My Aching Back

New survey confirms ophthalmologists are suffering. Cheryl Guttman Krader reports from ASCRS 2021 in Las Vegas, USA. A recent online survey confirms previous research showing musculoskeletal complaints are common among ophthalmologists, providing new information about causes, severity, and interventions for management. “In previous studies, 50% to 70% of ophthalmologists reported musculoskeletal complaints—most commonly in the neck and back. Our study was designed to quantify the frequency of musculoskeletal complaints as well as the setting, location, intensity, and effects of these musculoskeletal issues,” explained Nicholas E Tan, BA. The researchers emailed a SurveyMonkey questionnaire to a total of 245 US ophthalmologists, including comprehensive ophthalmologists and cornea, glaucoma, and retina specialists. They received 144 partially completed surveys in return. The responding ophthalmologists had an average age of 50 years, were predominantly male and White, and worked an average of 45 hours per week. HIGH PREVALENCE AND FREQUENCY Overall, 72% of respondents reported a history of a musculoskeletal diagnosis, and 81% reported musculoskeletal pain, discomfort, or disability episodes in the 12-month period preceding the COVID-19 pandemic. Nearly 50% of the respondents reported experiencing pain daily or weekly. The neck, low back, and shoulders were the most affected locations. “Our survey suggests there may an underdiagnosis of musculoskeletal pathology, especially involving the shoulder,” he commented. While frequent, the musculoskeletal problems had a minimal impact overall. On the validated Total Disability Index (TDI), the mean score corresponded to mild disability, and the worst reported score indicated moderate disability. There was a trend for women to experience worse pain than men, but no found associations between the TDI score and other demographic characteristics, years in practice, or practice volume. EXACERBATORS AND SOLUTIONS Among respondents reporting pain, almost two-thirds indicated their pain worsened by performing surgery and approximately half identified working in the clinic as an aggravator. Approximately 20% of the respondents reporting pain indicated it made operating or conducting clinic exams moderately more difficult or worse. Furthermore, pain episodes often extended beyond the workplace, Mr Tan said. Changing posture was the most common modification implemented to attempt to reduce or prevent pain. Changing equipment was an infrequent modification. Increasing the frequency of stretching or exercise was the most common strategy used to treat pain. Over-the-counter oral medications and manual therapy were also common treatments. “Those with greater disability, measured by a higher TDI score, were more likely to attempt modifications or treatments for pain,” Mr Tan said. Nicholas E Tan is a medical student, SUNY Downstate College of Medicine, Brooklyn, NY, USA. Nicholas.tan@downstate.edu, drradcliffe@gmail.com