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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 for 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 from a physical examination can help your doctor sort out where the problem lies.

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.

Decreased sensation on your fourth finger might suggest an ulnar neuropathy, an irritation or compression of the ulnar nerve that travels down the arm into the hand.

The most common place of origin 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.

Q: I have been getting massages for back pain. My therapist says I have over-stretched ligaments in my lower back that run from my lower lumbar spine onto my gluteus maximus. Should I be considering other treatment options, such as surgery?

A: Massage can definitely make people with back problems feel better. But if the symptoms persist, it’s important to be sure the diagnosis is correct.

I’m guessing from your massage therapist’s diagnosis that you have low back pain that radiates into the buttock. In this situation, a physician might diagnose sciatica or muscle spasm rather than overstretched ligaments.

However, the diagnosis depends on the details of your symptoms, the results of your physical examination and, in certain cases, the results of imaging tests.

Keep in mind there are many causes of low back pain. Some of the most common include:

• Muscle spasm or other muscle injury
• Sciatica, a condition in which the sciatic nerve is compressed as it travels from the spinal cord to the leg
• Osteoarthritis (also called degenerative joint disease)
• Spinal stenosis, a degenerative or congenital disorder in which the spinal cord is compressed by the surrounding bones, discs and ligaments.

Rarer and more serious causes of back pain include fracture (more common among people with osteoporosis), infection and cancer. Your doctor can usually rule out these serious causes of back pain.

However, even after a full evaluation, the cause of low back pain is often uncertain. While the uncertainty can be frustrating, the good news is that most new back pain resolves within a few weeks, regardless of treatment.

Most back problems (including ligament injuries) do not require surgery. Finding a fitness routine with a good balance of rest and exercise — and avoiding activities that may have triggered your symptoms — can often help the body heal such injuries on its own.

Surgery is generally reserved for people who have conditions that can be improved with surgery, such as disc herniation or spinal stenosis, and whose symptoms have not responded to more conservative treatment.

If you haven’t done so already, I would recommend that you see your doctor for a detailed review of your symptoms and a physical examination. If your doctor suspects an unusual or serious cause of back pain, or believes your condition may require surgery, your doctor will likely order additional testing, such as X-rays or an MRI.

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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