Value of some clinical provocative tests in carpal tunnel syndrome: do we need electrophysiology and can we predict the outcome?

Despite the high incidence of CTS, there are no precise diagnostic criteria. The history is useful, but the value of so-called provocative tests is questionable. Electrophysiology is required in the atypical cases; however, it has no prognostic value. There is no good correlation between electrophysiology and symptoms. The outcome seems to be favorable in patients without workmen's compensation, with a mild to moderate impairment preoperatively, and with a favorable response to carpal tunnel infiltration. Postoperatively the electrophysiologic parameters ameliorate symptoms, but this is not correlated to the patient's satisfaction.