What are the main symptoms of pleurisy. How is pleurisy diagnosed. What treatments are available 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.

Understanding Pleurisy: Causes and Symptoms

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, particularly when breathing deeply or coughing. But what exactly causes pleurisy?

Common causes of pleurisy include:

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

The primary symptom of pleurisy is a sharp, stabbing pain in the chest that worsens with breathing. Other symptoms may include:

• Shortness of breath
• Rapid, shallow breathing
• Cough
• Fever
• Pain in the shoulders, back, or upper abdomen

Is pleurisy always accompanied by fluid buildup? Not necessarily. When fluid accumulates between the pleural layers, it’s called pleural effusion. However, in cases without fluid, the condition is referred to as dry pleurisy.

Recognizing the Signs: When to Seek Medical Attention

While mild cases of pleurisy may resolve on their own, certain symptoms warrant immediate medical attention. When should you consult a healthcare professional?

Seek urgent medical care if you experience:

• Sharp chest pain that persists or worsens
• Difficulty breathing or shortness of breath
• Coughing up blood
• Chest pain accompanied by fever

In some cases, pleurisy symptoms may mimic those of more serious conditions like heart attacks or pulmonary embolisms. If you experience sudden, severe chest pain lasting more than 15 minutes or spreading to your arms, back, or jaw, call emergency services immediately.

Diagnosing Pleurisy: Medical Examinations and Tests

How do healthcare providers diagnose pleurisy? The diagnostic process typically involves several steps:

1. Physical examination: Your doctor will listen to your lungs with a stethoscope, potentially hearing a characteristic rubbing sound.
2. Medical history review: Your healthcare provider will ask about your symptoms and any potential risk factors.
3. Imaging tests: These may include chest X-rays, CT scans, or ultrasounds to visualize the lungs and pleura.
4. Blood tests: These can help identify underlying infections or autoimmune conditions.

In some cases, additional tests may be necessary to determine the underlying cause of pleurisy. These might include pleural fluid analysis or lung function tests.

Treatment Options for Pleurisy: From Home Remedies to Medical Interventions

What treatments are available for pleurisy? The approach to treating pleurisy depends on its underlying cause and severity. Options may include:

• Over-the-counter pain relievers (e.g., ibuprofen, acetaminophen)
• Prescription medications (such as antibiotics for bacterial infections)
• Rest and supportive care
• Drainage of excess pleural fluid (in cases of pleural effusion)

Can pleurisy be treated at home? For mild cases, home remedies may help alleviate symptoms:

• Rest in a position that eases pain (often lying on the affected side)
• Apply heat or cold to the chest area
• Take deep breaths to prevent lung collapse, despite the pain
• Avoid smoking and second-hand smoke

However, it’s crucial to consult a healthcare provider before attempting self-treatment, as pleurisy can sometimes indicate a more serious underlying condition.

Complications and Prognosis: What to Expect with Pleurisy

While many cases of pleurisy resolve without complications, some patients may experience more serious outcomes. Potential complications of pleurisy include:

• Pleural effusion (fluid buildup)
• Empyema (pus accumulation in the pleural space)
• Pneumothorax (collapsed lung)
• Respiratory failure (in severe cases)

How long does pleurisy typically last? The duration of pleurisy varies depending on its cause and severity. Viral pleurisy may resolve within a few days to weeks, while bacterial pleurisy might require antibiotic treatment for several weeks. Chronic conditions like autoimmune diseases may lead to recurring episodes of pleurisy.

Prevention Strategies: Reducing Your Risk of Pleurisy

Can pleurisy be prevented? While not all cases of pleurisy are preventable, 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
• Protect yourself from exposure to environmental toxins

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 Lifestyle Adjustments

For those diagnosed with pleurisy, managing the condition effectively often requires lifestyle adjustments. How can you cope with pleurisy in your daily life?

• Follow your healthcare provider’s treatment plan diligently
• Practice good posture to reduce chest pain
• Use relaxation techniques to manage pain and anxiety
• Maintain a healthy diet and stay hydrated
• Avoid strenuous activities until symptoms improve

Is it safe to exercise with pleurisy? While rest is important during the acute phase, gentle exercises like deep breathing and gradual movement can help prevent complications once symptoms begin to improve. Always consult your healthcare provider before resuming physical activities.

Support Resources for Pleurisy Patients

Living with pleurisy can be challenging, but support is available. Consider these resources:

• Join support groups for individuals with respiratory conditions
• Consult with a respiratory therapist for breathing exercises
• Explore pain management techniques with a specialist
• Seek counseling if chronic pain affects your mental health

Remember, every individual’s experience with pleurisy is unique. Working closely with your healthcare team can help you develop a personalized management plan.

Pleurisy in Special Populations: Considerations for Different Age Groups

How does pleurisy affect different age groups? While pleurisy can occur at any age, its presentation and management may vary:

Pleurisy in Children

In children, pleurisy is often associated with respiratory infections. Symptoms may include:

• Rapid breathing
• Chest or abdominal pain
• Fever
• Cough

Diagnosis and treatment in children require special consideration due to their developing bodies and immune systems.

Pleurisy in Older Adults

Older adults may be at higher risk for pleurisy due to:

• Weakened immune systems
• Increased likelihood of underlying health conditions
• Greater susceptibility to respiratory infections

Management in older adults often involves addressing both the pleurisy and any concurrent health issues.

Pleurisy During Pregnancy

Pregnant women with pleurisy require careful management to ensure both maternal and fetal health. Treatment options may be limited due to potential risks to the developing fetus.

In all cases, personalized care from healthcare professionals is essential for optimal outcomes.

Future Directions: Research and Advancements in Pleurisy Management

What does the future hold for pleurisy treatment and management? Ongoing research is focusing on several areas:

• Improved diagnostic techniques for faster, more accurate identification of underlying causes
• Development of targeted therapies for specific types of pleurisy
• Exploration of novel pain management strategies
• Investigation of potential preventive measures for recurrent pleurisy

These advancements may lead to more effective treatments and better outcomes for individuals affected by pleurisy in the future.

Emerging Technologies in Pleurisy Care

Technological innovations are also shaping the landscape of pleurisy management:

• Telemedicine platforms for remote monitoring and follow-up care
• Wearable devices to track respiratory function and symptoms
• AI-assisted diagnostic tools for more precise identification of pleural conditions
• Minimally invasive techniques for pleural fluid drainage and biopsy

As research progresses and technology advances, the outlook for pleurisy patients continues to improve, offering hope for more effective management and enhanced 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.