Pleurisy is an inflammation of the membranes between your lungs and your ribcage. There are several possible causes and if you have the symptoms, you need to see your doctor for treatment.
- The membranes that line your lungs and your chest wall are called the pleura. When these get inflamed, they rub and grate against each other. This is pleurisy (also known as pleuritis).
- The most common symptom of pleurisy is a sharp stabbing pain in your chest when you breathe in deeply or cough or sneeze.
- The most common cause of pleurisy is a chest infection caused by a virus, such as the flu, or bacteria, such as pneumonia.
- If you have symptoms of pleurisy, you need to see your doctor. With treatment, most people recover within a few weeks. If you get treatment early, there will be no lasting damage to your lungs.
- Sometimes the fluid between the lung and chest wall membranes builds up and forms a pleural effusion. If this happens, you may feel less pain but find it harder to breathe.
|If you have severe chest pain, and especially if you also have other symptoms, such as coughing up blood, nausea or sweating, see a doctor immediately.|
What are the causes of pleurisy?
- a blood clot in the lungs (pulmonary embolism)
- injury – if the ribs are bruised or fractured, the pleura can become inflamed
- lung cancer
- autoimmune conditions, such as rheumatoid arthritis and lupus
- a collapsed lung (pneumothorax)
- tuberculosis (TB).
What are the symptoms of pleurisy?
The most common symptom of pleurisy is a sharp chest pain when you breathe in, cough, laugh or sneeze. You may also be short of breath, have a dry cough, develop a fever and generally feel unwell.
How is pleurisy diagnosed?
Your GP will do a physical exam, including listening to your chest. If they hear a distinctive dry, crunching sound that suggests you have pleurisy, they may ask for further tests to find out what has caused the pleurisy and how severe it is. These might include:
- blood tests
- chest x-rays or scans
- bronchoscopy – looking at your airways through a thin tube passed through your throat
- a biopsy – where a small sample of the pleural or lung tissue is removed for testing.
How is pleurisy treated?
Treatment is aimed at relieving your pain, with painkillers or non-steroidal anti-inflammatories. If the cause is not a viral infection, you will also be treated for the underlying cause of your pleurisy, such as pneumonia, tuberculosis (TB), or a pulmonary embolism. If you have a pleural effusion, the fluid will be drained off.
What self-care can I do if I have pleurisy?
You can care for yourself by:
- taking painkillers or any other medication as directed
- if you have a viral infection, following self-care for colds and flu
- ringing or seeking medical advice if you are not improving or get worse from when you first saw a doctor.
How can I prevent pleurisy?
- Have an annual flu vaccination.
- If you are elderly, have chronic illness or reduced immunity, talk to your doctor about being vaccinated against pneumonia.
- Pleurisy HealthDirect, Australia, 2017
- Pleurisy NHS Choices, UK, 2017
- Pleurisy Patient Info, UK, 2016
- British Thoracic Society pleural disease guideline 2010 Thorax – an international journal of respiratory medicine, Aug 2010
Information for healthcare providers
TB and pleuritis
Corticosteroids may reduce the time to resolution of pleural effusion and may reduce the risk of having pleural changes at the end of follow-up by almost one-third. See Cochrane Database of Systematic Reviews. What is tuberculous pleurisy and how might corticosteroids work? 2017