Many sonographers in Singapore have work-related musculoskeletal disorders despite good ergonomic awareness, according to a local study.
Results of a cross-sectional online survey showed that nearly all respondents (98.5 percent) reported having work-related musculoskeletal disorders. The most affected regions were the shoulders (88.1 percent), lower back (77.6 percent), neck (68.7 percent), and wrists (65.7 percent). [Radiography (Lond) 2026;doi:10.1016/j.radi.2026.103595]
The symptoms caused substantial work interference for some of the affected respondents. Shoulder and neck discomfort drove the highest rates of substantial work interference, at 20.3 percent and 19.6 percent, respectively. Conversely, lower back symptoms accounted for a lower rate of substantial work interference (5.8 percent).
Most respondents (76.5 percent) reported a good level of ergonomic awareness (score 6–7), with a mean score of 6.23. Overall ergonomic awareness score did not translate into a lower discomfort score (p=0.18). However, awareness of the importance of regular breaks and the self-reported behaviour of stretching after scans were associated with lower discomfort scores (p=0.01).
“The findings of this exploratory study suggest that WMSDs are highly prevalent among sonographers in Singapore, and that the relationship between ergonomic awareness and demographics with musculoskeletal outcomes may be more complex than a simple knowledge-behaviour link,” the investigators said.
However, “it should be noted that this prevalence estimate reflects a self-reported sensitive, low-threshold definition of any discomfort with a frequency other than ’never’ in the past month and may therefore be higher than estimates from studies using longer recall periods or higher severity thresholds and should not be considered as clinically diagnosed disorders,” they added.
Ergonomic awareness is not protection
The findings also reveal a gap between ergonomic knowledge and its practical implementation, which may be influenced by institutional constraints and workflow demands, according to the investigators.
While 82.4 percent of the respondents reported knowing that not taking regular breaks increases the risk of work-related musculoskeletal disorders, only 11.9 percent adopted this practice.
“Healthcare institutions may benefit from policy-level changes that enable healthier work routines,” the investigators said. “Potential strategies worth exploring include protected break schedules, scan-list optimization with adequate time buffers, task rotation where feasible, and embedding ergonomics into professional development programmes.”
The investigators called for additional research using larger, more representative samples and longitudinal designs to confirm the present findings and evaluate the effectiveness of specific interventions before firm recommendations can be made.
The cross-sectional online survey involved 68 sonographers working across 24 healthcare institutions in Singapore. Most of them were in the 30–39 and 20–29 age groups (41.2 percent and 32.2 percent, respectively), practiced general sonography (73.6 percent) in public hospitals/clinics (76.5 percent), performed 10–15 scans per day on average (45.6 percent), and spent 6–8 scanning h per day (64.7 percent).
The survey covered demographic and work-related characteristics, ergonomic awareness items, and discomfort across 12 body regions using the Cornell Musculoskeletal Discomfort Questionnaire.