A local teacher and explorer presents to your clinic complaining of some pain in his right hand. He reports having recently returned from an expedition in Egypt where he admits to using a whip repeatedly over a period of several weeks. He is normally fit and well other than a strong phobia of snakes. He denies any fever or wrist swelling. He complains of numbness and tingling in his thumb, index and middle finger. He reports this is worse at night and sometimes shaking his hand temporarily improves the pain. On examination, he is afebrile. His hand does not look swollen or red. He does indeed have sensory loss over his thumb and index finger on the palmar side of his hand.