Work-related carpal tunnel syndrome: the facts and the myths.

Carpal tunnel syndrome is a medical disease, not an injury, although symptoms may occur in association with certain physical activities of the upper extremity. The concept of work-related carpal tunnel syndrome has grown to such proportion as to be problematic for society, having spawned health care industries to support a cultural concept and a largely mythical medical paradigm. Because of these social and economic forces, cultural perceptions and expectations have adjusted to this flawed medical model. Success in improving patient management and making the best use of sound medical evidence depends on the concurrent use of educational strategies addressing social influences and attitudinal changes of practicing physicians, patients, and third-party administrators. The promotion of evidence-based medicine is key. This article discusses these controversies and suggests ways of managing carpal tunnel syndrome.