Carpal tunnel syndrome in occupational medicine practice.

Work-related overload syndromes are chiefly associated with the upper limbs, where carpal tunnel syndrome (CTS) plays a leading role. This article analyses methods of diagnosing CTS, with special emphasis on those that can be used by physicians in early diagnosis of CTS in workers doing monotonous work. It also discusses occupational (e.g., assembly work, typing, playing instruments, packaging and work associated with the use of a hammer or pruning scissors) and extra-occupational factors (e.g., post-traumatic deformation of bone elements of the carpal tunnel, degenerative and inflammatory changes in tendon sheaths, connective tissue hypertrophy or formation of crystal deposits) leading to CTS; diagnostic methods (subjective symptoms, physical examination and manual provocative tests, vibration perception threshold, electrophysiological examination and imaging methods); and therapeutic and preventive management tools accessible in occupational medicine practice.