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A 65-Year-Old Woman Comes to the Physician for Mild Pain

question 69

Multiple Choice

A 65-year-old woman comes to the physician for mild pain, tingling, and numbness in her right hand. The symptoms started 2 weeks ago and are worse at night. She experiences neck pain occasionally but has no shooting or radiating pain. The patient has not had any recent head/neck trauma, headache, muscle weakness, or bowel/bladder incontinence. Her past medical history includes hypertension, hyperlipidemia, and cervical degenerative disk disease. The patient has a 30-pack-year smoking history. She is retired and knits frequently as a hobby.
Her blood pressure is 150/90 mm Hg and pulse is 88/min. Examination of the right hand reveals decreased sensation to pain and temperature along the ventral aspect of the first 3 digits and the radial half of the fourth digit. Sensation over the thenar eminence is preserved. There is no muscle weakness or atrophy.
Which of the following is the most appropriate next step in management of this patient?

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