Beyond Ergonomics

Preventing RSIs in Medical Laboratory Professionals

PHOTOGRAPHY: HALMYRE CREATIVE

Medical laboratory professionals (MLPs) are often described as working in clean, controlled environments. But anyone who has spent time at a bench knows the reality is very different. Pipetting hundreds of samples, leaning into microscopes, standing at biosafety cabinets and performing fine, repetitive hand movements for hours at a time place real physical demands on the body. Over time, those demands add up. Though they are often under-recognized or accepted as “part of the job,” repetitive strain injuries (RSIs) — also known as work-related musculoskeletal disorders (MSDs) — are common in laboratory professionals. A CSMLS report on in-job injuries found that among 250 MLPs, pathologists, microbiologists and biochemistry technologists, 21 per cent suffered from musculoskeletal symptoms across various body regions, eight per cent had neck pain and seven per cent experienced lower back pain. A 2017 study published in the Journal of Occupational Health found that almost 1 in 10 MLPs suffered from carpal tunnel syndrome, which occurs when tendons in the wrist's narrow carpal tunnel become overused and inflamed increasing pressure on the median nerve. Both of these findings mirror broader occupational health research showing that repetitive hand use and forceful or sustained gripping significantly increase the risk of nerve compression in the wrist.

Why Lab Work is Hard on the Body

The work of laboratory professionals combines several well-known ergonomic risk factors:

  • Repetitive fine-motor tasks, such as pipetting, capping and uncapping tubes, slide handling and specimen manipulation, often performed hundreds of times per shift.
  • Static and awkward postures, particularly during microscopy and biosafety cabinet work, which commonly involve forward head posture, neck flexion and sustained shoulder elevation.
  • Prolonged standing or sitting, contributing to lower back, hip, knee and circulatory strain.
  • High workload and limited recovery time, especially in high-throughput laboratories where breaks between tasks are scarce.

Although many senior roles are primarily office-based, they can involve extended computer work, making those professionals as susceptible to RSIs as any office worker. A stiff neck, sore wrist or aching lower back may seem minor at first, something that’s easy to ignore, especially during busy periods when taking a break feels impossible. But ignoring early symptoms can have long-term consequences, according to Miriam Mulkewich, BPE, BHScPT, Registered Physiotherapist and co-owner of Fit for Life Physiotherapy in Burlington, ON. Persistent RSIs can progress to chronic pain, tendonitis, nerve compression, reduced grip strength and lasting loss of dexterity, all of which can limit a lab professional's ability to pipette, manipulate specimens or work efficiently in any setting, she says. Over time, the pain and fatigue associated with RSIs can increase errors and contribute to burnout and absenteeism. For lab professionals whose work depends on fine motor control and hand endurance, what begins as “just a sore wrist” can have serious implications for their careers. And, as Mulkewich points out, the impact of these injuries does not stop at the lab door. Chronic pain often affects sleep, mood, physical activity and quality of life outside of work.

“Persistent RSIs can progress to chronic pain, tendonitis, nerve compression, reduced grip strength and lasting loss of dexterity, all of which can limit a lab professional's ability to pipette, manipulate specimens or work efficiently in any setting.”

