Patients may be under the impression that their problems represent an injury sustained by performing repetitive activities at work. Work related repetitive strain injury is also referred to as cumulative trauma disorder, fibrositis, as well as a number of similar descriptive names. The syndrome is commonly used to refer to symptoms due to excessive use of the upper extremity. It is a poorly defined condition which lacks a precise definition and is not based on any objective findings or assessment. Many patients reporting repetitive strain injury do not have any diagnosable condition involving the upper extremity, and there is not a preponderance of current scientific evidence that tenosynovitis, tennis elbow, carpal tunnel syndrome, or in fact any other diagnosable condition has resulted from repetitive activity in an otherwise healthy individual trained to perform such work. There is current debate as to whether or not a repetitive strain syndrome exists at all. Many disorders ascribed to repetitive activities are simply common in the general population, with incidence determined by age, sex, and body constitution rather than activity or occupation. Patients who have painful medical disorders of the upper extremity may be more aware of their symptoms while engaged in a work-related posture or activity, but this is not credible evidence of causation. Mislabeling a patient's complaints and mistakenly relating these complaints to a work injury work is harmful, particularly when complaints are ill defined. The diagnosis of repetitive strain syndrome is associated with an increased risk for failure to return to work following surgery.