Abstract
Background and study aims Colonoscopy is physically demanding for endoscopists and patients. Repetitive movements
during colonoscopy can lead to overuse injuries. We aimed to explore the prevalence
and range of colonoscopy-related musculoskeletal injuries (CRIs) in endoscopists.
Methods A cross-sectional electronic survey of 1825 endoscopists was performed. The sample
was composed of members of the British Society of Gastroenterology, European Society
of Gastrointestinal Endoscopy, and National Nurse Endoscopy Group (UK). The survey
comprised 20 questions. These included: endoscopists’ workload, level of experience,
and their perceived CRIs. All endoscopists who perform colonoscopy independently were
included in the analysis.
Results A total of 368 questionnaires were completed of 1825 surveyed (20.16 %). Of those,
319 participants (17.48 %) were fully independent in colonoscopy. Of 319 endoscopists,
254 (79.6 %) have experienced musculoskeletal injuries. These were reported as either
possibly (n = 143, 56.3 %) or definitely (n = 90, 35.4 %) related to colonoscopy.
Commonly injured areas were the lower back (n = 85, 36.5 %), neck (n = 82, 35.2 %)
and left thumb (n = 79, 33.9 %). Of the injured endoscopists, 98 (30.7 %) made some
modification to their practice, such as stretching exercises and ergonomic changes.
Of the endoscopists, 134 (42.0 %) thought that repetitive limb strain was a likely
causative mechanism. Around 40 % believed that torquing the scope and challenging
body position were precipitating CRIs. Several treatment modalities were used to treat
CRIs. These included; physiotherapy (n = 109), medications (n = 70), rest (n = 43),
splinting (n = 31), steroid injections (n = 26) and surgery (n = 11).
Conclusions A significant proportion of colonoscopists experience CRIs. The majority of the suggested
modifications to practice can be adopted by any endoscopist. These results highlight
the need to recognise CRI as an important occupational health hazard and to adopt
preventative strategies routinely in the future.