Pleurisy involves inflammation of the pleura that causes intense pain while breathing. It can also occur along with pleural effusion where there is surplus build-up of fluid amidst the layers of the membrane. The pleura is a double-layered membrane that helps in protecting and lubricating the surface of the lungs as they inflate and deflate in the rib cage.
The pleural space is a thin gap filled with fluid between the 2 membranes that allow smooth sliding of the 2 layers. If pleurisy is present, these membranes are inflamed during breathing, sneezing and coughing. The inflamed and rough surfaces painfully slide against each other.
Possible causes of pleurisy
The usual causes of pleurisy are viral infections such as the following:
- Lung infections such as pneumonia and tuberculosis
- Chest injuries
- Reactions to certain medications
Chest pain that is aggravated by breathing, sneezing or coughing. - Certain medical conditions such as rheumatoid arthritis, systemic lupus erythematosus (SLE), pulmonary embolism, cancer and liver diseases
What are the indications?
- Chest pain that is aggravated by breathing, sneezing or coughing
- Pain that radiates to the shoulder and back
- Shortness of breath since the individual attempts to reduce the frequency of inhaling and exhaling
- Fever in some cases
- Coughing can occur in some individuals
- In some cases, pleural effusion is present which involves buildup of fluid in the pleural space. If there is moderate fluid, there is less pain or no pain at all. If the fluid buildup is significant, it causes compression of the lungs where they collapse either partially or completely.
The individual should consult a doctor right away if he/she experiences unexplained acute chest pain during breathing since there might be an issue with the lungs or heart which triggers chest pain.
Management
The treatment for pleurisy is based on the underlying cause and if pleural effusion is present.
- In case bacterial pneumonia is the cause, antibiotics are started to control the infection. For viral cases, pleurisy often settles on its own.
- Complete bed rest is needed in which the individual is in a comfortable position. The individual should avoid any strenuous activities.
- Over-the-counter pain medications or non-steroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen can be given to reduce the pain and inflammation.
- Drainage of excess fluid is recommended if there is significant pleural effusion.
Pleurisy typically lasts for a few days up to a few weeks. In rare instances, the virus or bacteria can spread and cause the condition in others.