As a result of the changed profile of the occupational physician to that of medical advisor and case manager within the field of company health management, examination of the musculoskeletal system has become an increasingly important task. It must be backed up by a strategy of workplace evaluation and anamnesis, graded medical diagnostic procedures in accordance with the activities of the occupational physician and agreements about the aims and content of the resulting occupational-medical advice. The task of the occupational physician differs somewhat from that of the clinical disciplines as a result of its preventive and exposure-oriented basis. Employees and companies expect assessments, recommendations and assistance which help to maintain working and earning capacity. Health deficits with a threatened loss of function must be recognised even when the employee might not yet consult his GP, and the extent to which functional disturbances and disease can be stabilised or healed by preventive measures must be clarified. In the case of recognised diseases, the occupational origins and consequences at the workplace must be evaluated. The anamnesis also serves to distinguish between disturbances in well-being and psychosocial disturbances, which e.g. as a result of pain are projected onto the musculoskeletal system, and somatic disturbances, and thus to develop specific measures of intervention. The examination should not ignore any severe diseases, but should concentrate in particular on the most frequent functional disturbances. A recommended anamnesis is presented in this publication as part of a concept for the occupational-medical assessment of the musculoskeletal system. It is based on the standards used in comprehensive anamnestic instruments and is divided into three sections: the anamnesis filled in by the patient is supplemented by a medical anamnesis if there are discrepancies. If necessary, additional data regarding vibration-specific symptoms of the arms and hands are collected.
