Dr. Hadler pointed out the illogic of a high incidence of carpal tunnel syndrome cases being identified in one particular facility or location, when a low incidence of CTS is concurrently reported at another facility or location using the identical keyboards. He concludes that it is the workers' compensation system which creates claimants where none should exists. I am in complete agreement with the opinions of Drs. I am also in more sensitive agreement with Dr. Hooper's further concern that some of the people in the audience who are responsible for managing claims at companies across the country may actually believe Dr. Hadler. Dr. Hadler's premise that psychosocial issues are important determinants of CTDs is true, but his conclusion that such claimants' symptoms are not work-related is not only false, but dangerous.
Mental factors do affect pain, and especially litigation.
Such a simplistic and myopic approach to a massive and widespread phenomenon ignores and obstructs the opportunity for real science to assist in the resolution of a great deal of human suffering. Such factors also include not only obesity, pregnancy and medical history, but even wrist dimensions. On the simplest level, an employee's attitude about a job is an extremely important issue in not only the onset of symptoms, but treatment and disability management. Although my evidence is only anecdotal to date, I believe that carpal tunnel plagues are a real phenomenon. I would also suggest, as I have been doing for many years, that employers come to acknowledge the importance of nonphysical factors in the precipitation of CTDs in their employees.