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7; 95 %CI 1.3-25., lower ESD (odds ratio 4.9; 95 %CI 1.1-22., and lower gastrointestinal treatment (odds ratio 5.6; 95 %CI 2.3-13.3) were significantly associated with the development of MSDs in the low back area. Moreover, longer lower ESD (odds ratio 5.0; 95 % CI 1.2-20.2) was a risk factor for symptoms in the left shoulder. Conclusion This study suggests a correlation between the volume of therapeutic endoscopic procedures including ESD and the risk of MSDs mainly low back area and left shoulder. Managing monthly total endoscop