disability among surgeons. Implementing these strategies will enhance surgeon health, procedural efficiency, and overall patient care quality in resource-limited settings.