Repetitive Stress Injury: Diagnosis or Self-Fulfilling Prophecy?*
Robert M. Szabo, M.D., M.P.H.†; Kenneth J. King, J.D.‡

The vague definitions of so-called repetitive stress injuries are indicative of the fact that scientific studies have failed to show that repetitive motion causes injury.

Given the uncertainty about causation, work-related musculoskeletal disorders (WRMSDs) is a more readily accepted term to describe these phenomena.

There is little doubt that most ergonomic interventions increase comfort in the work environment, which is of great benefit to the worker.

Many proponents of ergonomics assert that the elimination of certain risk factors related to force, repetition, and posture can prevent or even cure work-related musculoskeletal disorders of the upper extremity. However, there is little scientific support for this position.

Undue reliance on ergonomics to treat musculoskeletal disorders, to the exclusion of proper diagnosis and attention to medical and health risk factors, can have adverse consequences for the patient.

Science rather than politics and public policy should determine what causes injury and disease.

The failure of numerous plaintiffs in litigation regarding repetitive stress injury due to use of computer keyboards is important because, when judges and lay jurors were presented with both sides of the issue, they rejected these claims in a forum (the judicial system) that traditionally compensates individuals bringing so-called mass-tort cases.

Understanding the Relevant Definitions

Repetitive motion disorders include a spectrum of musculoskeletal symptoms that are attributed to occupations believed to be hazardous. Terms such as repetitive stress (strain) injury (RSI), cumulative trauma disorder, and repetitive trauma injury are used interchangeably to describe a constellation of symptoms related to the soft tissues of the musculoskeletal system. These so-called disorders, which are believed to be due to repeated exertions and movements of the body, supposedly develop over periods of weeks, months, or years2. These terms are being used to describe any painful condition of the upper extremity in workers engaged in repetitive activities.

The vague …

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