Pleurisy: Symptoms, Causes, Diagnosis and Treatment

Pleurisy is an inflammation of the membrane that separates your lungs from the chest wall. It can cause sharp and stabbing chest pain that worsens when you breathe or cough.

What causes this painful inflammation of the pleura? How can you recognize its early signs? And most importantly, how can you find quick relief?

What Is Pleurisy?

Pleurisy occurs when the pleura – the thin membrane covering your lungs – becomes inflamed. Normally, this membrane is lubricated, allowing your lungs to move smoothly as you breathe. But when inflamed, this movement causes irritation and painful friction.

The inflammation of pleuritis can turn the simple act of breathing into a painful ordeal. While it can affect anyone, certain groups like older adults and children may be more vulnerable.

Symptoms of Pleurisy

The primary symptom of pleurisy is sharp, stabbing chest pain, often worsening with deep breaths, coughing, sneezing, or even movement. However, pleurisy can present with additional symptoms, including:

Shortness of breath: Due to the discomfort, patients may try to take shallow breaths, leading to breathing difficulties.
Coughing: A dry, persistent cough.
Fever: Depending on the underlying cause of the pleurisy, fever may be present.
Pain that radiates: The chest pain may extend to the shoulders or back, making it hard to determine the exact source of discomfort.

Pleurisy in children can be trickier to identify. They may struggle to describe their pain, instead showing reluctance to move or play. Watch for short, shallow breathing patterns in your child, as it could be a sign they’re trying to minimize chest movement and avoid pain.

Pleurisy Causes

Several underlying conditions can lead to pleurisy, so Identifying the root cause is essential for proper treatment. Some common causes include:

Viral infections: Respiratory viruses are among the most frequent causes of pleurisy. Influenza and other viral infections can trigger inflammation of the pleura.
Bacterial infections: In some cases, bacterial infections such as pneumonia or tuberculosis can result in pleurisy. Bacterial pleurisy tends to be more severe and may require antibiotics for treatment.
Pulmonary embolism: This occurs when a blood clot travels to the lungs, blocking blood flow and causing inflammation and pain in the pleura.
Autoimmune disorders: Conditions like lupus or rheumatoid arthritis can cause inflammation of various body tissues, including the pleura.
Lung cancer: Although less common, pleurisy can be a symptom of lung cancer, especially if a tumor presses against the pleura.
Rib fractures or chest trauma: Physical injury to the chest can cause inflammation and lead to pleurisy.
Heart failure: Fluid buildup in the lungs due to congestive heart failure can irritate the pleura and result in pleurisy.

Pleurisy Diagnosis

Early and accurate diagnosis is critical for managing pleurisy effectively. The diagnosis often begins with a detailed medical history and physical examination.

Your doctor may listen to your lungs with a stethoscope to detect abnormal sounds caused by the friction between the inflamed pleural layers.

Diagnostic tests used to confirm pleurisy include:

Chest X-ray: This imaging technique helps detect fluid buildup or other abnormalities in the lungs.
CT scan: A more detailed imaging test that provides a clearer view of the pleura and surrounding structures.
Ultrasound: In cases of pleural effusion (fluid buildup), an ultrasound can help locate the fluid and guide treatment.
Blood tests: These can help identify infections, autoimmune conditions, or other underlying causes.
Thoracentesis: If fluid has accumulated in the pleural space, a sample may be taken using a needle to analyze the cause of inflammation.

Pleurisy Treatment

The treatment for pleurisy depends on the underlying cause, and relieving symptoms is the first step in management.

Medications:

Anti-inflammatory drugs: Nonsteroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen, are often prescribed to reduce inflammation and pain.
Antibiotics: If pleurisy is caused by bacterial infections, antibiotics are necessary to clear the infection.
Antiviral medications: In cases where a viral infection is the culprit, antivirals may be used, although viral pleurisy often resolves on its own with supportive care.
Steroids: For pleurisy associated with autoimmune conditions, corticosteroids may be prescribed to reduce inflammation.
Pain management: Depending on the severity of the pain, stronger prescription pain relievers may be recommended.

Drainage of fluid (Thoracentesis):

If pleurisy leads to significant fluid buildup in the pleural space (pleural effusion), draining the fluid can alleviate pain and improve breathing. In some cases, a chest tube may be inserted to continuously drain the fluid.

Treatment of underlying conditions:

Addressing the root cause of pleurisy, such as treating pneumonia or managing autoimmune diseases, could be useful for long-term relief and prevention complications.

Complications of Pleurisy

While pleurisy can often be managed effectively, it can lead to complications, especially if left untreated. The most common complications include:

Pleural effusion: Fluid accumulation in the pleural space, which can cause difficulty breathing and may require medical intervention.
Atelectasis: This occurs when part of the lung collapses due to pressure from fluid buildup, leading to breathing difficulties.
Empyema: If the fluid in the pleura becomes infected, it can turn into pus, leading to a serious condition called empyema that often requires drainage and antibiotics.

Pleurisy Prevention

While it’s not always possible to prevent pleurisy, certain measures can reduce your risk:

Vaccination: Stay up-to-date with vaccinations for pneumonia, influenza, and other respiratory infections.
Timely treatment of infections: Address respiratory infections promptly to reduce the risk of them spreading to the pleura.
Manage chronic conditions: For individuals with autoimmune diseases, regular treatment and monitoring can help prevent inflammation of the pleura.

If you or a loved one is experiencing symptoms of pleurisy, it’s important to seek medical advice to receive appropriate care and treatment.

At ER of Fort Worth, we are steadfastly committed to providing exceptional medical care, embodying our unwavering dedication to excellence in serving the local community. Our experienced medical team is equipped to diagnose and treat pleurisy, ensuring that you receive the highest level of care.

Request a Comprehensive Pleurisy Assessment

FAQs

What helps pleurisy go away?

Treatment for pleurisy depends on the underlying cause, such as antibiotics for infections or anti-inflammatory medications for pain relief. Rest, proper hydration, and addressing the root condition are key to recovery.

Is pleurisy an emergency?

Pleurisy can be an emergency if accompanied by severe symptoms like difficulty breathing, high fever, or chest pain that worsens rapidly.

How to sleep with pleurisy?

To sleep with pleurisy, try lying on the side that causes less pain, which can help reduce discomfort from breathing movements. Elevating your upper body may also ease pressure on the chest and improve breathing. However, you should promptly visit your doctor to avoid complications.