What are the main symptoms of pleurisy. How is pleurisy diagnosed. What are the most effective treatments for pleurisy. When should you seek medical attention for pleurisy symptoms. Can pleurisy be prevented.

Understanding Pleurisy: A Comprehensive Overview

Pleurisy, also known as pleuritis, is a condition characterized by inflammation of the pleura, the thin membrane that covers the lungs and lines the chest cavity. This inflammation can cause significant discomfort and pain, particularly during breathing. Let’s delve deeper into this condition to gain a better understanding of its nature, symptoms, and treatment options.

Recognizing the Symptoms of Pleurisy

The primary symptom of pleurisy is a sharp, stabbing pain in the chest that worsens when breathing deeply, coughing, or sneezing. This pain may:

• Extend to the shoulders and back
• Intensify with movement
• Cause shallow, rapid breathing as a way to minimize discomfort

Additional symptoms may include:

• Fever
• Cough
• Shortness of breath
• Rapid breathing

In some cases, fluid may accumulate between the layers of the pleura, a condition known as pleural effusion. When this occurs, the chest pain may subside, but breathing difficulties may persist or worsen.

Causes and Risk Factors of Pleurisy

Pleurisy can be triggered by various factors, including:

• Viral infections
• Bacterial infections, such as pneumonia
• Certain autoimmune diseases (e.g., lupus, rheumatoid arthritis)
• Cancer
• Exposure to asbestos or other toxic substances
• Certain medications

Understanding these causes can help in both prevention and treatment of pleurisy. Individuals with a history of lung disease or weakened immune systems may be at higher risk for developing this condition.

Diagnosing Pleurisy: What to Expect

The diagnosis of pleurisy typically begins with a physical examination. During this examination, a healthcare provider may:

• Listen to your chest with a stethoscope to detect a characteristic squeaking or rubbing sound
• Ask about your symptoms and medical history
• Perform a thorough assessment of your breathing patterns

To confirm the diagnosis and rule out other conditions, your doctor may order additional tests such as:

• Chest X-rays
• CT scans
• Ultrasound
• Electrocardiogram (ECG)
• Blood tests

These tests help visualize the lungs and chest cavity, detect any fluid buildup, and assess lung function. They also aid in identifying underlying causes of pleurisy, such as pneumonia or pulmonary embolism.

Treatment Approaches for Pleurisy

The treatment of pleurisy focuses on addressing the underlying cause and managing symptoms. In many cases, particularly those caused by viral infections, pleurisy may resolve on its own within a few days. However, more severe cases or those with specific underlying conditions may require medical intervention.

Medication Options

Depending on the cause and severity of pleurisy, your doctor may prescribe:

• Non-steroidal anti-inflammatory drugs (NSAIDs) for pain relief
• Antibiotics for bacterial infections
• Anticoagulants if pulmonary embolism is suspected
• Steroids to reduce inflammation in certain cases

Home Care and Lifestyle Adjustments

To manage symptoms and promote recovery, you may be advised to:

• Rest and avoid strenuous activities
• Find comfortable positions that minimize pain during breathing
• Use over-the-counter pain relievers as recommended by your healthcare provider
• Apply heat or cold packs to the affected area for pain relief

Treatment for Pleural Effusion

If significant fluid buildup occurs, procedures such as thoracentesis may be necessary. This involves inserting a needle or catheter into the chest cavity to drain excess fluid, relieving pressure and improving breathing.

When to Seek Medical Attention for Pleurisy

While mild cases of pleurisy may resolve on their own, certain symptoms warrant immediate medical attention. Seek urgent care if you experience:

• Severe chest pain that persists or worsens
• Difficulty breathing or shortness of breath
• Coughing up blood
• High fever
• Signs of infection, such as chills or sweating

These symptoms could indicate a more serious underlying condition or complications of pleurisy that require prompt medical intervention.

Preventing Pleurisy: Strategies for Reducing Risk

While not all cases of pleurisy can be prevented, certain measures can help reduce your risk:

• Practice good hygiene to prevent viral and bacterial infections
• Get vaccinated against pneumonia and influenza
• Quit smoking and avoid exposure to secondhand smoke
• Manage underlying health conditions effectively
• Avoid exposure to environmental toxins and irritants

By adopting these preventive strategies, you can lower your chances of developing pleurisy and maintain better overall lung health.

