Carpal tunnel syndrome is often the result of multiple factors that increase pressure on the median nerve in the carpal tunnel. The exact cause is not always known. The incidence of carpal tunnel syndrome is increased in individuals with underlying nerve dysfunction (neuropathy), pregnancy, diabetes, injury, hypothyroidism, and rheumatoid arthritis. ☛ Female gender - the carpal tunnel is anatomically smaller in women. ☛ Genetic predisposition - patients are more likely to a have a family history of carpal tunnel syndrome if they experience symptoms in both wrists. This genetic predisposition may be related to the size of the carpal tunnel, familial predisposition to other medical conditions, or some undefined or unknown predisposing factor. ☛ Workplace factors - there is controversy regarding the role of workplace factors in the development of carpal tunnel syndrome. There is little clinical data to prove whether repetitive hand and wrist movements can cause carpal tunnel syndrome in people without predisposing factors. At one time it was common believed that computer use and/or clerical duties increase the risk of developing carpal tunnel syndrome, however, this association is not supported by most studies. ☛ Pregnancy - carpal tunnel syndrome may develop during pregnancy, particularly during the third trimester. In most cases, the symptoms gradually resolve over a period of weeks after delivery. For women who develop carpal tunnel syndrome during pregnancy, night time wrist splinting is recommended. Surgical decompression is sometimes indicated during pregnancy. ☛ Other - there is limited and conflicting data with regard to the potential association of age, estrogen-progestin oral contraceptive use, and smoking with carpal tunnel syndrome.