There’s a considerable swath of RSI literature that attempts to establish that no form of RSI is an identifiable physical disorder. (I phrased that very carefully, but I may still have gotten it slightly wrong; don’t think so, though.) To put it rather baldly, people like me are imagining things.
See, for example, this review of an RSI-is-psychosomatic book. (Lucire is a biggish name in that camp, I believe.) The argument goes something like this: RSI symptoms are all over the map; they aren’t easily treatable but are sometimes amenable to placebo effects and job-changing; diagnoses skyrocketed when carpal tunnel syndrome hit the media; diagnosis can lead to paid time off work; and reported cases correlate well with oppressive work environments. Ergo, what’s going on is psychological worker misery or plain old malingering, not physical breakdown.
Never mind that some of my symptoms are measurable, such as grip strength and joint range-of-motion. (Some doctors do nerve-conduction tests and other weirdnesses too, but not on me so far, so I can’t comment.) It’s certainly true that RSI diagnoses are largely based on reported sensation (e.g. numbness, tingling, pain), and people can lie about what they feel.
Nor am I one to deny the power of the brain to make the body miserable. Grad-school anxiety crossed with depression drove me right to dyshidrosis. There really isn’t any other explanation for that pair of outbreaks.
But. Can we possibly step back a bit and take a look at what else might be happening here?
The elephant in the cellar, of course, is sexist, classist, racist dismissal of low-status (usually pink-collar) employees. What I love about the usual line of talk is the notion that it’s easy to get an RSI diagnosis and a filled workman’s comp claim. Two words: one is “get” and the other is “real.” It doesn’t take much hanging out on the SOREHAND list to see the unbelievable barriers between an RSI sufferer and any form of treatment, let alone compensation. The wonder is that anybody gets workman’s comp at all.
I’m also highly dubious about the assumption that because oppressive work environments lead to RSI, the problem is psychosomatic. Aren’t oppressive work environments likely to force employees to work too fast and too hard, deny them needed breaks, offer them crap medical insurance if any at all, and ignore ergonomics? Isn’t this constellation of abuses a likelier avenue of inquiry than employee malingering?
As for wide-ranging diagnoses—come on, people, ordinary doctors simply don’t know what they’re doing with this stuff! That’s not the patients’ fault! I got misdiagnosed twice, and offered one treatment that hurt me worse. I don’t doubt that a lot of RSI studies have been fouled up by medical ignorance and misdiagnosis. That somehow means RSI isn’t real? Please.
Naturally, by way of bias disclosure, I find the idea that I am a punk malingerer highly offensive. Nonetheless, I think my history a pretty clear counterexample to the anti-RSI thesis. Of my three worst RSI breakouts, two happened on account of volunteer projects—senior wills for the high-school newspaper, and my undergraduate honors thesis. The third occurred in the course of my present job, in which I’ve been happier than in either of my previous several jobs. I was happy to do the things that injured me, in other words—yet when I was genuinely miserable at work or in grad school, nothing RSI-related happened.
What did these three RSI-causing situations have in common? Extremely heavy typing load, the first two attacks under much less than properly ergonomic conditions. Not to post hoc ergo propter hoc you smart folks, but sheesh, find me another correlation that explains things as well.
Malingering. Pfui.