Repetition and Pain: Data Are Incomplete

Letter to the Editor, The Wall Street Journal
Copyright 2000 The Wall Street Journal
October 3, 2000

Repetition and Pain: Data Are Incomplete

Your Sept. 18 page-one article "Proposed OSHA Rules ..." highlights how liberal our country has become. Many things about medicine have changed in my 20 years as a doctor (10 as a hand surgeon), but making conclusions in the face of incomplete data is still wrong. Yet this is the current American situation with "repetitive motion injuries."

The link between repetitive activities and the development of painful conditions has not been conclusively established in the medical literature. One problem is that an injured worker gets paid even when not being completely productive. Until this factor is removed from the equation, I doubt that the proper unbiased medical research can be done. But I do know this: Despite nearly half of my patients being on workers comp, it is rare that I see a complex, chronic, vague painful condition in a situation where the patient does not stand to gain financially from the employer. I'm not saying that repetition and pain are unrelated. We just don't know yet. Until then, piling expensive regulations on the backs of employers is unjustified.

As I watch the Olympics, I'm reminded of the Australian experience with this problem. When proof of cause and effect between workplace repetition and pain could not be established, the Supreme Court of Australia found that repetitive strain injury was not an injury, the employer  was not liable, and the plaintiff had to pay all costs. Their epidemic was over. Maybe some of our nation's attorneys and bureaucrats should go "down under."

Brantley Burns, M.D.
 Knoxville, Tenn.