Abstract
We studied how websites address the consequences of leaving common musculoskeletal conditions untreated, two that have a benign, self-limiting course without treatment (de Quervain tendinopathy, lateral epicondylitis) and one that is expected to have progressive nerve deterioration without treatment (carpal tunnel syndrome). Using a common search engine, the first 120 websites addressing each diagnosis were rated for statements regarding disease progression and need for surgery without treatment. Most sites stated that disease would worsen without treatment: carpal tunnel syndrome (99%), lateral epicondylitis (91%), and de Quervain tendinopathy (72%). For each condition, approximately a third of the websites stated surgery might become necessary. The observation of inadequate distinction between conditions that deteriorate with treatment from those that resolve without treatment emphasizes the potential for harm by reinforcing common misconceptions such as "this is taking too long" or "this will not resolve without treatment" and by jeopardizing personal health agency. Producers of online medical information can add an item to their quality checklist that ensures that people are accurately informed about a choice to not seek treatment.