Pleurisy is inflammation of the lung’s outer lining. The severity can range from mild to life threatening.

The tissue, called the pleura, between the lungs and the rib cage can become inflamed. This issue is called pleurisy.

Pleurisy often results from an infection. Sometimes, it stems from other medical conditions or trauma to the chest.

In many cases, pleurisy is mild and resolves without treatment. This makes it difficult for experts to estimate how common the condition is.

This article looks at the symptoms, treatments, causes, and complications of pleurisy.

An X-ray image showing the chest cavity of a person with pleurisyShare on Pinterest
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The pleura are the tissues that cover the inside of the chest cavity and the outside of the lungs. Between the pleura is a gap called the pleural space.

A small amount of fluid fills the pleural space. When the person breathes in, this fluid allows the pleura to glide smoothly against one another.

In a person with pleurisy, the pleura become inflamed and rub together, causing chest pain.

Pleurisy can develop rapidly due to a health emergency, such as:

  • a collapsed lung, which is called pneumothorax
  • heart problems
  • trauma to the chest

People can also have chronic pleurisy, which lasts for days to weeks. This might result from an infection, such as tuberculosis (TB), or another health issue, such as rheumatoid arthritis or cancer.

Pleurisy is only contagious if it results from a contagious infection, such as TB.

The most characteristic symptom of pleurisy is sharp, stabbing pain in the chest or shoulder. Some people report dull aching or burning pain.

The pain gets worse when the person is:

  • breathing deeply
  • coughing
  • sneezing
  • moving their chest or trunk

Also, a person usually has additional symptoms of the health issue responsible for the pleurisy.

Monitoring the duration, progression, and reoccurrence of pleurisy can help the doctor find the cause.

A variety of issues can cause pleurisy. In many cases, it is a complication of another medical condition.

The most common cause of pleurisy is a viral infection, such as the flu. Pleurisy develops when the infection spreads to the pleural cavity.

Other causes of pleurisy include:

  • bacterial infections, such as pneumonia or TB
  • rheumatoid arthritis, lupus, and other autoimmune conditions
  • a chest injury
  • a blood clot in the lung, called a pulmonary embolism
  • a pleural tumor
  • lung cancer

When bacterial pneumonia was more widespread, pleurisy was a common complication. It has occurred less frequently since the introduction of antibiotics.

Cigarette smoking is unlikely to cause pleurisy directly, but it can cause coughing and worsen pleurisy symptoms.

Doctors treat pleurisy by addressing the underlying cause. They also recommend ways to relieve the chest and shoulder pain.

Pleurisy caused by a viral infection usually goes away without treatment. When a bacterial infection is the cause, treatment involves taking antibiotics.

Also, pleurisy sometimes causes fluid to build up around the lungs — an issue called a pleural effusion. If this occurs, the fluid may need to be drained through a tube in the chest.

Managing pain at home

Medication can ease the pain of pleurisy. A person might benefit from taking nonsteroidal anti-inflammatory drugs, or NSAIDs, such as ibuprofen (Advil).

For severe cases, doctors may prescribe pain and cough medicines, including codeine-based cough syrup.

Resting in certain positions can help a person feel more comfortable. Many people find that lying on the side of the chest that hurts can help ease the pain.

A doctor can diagnose pleurisy with a physical examination and by asking about recent and general medical history. They then investigate the cause of the inflammation.

During the physical exam, the doctor may be able to hear the pleural membranes rubbing together, using a stethoscope. This sound is called a pleural friction rub.

Doctors can also diagnose pleurisy with imaging tests, such as CT or MRI scans. They can also order chest X-rays, which can show a previously undetected rib injury or signs of infection.

If a person has plural effusion, the doctor might use a needle to take a fluid sample for testing. This procedure is called thoracentesis.

They may also order blood tests to check for autoimmune disorders or a biopsy to test for cancer.

Pleurisy is treatable, and with treatment the prognosis is good, but it can cause complications that can be dangerous, such as:

Pleural effusion

This is a buildup of fluid in the pleural cavity.

The buildup may push the pleural membranes apart and partly relieve the pain caused by the pleura rubbing together. However, it may push against the lung and diaphragm, making breathing more difficult and causing shortness of breath.

A doctor needs to determine the cause of a pleural effusion, which might require them to remove the fluid for diagnostic purposes, as well as to relieve the symptoms.

If a person with pleurisy has a pleural effusion, the cause may be a clot in the lungs, which can impair blood flow.

Pneumothorax

A collapsed lung is called pneumothorax, and it can follow trauma to the chest wall. The collapse of one or both lungs can lead to a buildup of air or gas in the pleural cavity.

The most common symptom is sudden pain in one side and shortness of breath. Treatment usually involves inserting a needle or tube to remove the excess air.

Hemothorax

Hemothorax is a buildup of blood in the pleural cavity. This most often occurs after trauma to the chest.

Treatment involves draining the blood and any air from the pleural cavity.

Detecting and managing the underlying health problem quickly may prevent pleurisy from developing.

For example, an early diagnosis and timely treatment of an infection may either prevent fluid from building up in the pleural cavity or minimize levels of inflammation.

Because chest pain, the most common symptom of pleurisy, is general, the issue can be difficult to diagnose.

Getting plenty of rest and maintaining a healthful diet can also help prevent issues such as pleurisy from developing in response to an illness.

Pleurisy is inflammation of the tissues that line the outside of the lungs and the inner chest wall.

The main symptom is chest pain and sometimes shoulder pain, and the most common cause is a viral infection, though other health issues can be responsible.

Treatment aims to ease the pain and treat the underlying cause.