Musculoskeletal Problems in Healthcare Professionals

This article provides an overview of musculoskeletal problems among healthcare professionals. It discusses the prevalence, risk factors, and preventive measures of musculoskeletal disorders. The article also highlights the need for increased awareness and education among healthcare professionals to address these problems. The study objectives and further research recommendations are also presented.

Running head: MUSCULOSKELETAL PROBLEMS
1
Musculoskeletal problems
Name
Institutional Affiliation

MUSCULOSKELETAL PROBLEMS 2
Introduction
Evidence on the Topic
Musculoskeletal disorders refer to problems affecting the joints, bones and muscles.
Musculoskeletal disorders are extremely prevalent and affect 50% of adults in the United
States, which adds up to around 126 million individuals (Campbell, 2017). A
musculoskeletal disorders one of the rapidly increasing problems in occupational health. The
conditions are highly prevalent among workers who perform duties such as heavy lifting,
excessively repetitive tasks and activities performed in awkward posters. The World Health
Organization (WHO) and International Labour Organization (ILO) regard musculoskeletal
classifies musculoskeletal disorders as a work-related problem (Luan et al., 2018).
Musculoskeletal disorders are prevalent among healthcare professionals. Koyuncu
and Karcioglu (2018) conducted a prospective cross-sectional study among healthcare
professionals in a community training hospital with a capacity of 700 beds. The study
included 216 health care workers within healthcare sectors. The findings indicated that 173
workers (79.7%) reported musculoskeletal conditions. Female workers reported a higher
prevalence that males. The quality work life was higher among workers with no incidence of
musculoskeletal conditions. The evidence demonstrated the high prevalence of
musculoskeletal problems among healthcare professionals.
Motivation of the Review
Researchers have paid adequate attention to the issue of musculoskeletal problems in
the healthcare sector. However, most of the identified studies are cross-sectional studies.
Therefore, there is need for a systematic review to provide an overview of evidence and
achieve a general view of different researchers regarding musculoskeletal problems.

MUSCULOSKELETAL PROBLEMS 3
Methods
Search Strategy
Data Sources. The researcher selected the articles from six databases, including
Medline, EBSCOhost, ProQuest, Web of Science, PubMed, and Google Scholar. The
selected articles focused on musculoskeletal problems with a bias on the health sector. All
the identified articles were relevant to musculoskeletal problems. The researcher searched
articles published in the English language between 2015 and 2019.
Search terms. The main search terms used to select articles included
“musculoskeletal”, “problems”, and “healthcare”, “professionals”. The resarcher combined
the search terms to form search phrases such as “healthcare professionals” and
“musculoskeletal problems”, “musculoskeletal disorder”. Other complementary searches
included “healthcare sector”, “work-related” and “work-related musculoskeletal problems”.
The identified articles were then reviewed to establish their eligibility for the study.
Inclusion/Exclusion Criteria
The first step was to select journals published in English language that were less than
five years (2014 to 2019). The researcher excluded articles published in a different language
other than English from the study. The mentioned search terms helped to identify studies
related to musculoskeletal problems. The articles that had titles mentioning musculoskeletal
problems, healthcare professionals, and work-related musculoskeletal problems were
searched. The researcher excluded articles related to other sectors other than the healthcare
sector from the study. In the initial search, a total of 86 articles were identified (n=86). A
total of 59 (n=59) articles were included in the study following an exclusion of duplicates,
amounting to 17 articles. Duplicates meant that an article appears more than once among the
eligible articles. The identified articles were then reviewed to establish their eligible
appearing more in more than one database. The next step involved examining the abstracts

