162) A 42 year old man is evaluated in your office for pain in his left hand. He has a chronic history of biciptal tendinopathy in his left upper extremity and Gastro-esophageal Reflux disease. He denies any history of recent trauma. He reports sudden onset of pain in his left hand that is associated with burning sensation. On physical examination, the left hand is swollen, pal, cool and tender to touch. Radial and ulnar pulses are intact. The image of his hands is shown below:

The cornerstone of the treatment modalities in this condition:

A)  Encouraging normal use of the limb

B)  Immobilization in plaster cast

C) Surgical decompression

D) Arterial Bypass surgery

E)     Prevention of exposure to cold temperatures