Markers of pain severity and a modifiable factor for frequent musculoskeletal pain in surgeons

Introduction. Work-related musculoskeletal pain (MSP) is highly prevalent in surgeons and may reduce work capacity. Identifying clinical markers of pain severity and modifiable factors is important for prevention.

Objective. To assess associations between clinical and anamnestic characteristics affecting intraoperative performance and a high frequency of MSP episodes in surgeons.

Materials and methods. A cross-sectional survey was conducted in one hundred two surgeons. Pain frequency was dichotomized into low (rare/sometimes) and high (often/constant). The analysis included medical consultation due to pain, intraoperative pauses caused by pain, pain intensity on the Numeric Rating Scale (NRS), history of musculoskeletal injuries, and physical activity. Independent associations were assessed using Firth’s penalized logistic regression.

Results. High pain frequency was associated with medical consultation (OR = 7.98; 95% CI: 2.50–25.47; p < 0.001), frequent/constant intraoperative pauses (OR = 31.19; 95% CI: 4.31–226.01; p < 0.001), NRS pain intensity ≥ 4 (OR = 3.19; 95% CI: 1.04–9.75; p = 0.042), and previous musculoskeletal injuries (OR = 4.94; 95% CI: 1.03–23.63; p = 0.046). Physical activity ≥ once per week showed a negative association with high pain frequency (OR = 0.27; 95% CI: 0.08–0.90; p = 0.034).

Limitations. The interpretation of the results should consider the study limitations. The cross-sectional design does not allow causal inferences to be established. The relatively small sample size resulted in wide confidence intervals for some odds ratio estimates.

Conclusion. High-frequency MSP among surgeons was associated with clinical markers of pain severity affecting intraoperative performance, a history of musculoskeletal injuries, and a modifiable factor – lack of regular physical activity.

Compliance with ethical standards. The study was approved by the Local Ethics Committee of the East-Siberian Institute of Medical and Ecological Research (Protocol No. 3 dated 24/03/2025). The study was conducted in accordance with the Declaration of Helsinki of the World Medical Association (as amended in 2013). Written informed consent was obtained from all participants.

Contribution:
Budaev A.E. – study concept and design, data collection and processing, statistical analysis, writing text, editing;
Lakhman O.L. – study concept and design, editing.
All authors are responsible for the integrity of all parts of the manuscript and approval of the manuscript final version.

Conflict of interest. The authors declare no conflict of interest.

Funding. The study was supported by institutional funding allocated for the state assignment of the East-Siberian Institute of Medical and Ecological Research.

Received: February 2, 2026 / Accepted: May 20, 2026 / Published: June 18, 2026

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