Journals published in English language that
were less than five years (2014 to 2019)
(n=86)
Articles included in the study (n=59)
17 duplicates
excluded
Articles that discussed musculoskeletal
problems among healthcare professionals
only (n=31)
Exclusion of 28 articles
that did not focus on
musculoskeletal problems
among healthcare
professionals
Inclusion of 23 (n=23) articles
Exclusion of 8 articles
after full screening of
articles
10 studies included in the final study (n=10)
Exclusion due to other reasons such
as lack of comprehensive evidence,
methodology used and the nature of
the study
MUSCULOSKELETAL PROBLEMS 4
of the remaining articles to establish their relevance to the study. At this stage, the inclusion
criteria were that the articles must focus on musculoskeletal problems among healthcare
professionals. The researcher excluded articles that discussed other stakeholders apart from
healthcare professionals from the study. The exclusion yielded 31 (n=31) articles.
Further, the full texts were reviewed to assess their relevance. The researcher included a
total of 23 (n=23) articles in the study following the exclusion of irrelevant articles. The
researcher then screened the 23 articles eligible for the study and excluded 13 articles for
various reasons such as lack of extensive evidence, the methodology used, and the nature of
the study. The total number s articles reviewed was10 (n=10) articles. Appendix A
demonstrates the summary of eligible studies. The flow chart diagram below demonstrates
the literature search process.

MUSCULOSKELETAL PROBLEMS 5
Figure 1: Flow Chart. Source: (Researcher)
Results
Summary of Evidence
The systematic literature review yielded essential insights related to
musculoskeletal problems. The evidence gathered from the reviewed articles demonstrated
that musculoskeletal problems are highly prevalent among most categories of healthcare
professionals across different countries (Iqbal & Alghadir, 2015; Luan et al., 2018; Rahman
et al., 2017). Musculoskeletal problems affect the working capabilities of healthcare
professionals. Dentists are the category of healthcare professionals with the highest
prevalence of musculoskeletal problems. Other categories that demonstrated a high risk
include physical therapists, doctors of Chinese medicine, and registered nurses (Wang, Liu,
Lu & Koo, 2015). The findings slightly differed from Yasobant and Rajkumar (2015), who
stated that nurses were at the highest risk, followed closely by physiotherapists and dentists.
Physicians and laboratory technicians have the lowest risk of musculoskeletal problems.
The evidence from the articles presented various risk factors that predispose the
healthcare professionals to musculoskeletal problems. Yasobant and Rajkumar (2014)
attributed the risk of musculoskeletal problems among healthcare providers to the nature of
their work, which involves working in one position for long, increased workload, and
working in cramped or awkward positions. Musculoskeletal disorders were associated with
various psychological factors such as fatigue and stress; workload-related factors such as
break times and work hours per week; ergonomic factors and employment status (Dong,
Zhang, Liu, Shao & Xu, 2019). Dong et al. (2019) explained that ergonomic factor such as
bending the trunk, neck, standing and walking for long and maintaining shoulder abduction
for long is associated with increased musculoskeletal conditions in various parts of the body.

MUSCULOSKELETAL PROBLEMS 6
Other risk factors of musculoskeletal problems include sex, income levels, occupation, level
of education, and age. Koyuncu and Karcioglu (2018) pointed out that female sex, university
graduation, being a doctor or nurse; high income and old age predispose persons to
musculoskeletal problems. For instance, Mirmohammadi, Yazdani, Etemadinejad, and
Asgarinejad (2015) established that female nurses were at a higher risk of musculoskeletal
disorders as compared to male nurses.
Various preventive measures are essential for preventing musculoskeletal problems.
The prevention of musculoskeletal problems among healthcare professionals is achievable
by addressing the individual, ergonomic, organizational, and psychological factors that
predispose healthcare professionals to musculoskeletal disorders (Dong et al., 2019). Three
articles upheld the importance of ergonomic interventions in addressing musculoskeletal
problems (Dong et al., 2019; Iqbal & Alghadir, 2015; Mirmohammadi et al., 2015; Wang et
al., 2015). Therefore, Ergonomic interventions were found to be effective in preventing and
managing musculoskeletal problems among healthcare professionals. Unfortunately, the lack
of adequate education and awareness regarding the effectiveness and adoption of ergonomic
is common among healthcare providers. There seemed to be a consensus among researchers
on the increased need to enhance awareness among healthcare providers regarding
musculoskeletal disorders. Re-orientation and education of the healthcare professionals on
the advantages of ergonomic practices are essential (Ephraim-Emmanuel, Ogbomade,
Idumesaro & Ugwoke, 2019; Luan et al., 2018). Researchers recommended that education
programs regarding musculoskeletal problems be made mandatory in the healthcare sector
(Rahman et al., 2017). Effective preventive interventions may provide a solution to
musculoskeletal problems in healthcare settings.
Conclusion
Conclusion from Evidence

