Characteristics of headaches among surgeons and associated factors: A cross-sectional study

Background: Surgeons performing Minimally Invasive Surgery (MIS) report significant neck/shoulder problems and visual symptoms. Headache is another commonly reported symptom but publications about the characteristics and associated risk factors are limited. Purpose of the study: To determine the characteristics of headache among MIS surgeons and the associations of headache with neck/shoulder problems, visual symptoms and other associated factors. Design: A cross-sectional study. Methods: A comprehensive online survey was sent to MIS surgeons inclusive of 63 questions about individual and workplace physical factors, characteristics of headache, neck/ shoulder problems and visual symptoms. Binary logistic regression models were conducted to determine the associations of the prevalence and severity of headache with risk factors. The main findings: Headaches in the last 7 days were reported by 36% of surgeons, with 37% of these of moderate to severe intensity. Frequent intense headaches were often preceded by neck pain. Surgeons with headache were eight times more likely to also experience visual symptoms and four times more likely to experience neck/shoulder problems. Several factors (frequently adopting forward head movement, surgical specialty, sex and age) were significantly associated with headaches (p <= 0.05). Conclusions: This study revealed headaches were present in one-third of MIS surgeons. During surgery, surgeons report adopting non-neutral neck/shoulder/head positions, which may explain headaches, neck/shoulder problems and visual symptoms. Evidence based strategies to assist surgeons better manage these symptoms are warranted. Crown Copyright (C) 2020 Published by Elsevier Ltd on behalf of Royal College of Surgeons of Edinburgh (Scottish charity number SC005317) and Royal College of Surgeons in Ireland. All rights reserved.