Pleurisy

What is pleurisy?

Pleurisy means inflammation of the pleura – the layers of tissue between the lungs and ribcage. When these layers become inflamed, they rub against each other as the lungs expand and cause pain and discomfort in your chest.

Pleurisy symptoms

The main symptom of pleurisy is a sharp pain in the chest when you breathe. You might feel it in different parts of your chest, depending on which part of the pleura is inflamed. The pain may get worse as you move, cough, laugh or sneeze.

Other symptoms include:

• Pain that may spread to your shoulder or back

• Shortness of breath

• A dry cough

Causes of pleurisy

The most common cause of pleurisy is a virus, like flu. It can also be caused by:

• A blood clot in the lunge (known as a pulmonary embolism)

• Bacterial infections, like pneumonia

• Chest injuries - if your ribs are bruised or fractured

• Lung cancer

• Autoimmune conditions like rheumatoid arthritis and lupus

Is pleurisy contagious?

Pleurisy itself is not contagious. But it's often caused by contagious infections, like flu, which is possible to pass on to others.

How is pleurisy diagnosed?

If you experience sharp pains in the chest, talk to a doctor as soon as you can. They will ask you questions about your symptoms to get a better idea of the type of pain you’re experiencing. 

They will also listen to your chest. This is to see if they can detect any unusual noises made by the pleurae rubbing against each other – this is usually a distinctive, dry, crunching sound.

Usually, this will be enough to diagnose pleurisy, but some other lung disorders can cause similar pain to pleurisy, so you may need to have other tests to be sure. This might include a blood test or imaging test like a chest X-ray or ultrasound. Sometimes more invasive tests would be recommended such as a lung biopsy.

Pleurisy treatment

Treatments for pleurisy include reducing the pain and treating the underlying cause. 

Painkillers and non-steroidal anti-inflammatory drugs (NSAIDs), like ibuprofen, usually ease the pain.

If further treatment is needed, the medication will depend on what’s causing the pleurisy. If it’s caused by a viral infection, it’s likely to get better on its own within a few days, while a doctor may prescribe antibiotics if they’re sure it's caused by a bacterial infection.

What is pleural effusion?

Sometimes, pleurisy can cause a build-up of fluid around the lungs. This is known as pleural effusion. This can be treated with medication, or a doctor may want to drain the fluid away, using a thin needle inserted into the pleura. 

This will be done under general or local anaesthetic, and you might need to stay in the hospital for a few days to have the procedure.

What is the pleurisy recovery time?

If your pleurisy is caused by a viral infection, it’ll usually get better on its own after 2-3 days. If it’s a bacterial infection causing the inflammation, a doctor may prescribe antibiotics and you’ll usually feel better within 2 weeks.

Either way, the best route to recovery is to rest lots. Here are some other ways to recover quicker:

• Stay well-hydrated

• Practice deep breathing to help stop mucus from becoming trapped in your lungs. 

• Lie on the side that’s causing you pain – this may also help ease the pain while you recover. 

When should I talk to a doctor about pleurisy?

If you’re experiencing any of the symptoms of pleurisy, make an appointment to speak to a doctor. 

If pleurisy is diagnosed and treated quickly, it generally clears up with no long-lasting damage, but sometimes it can lead to more serious complications.

If you experience any of the following warning signs, seek immediate medical help:

• Coughing up blood

• Breathing difficulties or unusual shortness of breath

• Severe chest pain, especially if you also feel sick or sweaty