Ergonomics Matter — But They’re Only Part of the Picture

Across Canada, workplace ergonomic protections are governed by occupational health and safety legislation at both the federal and provincial levels. While regulations vary by jurisdiction, employers are broadly obligated to identify and control ergonomic hazards, conduct workstation assessments and provide appropriate training. In most jurisdictions, joint health and safety committees are also required to include musculoskeletal hazards in workplace inspections. Nevertheless, ergonomics-specific regulations remain inconsistent across the country, making workplace culture and individual awareness even more important. Within the workplace, the tools available to lab professionals and their employers are well established. Ergonomic assessments, adjustable seating and benches, task rotation, micro-breaks and regular ergonomics training all reduce risk. Even small changes, such as avoiding awkward wrist angles when adjusting microscope knobs or applying minimal force when pressing pipette plungers, can make a difference, as per this Lab Manager article. On the question of sitting versus standing, Mulkewich says neither extreme is ideal. Sitting for long periods puts strain on the lumbar discs and gradually tightens the hip flexors and hamstrings, which adds further stress to the back; but standing all day can create a different set of problems. As she points out, the body tends to sag into extension, increasing pressure on the facet joints of the spine and adding load through the knees. The best solution, she says, is a desk that allows workers to alternate between sitting and standing. In Mulkewich’s view, minimizing repetitive movement is just as important as changing postures. If you don’t move your body in different ways, you start to lose mobility and, “all of a sudden, when you do something that requires that mobility, certain joints are not going to be very happy,” she says. She advises changing tasks as often as possible. “What that break frequency looks like and how long those breaks are will look different for everyone, and it might take some trial and error to figure it out. It might also look different during a really acute phase of an injury… versus later when you’re feeling more recovered.” But even an ideal ergonomic setup and frequent changes of movement may not be enough. Most lab professionals have roughly 14 hours each day outside of work and commuting — and many of the same muscles and tendons stressed at work continue to be loaded at home, as leisure activities can involve similar repetitive patterns, such as sustained sitting, repeated bending and fixed postures, says Mulkewich. While patients often expect a solution in the form of a new chair or desk, the reality is that total daily load determines whether tissues recover or break down. “We don’t want to put everything into silos to kind of say, okay, here’s my work, here’s my sport,” she says. She stresses that an ergonomic lab bench cannot compensate for hours of poor posture at home or inadequate sleep. Long evenings spent hunched over a phone or slouched on a couch may undo the benefits of even the best workstation setup.

What Can Lab Professionals Do?

At home, as in the workplace, Mulkewich advises mixing up activities. Using gardening as an example, she suggests alternating among raking, digging, planting and watering rather than staying with one task. She also recommends taking regular breaks when watching TV or using a phone. If RSI symptoms persist for more than two to three weeks or significantly limit daily activity, consult a health care professional such as a physiotherapist, she says. It’s best that the root cause of the condition, whether it’s a mobility or a strength deficit, be identified as early as possible so that an appropriate treatment plan can be designed, she notes. If strengthening is needed, the right type and level of exercise matters. When a tendon is irritated, patients may need to modify how they load it — using lower weights and a different movement pattern — before gradually building back up, she says. “It’s not that you shouldn’t necessarily strengthen, but you need to ensure that you are doing the right type of strengthening exercise and that you are at the right level of resistance.” Mulkewich cautions against relying on rest alone as a solution to repetitive strain injuries. Although, people may initially feel better when they limit their activities, if the injured tendon or muscle hasn’t gotten stronger or more resilient, the pain is going to come back once it’s re-exposed to a big workload, she says. She also warns against stopping treatment too soon. Returning to regular routines before adequate strength has been rebuilt often triggers a cycle of recurring symptoms — pain returns, activity is reduced, the body weakens further and recovery takes longer, all of which impacts overall health and well-being. Mulkewich emphasizes that broader lifestyle factors matter too: stress, poor nutrition and insufficient sleep all influence how the body manages inflammation and addressing them is part of the recovery process. She observes that patients often report feeling better on vacation, probably because their activities tend to be more varied and enjoyable, and their overall stress level is lower, which can ease pain. She often asks patients what aspects of being on holiday made them feel better and then works with them to bring those elements into their everyday routine. That insight about vacations underscores a broader reality, namely that musculoskeletal health is cumulative, shaped by everything from bench posture to sleep quality to how you spend a Sunday afternoon. Preventing RSIs is not about ergonomics or personal responsibility alone — it’s about seeing the full picture. Laboratory professionals, managers and institutions all have a role to play. But so does the individual who notices a sore wrist and decides not to ignore it.


Katherine O’Brien

Special to the CJMLS

Katherine O’Brien is a Canadian medical writer specializing in healthcare systems, clinical practice, and public health

References
Katherine O’Brien is a Canadian medical writer specializing in healthcare systems, clinical practice, and public health

Katherine O’Brien

Special to the CJMLS