Pleurisy is a chest pain syndrome characterized by a sharp chest cavity pain that worsens with breathing. Pleurisy is caused by inflammation of the linings around the lungs (the pleura), a condition also known as pleuritis. There are two layers of pleura: one covering the lung and the other covering the inner wall of the chest. These two layers are lubricated by pleural fluid. Pleurisy is often associated with the accumulation of extra fluid in the space between the two layers of pleura. This fluid is referred to as a pleural effusion. The pain fibers of the lung are located in the pleura. When this tissue becomes inflamed, it results in a sharp pain in the chest that is worse with breathing. Other symptoms of pleurisy can include cough, chest tenderness, and shortness of breath.
The main symptom associated with pleurisy is a sharp, stabbing pain when you breathe. This pain might go away when you hold your breath or put pressure on the painful area. However, the pain will often get worse when you sneeze, cough, or move. Fever, chills, and loss of appetite are also possible symptoms, depending on the condition that’s causing the pleurisy.
Additional symptoms of pleurisy include:
- pain on one side of your chest
- pain in your shoulders and back
- shallow breathing to avoid feeling pain
- muscle aches
- shortness of breath
Pleurisy can be accompanied by a fluid buildup that puts pressure on the lungs and causes them to stop working properly. This fluid accumulation is called a pleural effusion. This fluid may initially act like a cushion, causing the chest pain to disappear. A person with a pleural effusion will experience shortness of breath as the fluid increases. An individual may also experience fever, chills, and a dry cough. These symptoms can indicate an infection in the fluid, also called an empyema.
Two large, thin layers of tissue called pleura separate your lungs from your chest wall. One layer wraps around the outside of the lungs. The other layer lines the inner chest wall. Between these two layers is a small space that's usually filled with a very small amount of liquid. The layers act like two pieces of smooth satin gliding past each other, allowing your lungs to expand and contract when you breathe without any resistance from the lining of the chest wall.
Causes of pleurisy include:
- A viral infection, such as the flu
- A bacterial infection, such as pneumonia
- A fungal infection
- Certain medications
- Lung cancer near the pleural surface
- Certain inherited diseases, such as sickle cell disease
Your doctor will want you to describe the type of pain you feel when you breathe or cough, and he’ll ask whether it gets better or worse as the day goes on. He’ll listen to your lungs with a stethoscope to see if they’re making any strange noises.
Treatment of pleurisy focuses on resolving the cause, such as a virus or other infections. Antibiotics will be prescribed if the inflammation is a result of a bacterial infection. In some cases, a person may need to have fluid drained from the pleural cavity through a tube that is inserted into the chest. Pain can be managed with aspirin, ibuprofen, or non-steroidal anti-inflammatory drugs (NSAIDs). In severe cases, prescription pain and cough medicines may be used, including codeine-based cough syrups.
Pleurisy can have severe long-term implications, but seeking medical treatment and adhering to your course of treatment can have extremely positive results. You and your doctor should identify any underlying causes of your pleurisy to help you recover.