Pleurisy

Symptoms of pleurisy

Symptoms of pleurisy include:

• the most common symptom is a sharp chest pain when you breathe deeply
• you sometimes also feel pain in your shoulder
• the pain may be worse when you cough, sneeze or move around
•  it may be relieved by taking shallow breaths
• other symptoms include shortness of breath and a dry cough

When to see your GP

See your GP if you have chest pain or other symptoms of pleurisy.

Pleurisy can usually be diagnosed based on your symptoms. Your GP will listen to your chest. A distinctive dry, crunching sound may suggest you have pleurisy.

Further tests may be needed to find out what's causing pleurisy and how severe it is.

Get immediate medical help if you have severe chest pain. This is particularly important if you also have other symptoms, such as coughing up blood, nausea or sweating.  

Treating pleurisy

Treatment for pleurisy usually involves relieving the pain and, in some cases, treating the underlying cause.

If treated quickly, pleurisy often gets better without causing any lasting lung damage.

Treating chest pain

Taking non-steroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen, often eases the pain.

If NSAIDs are unsuitable for you or don't work, your doctor may prescribe another painkiller.

It seems strange, but lying on the side of your chest that hurts may also help reduce the pain.

Treating the underlying cause

• if your pleurisy is caused by a viral infection, it will usually get better on its own after a few days
• if it's caused by a bacterial infection, you'll need antibiotics
• if your symptoms are particularly severe, or if you're already in poor health, you may need to be admitted to hospital

Treating pleural effusion

In some cases, pleurisy causes a build-up of excess fluid around the lungs called pleural effusion.

This can lead to shortness of breath that gets progressively worse. This is more likely if pleurisy is caused by pulmonary embolism or a bacterial infection.

If pleural effusion doesn't clear up as your pleurisy is treated, or if you're very short of breath, the fluid may need to be drained by inserting a needle or tube through the chest wall.

This can be done under general anaesthetic or local anaesthetic.

Causes of pleurisy

Most cases of pleurisy are caused by a virus, such as the flu virus.

Less common causes include:

• bacterial infections, such as pneumonia
• 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