Carpal Tunnel Syndrome: A Comprehensive Review

Carpal tunnel syndrome (CTS) is the most common peripheral entrapment neuropathy, arising from chronic compression of the median nerve within the carpal tunnel. It significantly reduces quality of life and work performance, particularly among individuals exposed to repetitive wrist movements, and is more prevalent in women between the ages of 40 and 60. Typical clinical manifestations include nocturnal paresthesias, progressive sensory deficits, and weakness of the thenar muscles, all of which impair daily hand function. Diagnosis relies on clinical evaluation, provocative tests, electrophysiological studies, and increasingly on imaging techniques, such as ultrasound, which offer high sensitivity and specificity. A variety of treatment strategies are available, ranging from conservative measures, including splinting, corticosteroid therapy, manual therapy, acupuncture, and extracorporeal shock wave therapy, to surgical interventions aimed at decompression of the median nerve. While non-surgical methods provide meaningful relief in early or mild cases, surgery remains the gold standard in advanced or refractory disease. Minimally invasive approaches, including endoscopic and ultrasound-guided release, as well as the WALANT (Wide Awake Local Anesthesia No Tourniquet) technique for anesthesia, represent recent advances that improve recovery time, reduce complications, and enhance patient satisfaction. CTS continues to present a significant clinical and socioeconomic challenge, and optimal management requires timely diagnosis and a tailored, evidence-based therapeutic approach.