Abstract
To clarify the causal relationship and potential mediators between educational attainment and carpal tunnel syndrome (CTS), as well as to evaluate whether educational attainment, cognition, and intelligence independently exert causal effects on CTS, we employed univariable Mendelian randomization (MR), multivariable MR, reverse MR, and 2-step MR approaches. Our research demonstrates that educational attainment exerts an independent causal effect on CTS, with this causal relationship being unidirectional. Five mediators were identified as significant influencers within the causal pathways connecting educational attainment and CTS. Targeting these mediators may be beneficial in the prevention of CTS.