A 43-year-old data entry clerk has pain and tingling in the fingers with positive Phalen's maneuver. What is the most appropriate intervention?

The most appropriate intervention for a patient presenting with pain and tingling in the fingers, especially with a positive Phalen's maneuver, is to splint the wrist in a neutral position. This suggestion aligns with the common management approach for carpal tunnel syndrome, which is characterized by symptoms such as those described in the question.

Wrist splinting, particularly when worn at night, helps to keep the wrist in a position that reduces pressure on the median nerve, alleviating the symptoms of numbness and tingling. By preventing flexion of the wrist, splinting can reduce inflammation and allow for healing. This non-invasive approach is often the first line of treatment for mild to moderate cases of carpal tunnel syndrome.

Other interventions mentioned are typically considered in situations where conservative management, like splinting, is insufficient. For example, a methylprednisolone dose pack may be used to reduce inflammation in conditions where swelling is significant, but it is not usually the first-line treatment for this specific scenario. Observation could be appropriate in very mild cases where symptoms are minimal and not bothersome. Surgery may be necessary for persistent symptoms or significant nerve compression that does not respond to conservative measures, but it is considered after other options are tried.

Thus,