MUSCULOSKELETAL PROBLEMS 7
The systematic review involved screening ten articles related to musculoskeletal or
problems among healthcare professionals. The evidence indicated a high prevalence of these
problems with dentists, nurses, and physiotherapist being the most affected. The nature of
work done by healthcare professionals is one predisposing factor. Other factors include age,
gender, and socio-economic status.
Ergonomic factors significantly contribute to musculoskeletal problems in healthcare
settings. Interventions focused on addressing these factors are essential among healthcare
professionals. However, most of the professionals lack adequate knowledge and awareness
regarding ergonomic interventions. Researchers acknowledged the importance of increased
awareness through education among healthcare professionals to reduce the risk of
musculoskeletal problems. Healthcare professionals may lack awareness of how to address
the problems that have become a barrier to their working capabilities. If possible, preventive
education should be made mandatory in healthcare settings.
Study Objectives of the Evidence
From the knowledge obtained through the review, a study focusing on ergonomic
interventions and the risk of musculoskeletal problems among nurses is essential. It is clear
that nurses are among the highest risk group. Ergonomic interventions have also been
mentioned as effective strategies for managing and preventing musculoskeletal problems.
The aim of the study is to examine the effectiveness of ergonomic interventions in
preventing musculoskeletal problems among healthcare professionals with a specific interest
in nurses. The study would focus on the following elements:
Study population: nurses wh. have previously experiences musculoskeletal
problems but have not undertaken any preventive or treatment intervention. Nurses who
have sought interventions for treatment or management of the problems will be excluded
from the study.

MUSCULOSKELETAL PROBLEMS 8
Intervention: the subjects selected in the study will undergo ergonomic intervention
programs such as workplace adjustments and modifications of working areas and desks.
Comparison group: All the participants in the study regardless of the group will
undergo basic exercise sessions twice a week for a period of seven weeks. This will ensure
that all participants regardless of the group will undergo a symptom relieving intervention
throughout the study.
Outcome: the expected outcomes are reduced musculoskeletal symptoms within 7
weeks in the study group.
Therefore, the research question is: In nurses with musculoskeletal problems, do
ergonomic interventions reduce musculoskeletal problems compared to basic exercises at 7
weeks?
Further Research
The articles in the study are from various countries, including China, Nigeria, India,
Turkey, Iran, and Vietnam. Six studies were developed using the cross-sectional study
design. Other research designs should be used t explore the phenomenon of musculoskeletal
problems in the healthcare sector. Yasobant and Rajkumar (2014) recommended the need
for a longitudinal study to accurately estimate the risk factors of musculoskeletal problems
and make informed recommendations on the prevention and treatment.

MUSCULOSKELETAL PROBLEMS 9
References
Campbell, L. C. (2017). Musculoskeletal Disorders Addressing Disparities in
Prevalence, Severity, and Treatment. North Carolina medical journal, 78(5),
315-317. doi: 10.18043/ncm.78.5.315
Dong, H., Zhang, Q., Liu, G., Shao, T., & Xu, Y. (2019). Prevalence and associated
factors of musculoskeletal disorders among Chinese healthcare professionals
working in tertiary hospitals: a cross-sectional study. BMC Musculoskeletal
Disorders, 20(1), 175. doi: 10.1186/s12891-019-2557-5
Ephraim-Emmanuel, B. C., Ogbomade, R., Idumesaro, B. N., & Ugwoke, I. (2019).
Knowledge, attitude and practice of preventing the occurrence of work-related
musculoskeletal disorders among doctors in University of Port-Harcourt
Teaching Hospital. Journal of Medical Research and Innovation, e000161-
e000161. doi: 10.1186/s12891-019-2557-5
Iqbal, Z., & Alghadir, A. (2015). Prevalence of work-related musculoskeletal disorders
among physical therapists. Med Pr, 66(4), 459-69. doi:10.13075/mp.5893.00142
Koyuncu, N., & Karcioglu, Ö. (2018). Musculoskeletal complaints in healthcare
personnel in hospital: An interdepartmental, cross-sectional
comparison. Medicine, 97(40). doi: 10.1097/MD.0000000000012597
Luan, H. D., Hai, N. T., Xanh, P. T., Giang, H. T., Van Thuc, P., Hong, N. M., & Khue,
P. M. (2018). Musculoskeletal Disorders: prevalence and associated factors
among District Hospital Nurses in Haiphong, Vietnam. BioMed research
international, 2018, 3162564. doi:10.1155/2018/3162564
Mirmohammadi, S., Yazdani, J., Etemadinejad, S., & Asgarinejad, H. (2015). A cross-
sectional study on work-related musculoskeletal disorders and associated risk

