What are the main symptoms of pleurisy. How is pleurisy diagnosed. What are the treatment options for pleurisy. When should you seek medical attention for pleurisy symptoms. What causes pleurisy and who is at risk. How long does pleurisy typically last. Can pleurisy be prevented.

Understanding Pleurisy: Causes, Symptoms, and Risk Factors

Pleurisy, also known as pleuritis, is a condition characterized by inflammation of the pleura, the thin lining surrounding the lungs and chest cavity. This inflammation can cause sharp chest pain, especially when breathing deeply or coughing. But what exactly causes pleurisy?

The causes of pleurisy can be diverse, including:

• Viral infections
• Bacterial infections (such as pneumonia)
• Cancer
• Inhalation of toxic substances (like asbestos)
• Certain medications
• Autoimmune diseases (e.g., lupus or rheumatoid arthritis)

Are you experiencing symptoms that might indicate pleurisy? The primary symptoms to watch for include:

• Sharp chest pain, especially when breathing in
• Pain that worsens with coughing or sneezing
• Pain that may spread to the shoulders and back
• Shortness of breath
• Rapid, shallow breathing
• Fever (in some cases)
• Cough

It’s important to note that the severity of symptoms can vary greatly from person to person. Some individuals may experience mild discomfort, while others might face severe pain that significantly impacts their daily activities.

Diagnosing Pleurisy: Medical Examination and Imaging Tests

How do healthcare professionals diagnose pleurisy? The diagnostic process typically begins with a thorough physical examination. During this examination, the doctor will listen to your chest using a stethoscope. A distinctive squeaking or rubbing sound, known as a pleural friction rub, may be heard, indicating the inflamed pleural surfaces rubbing against each other.

Following the physical examination, your healthcare provider may recommend several diagnostic tests to confirm the diagnosis and identify the underlying cause:

• Chest X-rays: These provide an initial view of the lungs and can reveal any fluid buildup or other abnormalities.
• CT scans: Offering more detailed images than X-rays, CT scans can help detect smaller amounts of fluid or subtle changes in lung tissue.
• Ultrasound: This non-invasive test can be particularly useful in detecting pleural effusion (fluid buildup between the pleural layers).
• Blood tests: These can help identify infections or autoimmune conditions that might be causing the pleurisy.
• Thoracentesis: In cases where pleural effusion is present, a sample of the fluid may be extracted and analyzed to determine its cause.

Is pleurisy always easy to diagnose? While the characteristic chest pain often points to pleurisy, sometimes the diagnosis can be challenging, especially if symptoms are mild or atypical. In such cases, your doctor may refer you to a pulmonologist or other specialist for further evaluation.

Treatment Options for Pleurisy: From Home Remedies to Medical Interventions

Once diagnosed, what are the treatment options for pleurisy? The approach to treating pleurisy depends on its underlying cause and severity. In many cases, especially those caused by viral infections, pleurisy may resolve on its own within a few days to two weeks. However, various treatments can help manage symptoms and address the root cause:

Pain Management

Alleviating pain is often the first step in treating pleurisy. Over-the-counter pain relievers such as ibuprofen or naproxen can help reduce both pain and inflammation. In some cases, your doctor may prescribe stronger pain medication.

Rest and Positioning

Finding a comfortable position can significantly reduce pain. Many people with pleurisy find relief by lying on the affected side, which limits movement of the inflamed pleura.

Treating Underlying Causes

If a bacterial infection is causing your pleurisy, your doctor will likely prescribe antibiotics. For cases related to autoimmune disorders, medications to manage these conditions may be necessary.

Managing Pleural Effusion

In cases where fluid has accumulated between the pleural layers (pleural effusion), drainage may be necessary. This can be done through a procedure called thoracentesis, where a needle is used to remove the excess fluid.

Lifestyle Modifications

Quitting smoking, if applicable, can help reduce irritation to the pleura and improve overall lung health. Additionally, maintaining good overall health through a balanced diet and regular exercise (once recovered) can support your immune system and potentially reduce the risk of future episodes.

When to Seek Medical Attention: Recognizing Serious Symptoms

While many cases of pleurisy can be managed at home, certain symptoms warrant immediate medical attention. When should you seek urgent care for pleurisy-like symptoms?

