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Around the lungs and lining the rib cage is a membrane called the pleura, and pleurisy occurs when that membrane becomes inflamed. The role of the pleura is to keep the lung surface lubricated as a person inhales and exhales. Between the pleura and the lung is a small space filled with fluid, which enables to the membrane layers to slide past one another gently. When pleurisy occurs, the inflammation reduces this space resulting in the membrane layers rubbing together, hence the terrible pain felt when breathing, coughing or sneezing.
Sometimes, as well as pleurisy, another lung condition can develop called a pleural effusion. This happens when that space is filled with excess fluid, which can lubricate the membrane, but also puts a lot of pressure on the lung, which stops them from inflating and deflating correctly. This can become a serious complication, and often the fluid will need to be drained.
If you have pleurisy you will probably know about it, as the pain is quite severe. The main symptoms of pleurisy include:
- Severe sharp pain on one side of the chest when breathing, sneezing, moving or coughing.
- Pain can also occur when talking.
- Chest pain that is relieved by holding your breath.
- Pain can occur in the back, neck, abdomen or shoulder.
- Shallow and fast breathing due to the pain.
As you can see, the main symptom is pain, and depending on what part of the lung is inflamed, will determine where the pain will be felt. Those with pleurisy tend to want to stay very still, as movement can trigger the pain. Pleurisy pain is normally fleeting, but when it occurs on every single breath you take, it can be very distressing.
The most common cause of pleurisy is a viral infection, which can make it difficult to treat, as viruses don’t respond to antibiotics. There are so many different types of virus that can cause illness, and identifying the specific virus responsible can be almost impossible to do. As well as virus infection, there are a number of other causes of pleurisy, and these include:
- Tuberculosis of the lung
- Systemic lupus erythematosus
- Injuries to the chest
- Rheumatoid arthritis
- Liver disease
- Pulmonary embolism
- Reactions to drug
Pleurisy in itself is not a concerning medical condition, but the underlying cause needs to be identified and treated. Especially as some of these causes are serious medical conditions in their own right, and could lead to more severe complications or risks to life.