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Read MoreMedically reviewed by Alan Lucks | MD, Alan Lucks MDPC Private Practice - New York on October 8th, 2023.
The pleura consists of two thin membranes—visceral (lung surface) and parietal (chest wall)—that normally glide smoothly with a thin layer of lubricating fluid between them.
Sharp, stabbing chest pain that worsens with deep inspiration is the hallmark symptom, often accompanied by a distinctive pleural friction rub heard through a stethoscope.
Viral infections cause 85-90% of cases, while bacterial pneumonia, pulmonary embolism, and autoimmune conditions like lupus account for most remaining cases.
Thoracentesis may be necessary when pleural effusion (fluid accumulation) exceeds 500mL, providing both diagnostic information and symptom relief.
Most viral cases resolve within 1-2 weeks with supportive care, while bacterial infections typically improve within 48-72 hours of appropriate antibiotic therapy.
Pleurisy is a type of chest pain that affects the pleura, the thin layers of tissue that cover your lungs and line the inside of your chest wall. When the pleurae become swollen and inflamed, they rub against each other, causing a sharp, stabbing pain each time you breathe deeply, cough, sneeze, or laugh.
Pleurisy can be caused by various factors, including:
Lung infections, such as bacterial pneumonia, viral infections like the flu, or fungal infections
Blood clots in the lungs (pulmonary embolism)
Collapsed lung (pneumothorax)
Autoimmune diseases, such as rheumatoid arthritis and lupus
COVID-19, although more research is needed
Other causes, such as chest injuries, lung cancer, sickle cell anemia, and mesothelioma
It's important to note that while pleurisy itself is not contagious, some of the bacteria and viruses that cause it can be.
The main symptom of pleurisy is a sharp, stabbing, or burning chest pain that worsens when you breathe deeply, cough, or sneeze. Other symptoms may include:
Pain in other body parts, such as the neck, shoulder, back, or belly
A cough (in some cases)
Fever and chills (in some cases)
Back pain that feels like a constant dull ache
To diagnose pleurisy, your doctor will ask about your symptoms and listen to your lungs with a stethoscope. They may also recommend additional tests, such as:
Imaging tests (X-ray, CT scan, or ultrasound)
Blood tests to check for infections or autoimmune diseases
Electrocardiogram (EKG) to rule out heart problems
Thoracentesis (examining a sample of pleural fluid)
Thoracoscopy (using a thin, flexible tube to look inside the chest cavity)
Treatment for pleurisy depends on the underlying cause. Options may include:
Antibiotics for bacterial infections
Antifungal drugs for fungal infections
Draining excess fluid from the pleural space
Painkillers and steroid medications to manage pain and inflammation
Cough suppressants (codeine) if coughing is too painful
The duration of pleurisy varies depending on the cause. Bacterial infections treated with antibiotics may resolve within a few days, while pleurisy caused by lung cancer or autoimmune diseases may persist for several weeks.
To manage pleurisy at home, follow these tips:
Take prescribed medications as directed
Use over-the-counter anti-inflammatory pain relievers, like ibuprofen
Get plenty of rest
Avoid smoking, as it can further irritate your lungs
Sleep on the side that's causing you pain, with your head propped up on pillows
Avoid activities that cause rapid breathing or excessive coughing
Resume daily activities and exercise gradually
If you suspect you have pleurisy, it's essential to seek medical attention to determine the underlying cause and receive appropriate treatment. With proper care and management, most cases of pleurisy can be resolved successfully.
For more information on pleurisy and other respiratory conditions, visit:
Early identification of the underlying cause is crucial since treatment varies dramatically between viral, bacterial, and autoimmune origins. Most patients experience significant pain relief within days of targeted treatment, though underlying conditions must be addressed to prevent recurrence. If you're experiencing sharp chest pain that worsens with breathing, Doctronic can help determine whether immediate medical attention is needed.
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