Question

A 48-year-old office worker presents with intermittent tingling and numbness of the thumb, index and middle fingers of the right hand, worse at night. Phalen and Tinel signs are positive. There is no thenar wasting. What is the most appropriate initial management?

Accepted Answer

Night-time wrist splinting in neutral position

Answer

Immediate surgical decompression

Answer

Oral prednisolone for 6 weeks

Answer

High-dose NSAIDs only

Answer

No treatment; reassure and discharge

Practice question

A 48-year-old office worker presents with intermittent tingling and numbness of the thumb, index and middle fingers of the right hand, worse at night. Phalen and Tinel signs are positive. There is no thenar wasting. What is the most appropriate initial management?