MUSCULOSKELETAL PROBLEMS 10
factors among hospital health cares. Procedia Manufacturing, 3, 4528-4534.
doi:10.3329/updcj.v7i1.33302
Rahman, M., Chowdhury, A., Zaman, M. S., Sultana, N., Amin, M. B., & Hossain, M.
M. (2017). Work-related musculoskeletal disorders among health care
professionals. Update Dental College Journal, 7(1), 4-9.
doi:10.3329/updcj.v7i1.33302
Wang, S. Y., Liu, L. C., Lu, M. C., & Koo, M. (2015). Comparisons of musculoskeletal
disorders among ten different medical professions in Taiwan: A nationwide,
population-based study. PloS one, 10(4), e0123750.
Yasobant, S., & Rajkumar, P. (2014). Work-related musculoskeletal disorders among
health care professionals: A cross-sectional assessment of risk factors in a tertiary
hospital, India. Indian Journal Of Occupational And Environmental
Medicine, 18(2), 75–81. doi:10.4103/0019-5278.146896
Yasobant, S., & Rajkumar, P. (2015). Health of the healthcare professionals: A risk
assessment study on work-related musculoskeletal disorders in a tertiary hospital,
Chennai, India. International Journal of Medicine and Public Health, 5(2). DOI:
10.4103/2230-8598.153836

Running head: MUSCULOSKELETAL PROBLEMS 11
Appendix A: Summary of Articles
Authors (Year) Method Country Findings/ Conclusion Recommendation
Dong, Zhang, Liu, Shao
& Xu (2019)
Multivariable logistic
regression analysis.
A self-administered
questionnaire
incorporating the Nordic
Musculoskeletal
Questionnaire and the
Dutch Musculoskeletal
Questionnaire was
conducted among 14,720
HCP in eight tertiary
hospitals
China Musculoskeletal disorders
were associated with
workload (work hours per
week, break times during
workday), psychological
factors (psychological
fatigue, mental stress),
employment status and
ergonomic factors.
Regarding the ergonomic
factors, lower back
musculoskeletal disorders
were associated with
bending the trunk
frequently, heavy or
awkward lifting, and
bending or twisting the
neck; knee
musculoskeletal disorders
were associated with
walking or standing for
long periods of time; and
shoulder musculoskeletal
disorders were associated
with maintaining shoulder
abduction for long
periods of time and
There is need to consider
the mentioned
psychological,
ergonomic, organizational
and individual
factors should be
considered in prevention
of musculoskeletal
disorders among
healthcare providers.

MUSCULOSKELETAL PROBLEMS 12
bending or twisting the
neck.
Ephraim-Emmanuel,
Ogbomade, Idumesaro &
Ugwoke (2019)
A descriptive, cross-
sectional study design
among 223 doctors
working at the University
of Port Harcourt
Teaching Hospital.
Nigeria Majority of the
respondents had good
knowledge and attitude
towards musculoskeletal
disorders’ prevention at
work. The practice of
ergonomic principles was
however not satisfactory.
Occurrence of work-
related musculoskeletal
disorders among study
respondents was
significantly associated
with the knowledge and
practice of ergonomic
principles required to
prevent the occurrence of
these disorders.
A re-orientation of
doctors to be more
involved in the actual
application of ergonomics
while working no matter
the compulsion or desire
to get the work done
should be done.
Iqbal & Alghadir (2015) An online survey among
100 physiotherapists in
Delhi.
India High prevalence of
work-related
musculoskeletal disorders
(92%)
The role of ergonomics
and techniques of patient
handling in development
of work-related pain
symptoms should be
addressed.
Koyuncu & Karcioglu
(2018)
Prospective cross-
sectional study was
performed in the 700-bed
community training
hospital.
Turkey The risk factors for
musculoskeletal
complaints among
healthcare professionals
increase due to female
sex, high-income,
Effort should be made to
ensure that to understand
musculoskeletal
complaints that affect
quality of work life

