Carpal tunnel symptoms usually begin gradually, with frequent burning, tingling, or itching and numbness in the hand and fingers. These symptoms tend to appear first in one or both hands during the night, since many people sleep with flexed wrists, but as the condition progresses and becomes worse, symptoms may occur during the day as well. Several factors can contribute to the cause of carpal tunnel symptoms, including rheumatoid arthritis, repeated use of vibrating hand tools, and fluid retention during pregnancy or menopause.