• Severe, persistent chest pain that doesn’t improve with over-the-counter pain relievers
• Difficulty breathing or shortness of breath that worsens over time
• Coughing up blood or noticing blood in your phlegm
• High fever accompanying chest pain
• Chest pain that spreads to your arms, back, neck, or jaw
• Sudden onset of severe chest pain lasting more than 15 minutes

These symptoms could indicate a more serious condition, such as a pulmonary embolism or heart attack, which require immediate medical intervention. It’s always better to err on the side of caution when it comes to chest pain and breathing difficulties.

Complications of Pleurisy: Understanding Potential Risks

While pleurisy itself is often not life-threatening, it can lead to complications if left untreated or if the underlying cause is severe. What are some potential complications of pleurisy?

Pleural Effusion

One of the most common complications is pleural effusion, where fluid accumulates between the pleural layers. This can compress the lung, making breathing difficult. In some cases, if the fluid becomes infected (empyema), it may require drainage and antibiotic treatment.

Atelectasis

Atelectasis refers to a partial or complete collapse of a lung or lobe of a lung. This can occur if pain from pleurisy prevents you from taking deep breaths, leading to poor air exchange in parts of the lungs.

Pneumothorax

In rare cases, the inflamed pleura can develop small tears, allowing air to leak into the pleural space. This condition, known as pneumothorax, can cause the lung to collapse partially or completely.

Chronic Pain

Some individuals may develop chronic pain following a bout of pleurisy, particularly if adhesions form between the pleural layers during the healing process.

Understanding these potential complications underscores the importance of proper diagnosis and treatment of pleurisy. If you’re experiencing persistent symptoms or have concerns about potential complications, it’s crucial to consult with your healthcare provider.

Prevention Strategies: Minimizing Your Risk of Pleurisy

While it’s not always possible to prevent pleurisy, there are steps you can take to reduce your risk. How can you minimize your chances of developing pleurisy?

• Practice good hygiene: Regular handwashing can help prevent viral and bacterial infections that may lead to pleurisy.
• Stay up-to-date with vaccinations: Vaccines against pneumonia and influenza can protect against infections that might cause pleurisy.
• Avoid smoking: Smoking irritates the lungs and can increase susceptibility to respiratory infections.
• Manage underlying conditions: If you have an autoimmune disorder or other chronic condition, work closely with your healthcare provider to keep it well-controlled.
• Protect yourself from environmental hazards: If you work in an environment with potential exposure to asbestos or other toxic substances, use appropriate protective equipment.
• Maintain a healthy lifestyle: A balanced diet, regular exercise, and adequate sleep can help boost your immune system.

Remember, while these strategies can help reduce your risk, they don’t guarantee prevention. If you have a history of pleurisy or are at high risk due to underlying conditions, discuss additional preventive measures with your healthcare provider.

Living with Pleurisy: Coping Strategies and Long-Term Outlook

Coping with pleurisy can be challenging, especially when the pain is severe. What strategies can help you manage life with pleurisy?

Pain Management Techniques

Beyond medication, techniques such as controlled breathing exercises and gentle stretching can help manage pain. Some people find relief through the application of heat or cold to the affected area.

Lifestyle Adjustments

During recovery, you may need to modify your daily activities to avoid exacerbating symptoms. This might include taking breaks more frequently, avoiding strenuous activities, and ensuring you get adequate rest.

Emotional Support

Dealing with chronic pain can take an emotional toll. Don’t hesitate to seek support from friends, family, or a mental health professional if you’re struggling to cope.

Follow-up Care

Regular follow-ups with your healthcare provider are crucial, especially if you have an underlying condition that contributed to your pleurisy. These check-ins can help monitor your recovery and adjust treatment as needed.

What is the long-term outlook for people who have experienced pleurisy? For most individuals, especially those with viral pleurisy, the condition resolves completely within a few weeks without long-term effects. However, the outlook can vary depending on the underlying cause. Those with chronic conditions may experience recurrent episodes and may need ongoing management.

It’s important to note that while pleurisy itself is typically not life-threatening, it can sometimes be a symptom of more serious conditions. This is why prompt diagnosis and appropriate treatment are crucial.

By understanding the nature of pleurisy, recognizing its symptoms, and knowing when to seek medical attention, you can better manage this condition and minimize its impact on your daily life. Remember, while pleurisy can be painful and disruptive, with proper care and management, most people recover fully and can return to their normal activities.

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.