Commuting to work can be a real pain, and it was no different in ancient Egypt. About 3500 years ago, the artisans who dug out and decorated the rock-cut royal tombs in the Valley of the Kings—the burial ground of Egypt's New Kingdom pharaohs—had to walk about 2 kilometers from their homes, over the Theban hills, to the royal necropolis for work. It was a steep climb, repeated week after week for years, leaving them suffering from osteoarthritis in the knees and ankles, according to a new study.

Egyptologists already knew a great deal about the village where the workers lived—Deir el-Medina, in modern Luxor—because of the vast amount of written material found there in the early 20th century. But they had paid little attention to the physical remains of the artisans and their families, found interred in tombs beside the village, their bones commingled after thousands of years of robbery. This has now changed thanks to research undertaken by Anne Austin, an osteologist and Egyptologist at Stanford University in Palo Alto, California.

Working in Egypt, Austin separated the commingled bones, estimated age and sex, and analyzed the joints for signs of osteoarthritis, which can cause pain and stiffness. She also compared them to remains found at other ancient Egyptian sites. She reports in the International Journal of Osteoarchaeology that many of the men at Deir el-Medina showed higher rates of osteoarthritis in the knees and ankles than did the women. The location of the disease, and its higher occurrence among men, struck Austin as odd. Although the artisans' work in the Valley of the Kings was hard—involving digging, carving, and painting in the rock-cut royal tombs that descend into the Theban hills—this would mainly affect the upper body, not the knees and ankles.

To explain this, Austin examined the textual evidence from the village—administrative records that detail the artisans' daily attendance at work, and even their absences—and the artisans' physical environment. While their female relatives remained in the village, each week, the artisans hiked from Deir el-Medina over the Theban hills to stone huts, which are still standing as ruins just above the Valley of the Kings. They lived in these huts during the work week, descending and ascending the hill to the valley each day. At the end of the week, they returned to Deir el-Medina. Although the journey was short, it was steep, Austin observes: a rise of 151 meters from Deir el-Medina to the huts, and 93 meters from the huts to the Valley of the Kings. On top of that, the ancient records show that the workers would have hiked on average about 161 days each year. With a career lasting on average about 25–35 years, that's a lot of hiking—enough to likely cause the osteoarthritis found in the artisans' lower limbs, Austin argues.

"Her work is an intriguing new way of looking at occupation-related injuries,” says Kristina Killgrove, a biological anthropologist at the University of West Florida in Pensacola, who was not involved in the research. And as Austin herself comments, this information will be useful for those attempting to understand osteoarthritis not only in past populations, but in people today.

Yet because the bones were jumbled together at Deir el-Medina, Austin notes, it’s hard to tell specifically when each of the villagers died and at which point in their lives they first developed osteoarthritis. "It will be important in the future to attempt to control for age-at-death, as osteoarthritis frequencies increase with age," Killgrove says.