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What’s causing my numb finger? There could be many reasons

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Some people with numbness and tingling of the fifth finger also have weakness in the hand or forearm muscles.

Q: My pinky finger has been numb and tingly for more than one week. I am not aware of any injury. What could be the reason?

A: The symptoms you’re describing suggest a problem with a nerve supplying sensation to the fifth (pinky) finger. Since it is lasting this long, you should call your doctor’s office to arrange an appointment.

Some people with numbness and tingling of the fifth finger also have weakness in the hand or forearm muscles. Or, there may be numbness in other fingers, the forearm or upper arm. The combination of symptoms and findings on physical examination can help your doctor sort out where the problem is.

For example, if only the fifth finger is numb and your hand and finger strength is normal, the problem is probably located in the wrist. Or a tight ring on the pinky can cause numbness and tingling. But if weakness is also present, the nerve problem is more likely to be higher up, maybe in the elbow.

If your doctor finds that you also have decreased sensation on the half your 4th finger next to pinky, it suggests an ulnar neuropathy, an irritation or compression of the ulnar nerve that travels down the arm into the hand. The most common place for these problems is the elbow, where the nerve travels through a groove near the skin’s surface. People often unconsciously lean on one of their elbows for prolonged periods, which then compresses the ulnar nerve.

Other causes of an ulnar neuropathy include injury to the arm; arthritis of the elbow or wrist; a ganglion cyst in the wrist; and diseases like diabetes that cause nerve damage. Ulnar neuropathy can also lead to a weaker than expected hand grip.

Although very unlikely with pinky numbness only, the problem could be related to a pinched nerve higher up in the neck or armpit area.

Treatment depends on how much the symptoms bother you and whether there is any decreased strength that you hadn’t recognized. If nerve compression is the cause, it’s important to avoid pressure on the nerve. Avoid wearing a tight ring on that finger. Don’t lean on your elbows or wrists. Wear protective padding over the elbow or a brace for the wrist.

Anti-inflammatory drugs can improve nerve irritation related to active arthritis. Tight control of blood sugar may reduce the risk of nerve damage from diabetes. Surgery may be offered for some cases of neuropathy related to trauma, arthritis, ganglion cysts or disc disease.

(Howard LeWine, M.D., is an internist at Brigham and Women’s Hospital in Boston and assistant professor at Harvard Medical School. For additional consumer health information, please visit www.health.harvard.edu.)

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