Pain, tingling, and loss of sensation in the hand are often clear indicators of carpal tunnel syndrome—a condition that is increasingly common and can significantly impact one’s quality of life. But what causes it?

Carpal tunnel syndrome is a compression disorder affecting the median nerve at the wrist. As its prevalence grows, so does its effect on daily functioning and overall well-being.

But what exactly causes this condition? And are there fast, effective solutions that don’t involve lengthy recovery times?

We discussed this with Professor Matteo Guzzini, Associate Professor of Musculoskeletal Disorders, orthopedic specialist, and expert in hand surgery and reconstructive microsurgery, at Ars Medica.

At the wrist, specifically on its inner side just beneath the transverse carpal ligament, the median nerve enters a narrow passage called the carpal tunnel. Like all tunnels, it has a floor and a ceiling—the floor is mainly formed by the carpal bones, while the ceiling consists of the transverse carpal ligament.

Within this tunnel run the flexor tendons of the fingers along with the median nerve itself.

For various reasons—most commonly due to thickening of the transverse ligament (which, as mentioned, forms the roof of the tunnel), or inflammation-related swelling of the flexor tendons—the nerve becomes compressed, much like being caught in a sandwich. This compression disrupts nerve conduction, particularly in the thumb, index, middle finger, and half of the ring finger, which are all areas served by the median nerve.

What are the symptoms of carpal tunnel syndrome?

Typically, patients experience tingling or numbness in the first three or four fingers, often at night or upon waking. This is frequently accompanied by a weakening of the thumb’s grip, making it harder to grasp small objects, which may begin to fall from the hand. Since the condition involves nerve compression, it is most commonly treated with surgery.

Is there an effective treatment for carpal tunnel syndrome?

Yes—today, carpal tunnel syndrome can be resolved with a minimally invasive surgical procedure performed on an outpatient basis. The surgery takes about three minutes and involves releasing the transverse carpal ligament to decompress the nerve, allowing it to function normally again.

Thanks to its minimally invasive nature, recovery is virtually immediate. Post-surgery, the patient wears a light bandage for one week. A slightly lighter bandage is applied during the second week, and stitches are removed after two weeks.

During this period, patients typically notice a rapid and continuous improvement in symptoms and are generally able to resume normal daily activities as early as the second week following the procedure.