Living with Pleurisy: Coping Strategies and Long-Term Outlook

For those diagnosed with pleurisy, coping with the condition involves a combination of medical treatment and lifestyle adjustments. Here are some strategies to help manage pleurisy and improve quality of life:

Pain Management Techniques

Beyond medication, consider these approaches to manage pain:

• Practice deep breathing exercises when pain allows
• Use relaxation techniques such as meditation or guided imagery
• Explore gentle stretches or yoga poses that don’t exacerbate symptoms
• Consider acupuncture or massage therapy with approval from your healthcare provider

Dietary Considerations

While there’s no specific diet for pleurisy, certain nutritional choices may support overall lung health:

• Consume anti-inflammatory foods rich in omega-3 fatty acids
• Increase intake of fruits and vegetables high in antioxidants
• Stay hydrated to help thin mucus and ease breathing
• Avoid foods that may trigger inflammation or allergic reactions

Emotional Support and Mental Health

Dealing with chronic pain and breathing difficulties can take a toll on mental health. Consider:

• Joining support groups for individuals with respiratory conditions
• Seeking counseling or therapy to manage stress and anxiety
• Practicing mindfulness to improve overall well-being
• Engaging in hobbies or activities that bring joy and distraction from symptoms

Long-Term Prognosis

The long-term outlook for pleurisy varies depending on the underlying cause and individual factors. Many cases resolve completely within a few weeks with proper treatment. However, some individuals may experience recurring episodes or develop chronic pleurisy, particularly if associated with autoimmune disorders or other chronic conditions.

Regular follow-up appointments with your healthcare provider are crucial for monitoring progress and adjusting treatment plans as needed. With appropriate management and lifestyle modifications, most people with pleurisy can maintain a good quality of life and minimize the impact of the condition on their daily activities.

Advances in Pleurisy Research and Treatment

Medical research continues to advance our understanding of pleurisy and improve treatment options. Some recent developments and areas of focus include:

Improved Diagnostic Techniques

Researchers are exploring more accurate and less invasive methods for diagnosing pleurisy and identifying its underlying causes. These include:

• Advanced imaging techniques with higher resolution and specificity
• Biomarker analysis for early detection of pleural inflammation
• AI-assisted interpretation of chest imaging for faster and more accurate diagnosis

Novel Treatment Approaches

Emerging therapies and treatment strategies show promise in managing pleurisy more effectively:

• Targeted anti-inflammatory medications with fewer side effects
• Gene therapy for treating genetic causes of recurrent pleurisy
• Immunomodulatory treatments for pleurisy associated with autoimmune disorders
• Minimally invasive surgical techniques for managing complicated cases

Personalized Medicine in Pleurisy Care

The field of personalized medicine is making strides in tailoring pleurisy treatments to individual patients based on:

• Genetic profiles that influence drug response and disease progression
• Microbiome analysis to guide antibiotic therapy in infectious pleurisy
• Predictive models for identifying patients at high risk for complications

These advancements offer hope for more effective, targeted treatments and improved outcomes for individuals with pleurisy. As research progresses, we can expect to see continued improvements in the diagnosis, treatment, and management of this challenging condition.

Understanding pleurisy, its symptoms, causes, and treatment options is crucial for anyone affected by this condition. By recognizing the signs early and seeking appropriate medical care, individuals can minimize discomfort and prevent potential complications. With ongoing advancements in medical research and treatment approaches, the outlook for those with pleurisy continues to improve, offering hope for better management and quality of life.

Pleurisy – NHS

Pleurisy is inflammation around the lungs, which causes sharp chest pain. It’s easy to treat and usually gets better in a few days, but can sometimes be a sign of something more serious, like pneumonia.

Check if it’s pleurisy

The main symptom of pleurisy is sharp chest pain when you breathe in.

The pain may be worse when you cough, sneeze or move around.

It may also spread to your shoulders and back.

Urgent advice: Ask for an urgent GP appointment or get help from NHS 111 if:

• you have sharp chest pain that comes and goes, or only happens when breathing or coughing
• you have sharp chest pain that has not got better after a few days
• you’ve coughed up a few small spots, flecks or streaks of blood, or noticed blood in your phlegm or on a handkerchief
• you’re feeling short of breath regularly

You can call 111 or get help from 111 online.