MUSCULOSKELETAL PROBLEMS 13
university graduation,
working as a nurse or a
physician, and older age
Luan, Hai, Xanh, Giang,
Van Thuc, Hong & Khue
(2018)
A cross-sectional study
was conducted on 1179
nurses working in 15
district hospitals using the
Standardized Nordic
Questionnaire.
Vietnam High prevalence of
Musculoskeletal
Disorders among nurses
in district hospitals in
Haiphong (74.7% in the
past 12 months and
41.1% in the last 7 days.
The symptoms limited
their work capabilities
There is need for
preventive action to
increase the awareness of
nurses regarding
musculoskeletal disorders
and improve their
working conditions
Mirmohammadi,
Yazdani, Etemadinejad&
Asgarinejad (2015)
Health care staffs and
nurses (n=110) in a public
hospital were involved in
the study. Data was
analysed using quick
exposure checklist (QEC)
and Nordic
Musculoskeletal
Questionnaire (NMQ)
Iran The QEC tool assessment
showed that there is a
high risk for work-related
musculoskeletal disorders
among health care staffs
who carrying or
transferring/relocating the
patients (L=4) and there
is a medium action level
for nurses who working
in standing position for
long time (L=3).
The female nurses are in
higher risk compare to
male nurses.
Ergonomics design as
prevention intervention is
necessary for addressing
work-related
musculoskeletal disorders
Rahman, Chowdhury,
Zaman, Sultana, Amin &
Hossain, (2017).
A descriptive cross
sectional study among
160 health care
professionals (doctors,
India High proportion of health
care professionals had
work-related
musculoskeletal disorders
Education programmes
on prevention and coping
strategies for
musculoskeletal disorders

MUSCULOSKELETAL PROBLEMS 14
nurses) working in a
tertiary care hospital
and they are on the risk
for development of
work-related
musculoskeletal disorders
be made mandatory for
health care professionals
Wang, Liu, Lu & Koo,
(2015).
Cox proportional hazards
model was used to
compare the risk of eight
musculoskeletal disorders
among the 10 different
medical professions using
dentists as the reference
category.
7,820 medical personnel
were included in the
analysis.
Taiwan Dentists as the reference
category (Dentists are
already known to
demonstrate high rates of
work-related
musculoskeletal
disorders), physical
therapists showed a
significantly higher risk
of all eight
musculoskeletal
disorders.
Physical therapists,
registered nurses, and
doctors of Chinese
medicine showed an even
higher risk of
musculoskeletal
disorders.
Ergonomics
improvements and
interventions that target
to specific groups of
medical personnel may be
required to reduce their
risk of musculoskeletal
disorders.
Yasobant & Rajkumar
(2014)
A cross-sectional study
conducted among
dentists, laboratory
technicians, nurses,
physicians, and
physiotherapists of
various clinical
departments in a tertiary
care hospital
India A high proportion of
health care professionals
reported wok-related
musculoskeletal disorders
at one or the other body
region, lower back being
the most commonly
affected area. Working in
the same position for long
A longitudinal study
using quantitative
analytical study is
essential for estimating
the risk factors for work-
related musculoskeletal
disorders to promote the
development for better
preventive measures

MUSCULOSKELETAL PROBLEMS 15
periods, working in
awkward or cramped
positions and handling an
excessive number of
patients or samples in one
day were the most
commonly reported job
risk factor that
contributed to the
development of work-
related musculoskeletal
disorders, in this study.
Yasobant & Rajkumar
(2015).
A cross-sectional
exposure-risk assessment
study, conducted on 140
healthcare professionals,
including dentists,
laboratory technicians,
nurses, physicians and
physiotherapists of
various clinical
departments in a tertiary
care hospital
India Nurses are at the highest
risk for developing wok-
related musculoskeletal
disorders, followed by
dentists and
physiotherapists whereas
laboratory technicians
and physicians have the
least.
Education, awareness,
and training programs on
prevention and coping
strategies for
musculoskeletal disorders
be made mandatory for
healthcare professionals.