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In 102,159 nurses, rotating and night shifts weren't significantly linked to more musculoskeletal pain, but trends leaned that way

BMC nursing (PubMed)Jul 1, 2026

AI-summarized from the linked source. Educational brief, not medical advice.

Brief summary

A meta-analysis of observational studies covering 102,159 nurses found no statistically significant association between rotating or fixed-night shifts and musculoskeletal pain compared with day shifts, though several estimates trended toward more pain in shift workers.

What NurseJet pulled from the source

This systematic review and meta-analysis of observational studies searched four databases from December 2024 to August 2025 and included 24 studies covering 102,159 nurses, with 13 studies contributing to the quantitative synthesis; only musculoskeletal pain outcomes were homogeneous enough to pool. Compared with day shifts, rotating shifts were not significantly associated with musculoskeletal pain (pooled estimate 1.15, 95% CI 0.98 to 1.35; I² = 7.2%), and fixed night shifts showed no significant association either (pooled estimate 1.09, 95% CI 0.94 to 1.27; I² = 81.1%). Region-specific analyses of neck, back/lumbar, shoulder, and lower-limb pain also found no significant associations, though several pooled estimates tended to be higher among rotating-shift workers. The authors conclude the relationship is complex and shaped by ergonomic, psychosocial, and organizational factors.

Why this matters for nurses

Musculoskeletal injury is a leading reason nurses leave the bedside, and shift scheduling is often blamed. This analysis tempers that assumption: across a very large pooled sample, shift pattern alone was not a statistically significant driver of musculoskeletal pain, suggesting that ergonomics, workload, and safe-handling support may matter more than the schedule itself, a useful reframe for how units and leaders target prevention.

Bedside takeaway

Be aware that across 102,159 nurses, rotating and night shifts were not significantly linked to more musculoskeletal pain, suggesting ergonomics, workload, and safe-handling support may matter more than the schedule.

Explain this for my unit

Key takeaways

  • Across 24 studies and 102,159 nurses, neither rotating nor fixed-night shifts were significantly associated with more musculoskeletal pain than day shifts.
  • Rotating versus day shifts: pooled estimate 1.15 (95% CI 0.98 to 1.35); fixed night versus day: 1.09 (95% CI 0.94 to 1.27).
  • Region-specific analyses (neck, back, shoulder, lower limb) also showed no significant associations, though several estimates leaned higher for rotating-shift workers.
  • The authors frame musculoskeletal pain in nurses as driven by multiple ergonomic, psychosocial, and organizational factors, not shift type alone.

Practice implications

  • For nurses and unit leaders, the takeaway is that reducing musculoskeletal injury likely depends more on ergonomics and safe patient-handling resources (lift equipment, adequate staffing for turns and transfers, and workload management) than on shift type by itself. The trend toward higher pain in rotating-shift workers, though not statistically significant, is a reason to attend to recovery time and body mechanics for staff on rotating schedules rather than to dismiss the concern.

Limitations & cautions

  • The synthesis pooled observational studies, which can show association but not causation and are prone to confounding, and it relied on inconsistent definitions of shift work and musculoskeletal outcomes across studies. Only musculoskeletal pain was homogeneous enough to meta-analyze, one comparison showed high heterogeneity (I² = 81.1% for fixed night shifts), and the non-significant trends toward more pain in shift workers leave the question unresolved; the authors call for longitudinal studies with standardized measures.
  • AI-summarized from the linked source. Review the original article before applying to practice.

Citations

Exact source links

Public citations are filtered to exact credible source pages. Homepage-only or invalid links stay in admin review and are not shown here.

BMC nursing (PubMed)

BMC nursing (PubMed). Impact of nursing shift patterns on work-related musculoskeletal disorders: a systematic review and meta-analysis.

Open original source

https://pubmed.ncbi.nlm.nih.gov/42387543/

Professional education only

This summary does not replace clinical judgment, facility policy, provider orders, or official guidelines. Verify practice changes against the original source and local protocol.

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