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A 35-year-old right-handed construction worker presents with complaints of nocturnal numbness and pain involving the right hand. Symptoms wake him and are then relieved by shaking his hand. There is some atrophy of the thenar eminence. Tinel sign is positive. What is the best advice for this patient?
Always ensure he has a firm grip on his equipment while working on the construction site as this may relieve pressure on the median nerve.
Apply ice to his wrist each evening after performing his usual work.
Wear a wrist splint at night as initial therapy prior to considering surgery.
Refer the patient to physical therapy for exercises to alleviate the pain.
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