Immediate action required: Call 999 or go to A&E if:

• you have sudden chest pain that lasts for 15 minutes or more
• you have sudden chest pain that spreads to your arms, back, neck or jaw
• you have difficulty breathing
• you’re coughing up more than just a few spots or streaks of blood
• you’re coughing up blood and finding it hard to breathe, have a very fast heartbeat, or have pain in your chest or upper back

These symptoms could be a sign of a more serious problem, such as a heart attack or a blood clot in the lungs (pulmonary embolism).

What happens at your appointment

If you have symptoms of pleurisy, a GP will examine you and listen to your chest.

The GP may refer you to a specialist if they’re not sure what’s causing your symptoms.

You may need to have tests, such as:

• blood tests
• a chest X-ray
• an ultrasound scan
• a CT scan

Treatment for pleurisy

Pleurisy will usually get better on its own in a few days without treatment from a GP.

If your symptoms are being caused by a bacterial infection, such as pneumonia, you may need antibiotics.

You can ease the chest pain by:

• taking painkillers such as paracetamol or ibuprofen
• resting in different positions until you find a comfortable one – lying on the painful side can help

You may need to have treatment in hospital if your symptoms are severe or being caused by something more serious, such as a pulmonary embolism or tuberculosis.

Page last reviewed: 18 May 2023
Next review due: 18 May 2026

Pleurisy | Cedars-Sinai

ABOUT

DIAGNOSIS

TREATMENT

Overview

Pleurisy, also known as pleuritis, is swelling of the thin lining around the chest cavity and lungs, also known as the pleura. This lining creates a smooth surface so the lungs glide easily in the chest while breathing. When the lining swells, the lungs rub painfully against the chest, causing swelling and chest pain.

In some cases, fluid can collect between the pleura. This is called pleural effusion. When there is no fluid, the condition is called dry pleurisy.

Symptoms

Usually the first sign of pleurisy is a sudden chest pain. The pain may be very mild or very severe. Sometimes the pain is only felt while breathing deeply or coughing. Other times, the pain may be felt all the time and get worse with deep breathing or coughing. Usually the pain is felt in the chest wall over the area that’s inflamed. You might also feel pain in the upper abdominal area, neck, back, and shoulders.

Because inhaling deeply hurts, a person with pleurisy tends to breathe quickly and shallowly. On the side where the pain is, the muscles of the chest move less than those on the other side. If fluid builds up between the layers of the pleura, the chest pain may go away. Large quantities of fluid can make expanding one or both lungs difficult.

Other symptoms may include:

• Fever
• Cough
• Shortness of breath
• Rapid breathing

Causes and Risk Factors

Irritation of the pleura can be caused by:

• Viruses
• Bacterial infections
• Cancer
• Inhaling asbestos or other toxic substances
• The use of certain medications
• Some types of autoimmune diseases, such as lupus or rheumatoid arthritis

Diagnosis

Diagnosis of pleurisy usually starts with a physical exam. Because the pain tied to pleurisy is distinct, it is often easy for the physician to diagnose. Using a stethoscope, the doctor may hear a squeaky, rubbing sound.

Chest X-rays and CT scans are often used to see an image of what is going on inside the lungs and chest. These tests help show if fluid is building up in the lungs. They will also show if the lungs are filling up with air as much as possible.

Other imaging tests may be used, such as an ultrasound or electrocardiogram, to rule out heart disease.

If fluid has begun to build up in the chest or lungs, the doctor may take a test sample of it. This will help determine the cause of the pleurisy and rule out the possibility of cancer.

A biopsy of a small sample of tissue may also be done to rule out the possibility of cancer. To do this, a needle will be used to remove a small tissue sample to be examined under a microscope.

A blood test to detect lupus or rheumatoid arthritis may also be performed.

Treatment

Treatment for pleurisy depends on what caused the condition. The experts at Cedars-Sinai’s Advanced Lung Disease Program can help you find the best treatment plan.

Antibiotics may be prescribed for infections caused by bacteria. If a virus causes the pleurisy, no treatment will be given. If the cause is lupus or an autoimmune disease, corticosteroids often quickly cure the pleurisy. These drugs suppress the immune system, which stops the swelling in the lining.

Nonsteroidal anti-inflammatory drugs, such as aspirin or ibuprofen, help relieve the chest pain. Codeine and other stronger pain relievers should not be used. These medicines can stop you from coughing. Coughing is important because it stops the lungs from collapsing and helps prevent pneumonia.

Holding a pillow against the part of the chest that hurts while coughing or breathing deeply can be helpful. Wrapping the chest in wide, elastic bandages can help relieve severe pain. Wrapping the chest also makes it harder to breathe and increases the risk of a collapsed lung or pneumonia.

