A 68-year-old woman presents to the clinic complaining of a 6-month history of intermittent numbness, tingling, and pain in her right hand. The symptoms primarily affect her thumb, index, and middle fingers and are most severe at night, frequently awakening her from sleep. She finds temporary relief by shaking or “wringing out” her hand. Over the past month, she has noticed increasing clumsiness, occasionally dropping small objects like her keys. She is a retired office clerk who worked for 30 years using a computer keyboard. Her past medical history is significant for hypertension and type 2 diabetes mellitus, both well-controlled. She takes lisinopril and metformin. She has no known allergies and does not smoke or drink alcohol. She appears well-developed, well-nourished, and is in no acute distress. Her BMI is 28.5 kg/m². Her blood pressure is 130/80 mmHg with a regular heart rate of 72 bpm, a respiratory rate of 14 breaths per minute, and a temperature of 98.6 degrees Fahrenheit.