Abstract
Carpal tunnel syndrome (CTS) is a condition caused by compression of the median nerve within a narrow osteofibrous canal at the wrist, leading to pain, numbness, and sensory impairment in the hand and fingers. It represents the most common form of entrapment neuropathy and constitutes a significant medical and social problem due to its high prevalence, chronic course, and negative impact on daily functioning and work capacity. Despite the relative uniformity of clinical manifestations, CTS develops in the context of a wide range of local and systemic disorders, reflecting substantial pathogenetic heterogeneity. This article provides an analytical review of current concepts regarding the pathogenesis of carpal tunnel syndrome, with particular emphasis on the diverse pathogenetic pathways involved in its development depending on the underlying condition. Anatomical and functional prerequisites for median nerve compression, as well as the common final compression–ischemic mechanism of neuropathy, are discussed. The importance of a comprehensive clinical and instrumental diagnostic approach is highlighted, along with the need for individualized, pathogenetically oriented prevention and treatment strategies aimed at correcting the underlying disease and reducing the risk of progression of compression neuropathy.