CTS usually results from a combination of factors that result in reduced space in the carpal tunnel region and, therefore, median nerve compression. Often, a single identifiable cause is not identified.  Factors that have been associated with CTS include work-related mechanical stress to the wrist and finger tendons, repetitive use of vibrating tools, diabetes and other metabolic disorders, hormonal imbalance such as thyroid disease, inflammatory disorders such as rheumatoid arthritis, fluid retention as can occur in pregnancy, wrist trauma that results in swelling or deformity of? the bones and tendons of the carpal tunnel, or the development of cysts or tumors in the carpal tunnel.