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Occupation and carpal tunnel syndrome

I congratulate Murray Stapleton for his thought provoking article and his meticulous assessment of some occupational variables in patients with carpal tunnel syndrome who submitted for medicolegal opinion.1 While neither I nor anybody else can prove the cause of carpal tunnel syndrome in any individual patient, Mr Stapleton’s conclusion is quite dramatic and therefore, some comments in response to this article are indicated. The essence of the paper is whether or not one can accept that ‘work is a significant contributing factor’ to the development of carpal tunnel syndrome in an individual. If one accepts that, in an individual patient, work indeed was a significant contributing factor to the development of carpal tunnel syndrome, one is not excluding other variables as co-contributors, but merely confirming that work was a significant contributing factor. Mr Stapleton lists six criteria that he believes should be met for an occupation to be a significant contributing factor.