© 2000-2022 The StayWell Company, LLC. All rights reserved. This information is not intended as a substitute for professional medical care. Always follow your healthcare professional’s instructions.

Pleurisy – health articles

Human lungs are located in the chest cavity. Outside they are covered with pleura. The pleura is a serous membrane that lines the inner layer of the chest cavity and envelops both lungs. The pleura is made up of mesothelial cells.

Pleurisy – an inflammatory disease of the pleura, which is characterized by the deposition of fibrin on their surface (fibrinous or dry pleurisy), or the accumulation of fluid in the pleural cavity (exudative pleurisy).

This disease is very common. This is the most commonly diagnosed pathology of the lungs. In the general structure of the incidence of the population, pleurisy accounts for 5-15%.

Causes

Pleurisy is a disease that in most cases develops on the basis of some existing pathology. The most common cause of the development of an inflammatory reaction in the pleural cavity are various infections. Often pleurisy occurs against the background of systemic diseases, tumors, injuries.

Some authors refer to pleurisy and cases of pleural effusion without a clear presence of an inflammatory response. This situation is not entirely correct, since pleurisy is an ailment that involves an obligatory inflammatory component.

The following causes of pleurisy are distinguished:

• infection of the pleura;
• tuberculosis;
• allergic inflammatory reaction;
• autoimmune and systemic diseases;
• exposure to chemicals;
• chest injury;
• exposure to ionizing radiation;
• exposure to pancreatic enzymes;
• primary and metastatic tumors of the pleura.

Symptoms

The clinic of dry pleurisy is characterized by stabbing pains in the chest, aggravated by coughing, breathing and movement. The patient is forced to take a position, lying on a sore side, to limit the mobility of the chest. Breathing is superficial, sparing, the affected half of the chest noticeably lags behind during respiratory movements. Body temperature sometimes rises to subfebrile values, the course of pleurisy may be accompanied by chills, night sweats, and weakness.

Diaphragmatic dry pleurisy has a specific clinic: pain in the hypochondrium, chest and abdominal cavity, flatulence, hiccups, tension in the abdominal muscles.

The onset of exudative pleurisy is accompanied by a dull pain in the affected side, reflex arising painful dry cough, lagging of the corresponding half of the chest in breathing, pleural friction noise. As the exudate accumulates, the pain is replaced by a feeling of heaviness in the side, increasing shortness of breath. Exudative pleurisy is characterized by general symptoms: weakness, febrile body temperature, loss of appetite, sweating.

Diagnosis

An external examination performed by a physician is very important for diagnosing pleurisy and determining its nature. During auscultation (listening to the lungs in different phases of breathing with a stethoscope), pleural friction noise can be detected, which is specific for fibrinous pleurisy, with exudative pleurisy during percussion (tapping a certain area to identify characteristic sound phenomena), there is a dullness of percussion sound above the effusion zone. Thus, it is possible to determine the spread of exudate in the pleural cavity.

In the general and biochemical blood tests, nonspecific inflammatory changes are noted: ESR acceleration, increase in the number of leukocytes; the appearance or increase in the concentration of inflammatory proteins.

Instrumental methods (ultrasound, radiography) play a significant role in the diagnosis of pleurisy, as they allow you to see the area of ​​the lesion and determine the nature of the inflammatory process.

Treatment

Treatment is determined by the form of pleurisy. Treatment of an infectious type of inflammation of the pleura involves the use of antibiotics and other antimicrobial agents, diuretics, painkillers. In the case of exudative inflammation, physiotherapy and exercise therapy can be used, but only after the effusion has resolved. If pulmonary tuberculosis is the cause of inflammation of the pleura, anti-tuberculosis drugs are prescribed.

Treatment involves the use of symptomatic remedies. If there are pleural fibrinous overlays (dry pleurisy), the patient should be provided with complete rest. In case of cough, antitussives are prescribed. Treatment often includes the setting of cans, mustard plasters, the use of anti-inflammatory drugs, and breathing exercises.

If a large volume of fluid has accumulated, a pleural puncture may be required.

Nutrition for pleurisy should be complete and meet physiological needs. It is required to include more foods rich in vitamins in the diet. The diet for pleurisy involves limiting the intake of carbohydrates and salt. It is also required to reduce the amount of liquid you drink to 500-600 ml. As for non-infectious pleurisy, its treatment involves the elimination of the underlying disease.