DEAR DR. ROACH: What is known about Parsonage-Turner syndrome? One of my brothers has severe shoulder pain. He had an MRI done and was told that it may be Parsonage-Turner syndrome. Can this be related to COVID? He has been recommended to a neurologist, but they probably won’t be able to help. He decided to do acupuncture and will be scheduling an appointment soon. — L.A.

ANSWER: The nerve roots that come off the spinal cord in the lower neck and upper chest come together in the lower neck and the axilla (armpit) to form a complex neurological structure called the brachial plexus. Neuralgic amyotrophy — also called Parsonage-Turner syndrome, paralytic brachial neuritis, and other names — is an inflammation of the brachial plexus.

The classic symptom of neuralgic amyotrophy is the sudden onset of severe pain in the shoulder and outer upper arm. The pain can be excruciating and later associated with weakness, with a prominent “winged” scapula (shoulder blade) that is frequently present. An MRI does not make the diagnosis of neuralgic amyotrophy, but it is recommended to be sure that there isn’t something else (like a tumor) causing damage to the brachial plexus. The diagnosis is supported by needle electromyography (EMG).

There are case reports of COVID-19 infections triggering neuralgic amyotrophy. Like so many conditions, it appears that there may be an autoimmune component, which can be triggered by an infection. Other infections, such as Lyme disease, can cause a similar-appearing syndrome of brachial plexus damage and should also be considered.

As you suggest, there isn’t any specific treatment for neuralgic amyotrophy. Physical therapy will help people maintain or recover function, but it doesn’t make the underlying problem get better any faster. The pain tends to get better over weeks, but the weakness can last for up to three years.

I found a single case report of a person with neuralgic amyotrophy who got better with acupuncture.

DEAR DR. ROACH: I am 78 years old and 5 feet tall, and I weigh 90 pounds. My overall look is fine. However, in the past year, I have developed a huge stomach. My clothes are tight around the waist, and I’m very uncomfortable in them. I’m told by my doctors that I shouldn’t lose any weight, but when I happen to lose a couple of pounds, it only shows in my face.

I exercise frequently and also do a lot of gardening. Is it possible for me to lose the stomach, and if so, how would I do it? My appetite has waned somewhat, so I eat smaller portions. Am I fighting a losing battle? — E.S.

ANSWER: When I hear women say that they are developing swelling or enlargement in the abdomen despite not eating more than usual, I become very concerned about ovarian cancer and other less-common abdominal problems that can show up with excess abdominal fluid. Women with this issue should have a sonogram or a CT scan to see if there is fluid in the abdomen or any mass that doesn’t belong there.

I sincerely hope I am wrong, but I have seen this diagnosis missed too many times. I’d recommend asking your doctor specifically about this possibility.

If this is not the issue, then I have to tell you that I don’t know of any way to choose where the weight loss happens. I have had patients, friends and family who note that when they are able to lose weight, they lose weight in places that they didn’t want to.

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Dr. Roach regrets that he is unable to answer individual letters, but will incorporate them in the column whenever possible. Readers may email questions to ToYourGoodHealth@med.cornell.edu.(c) 2025 North America Syndicate Inc. All Rights Reserved