The Pain Of Pleurisy

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.

Pleurisy Symptoms

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.

Pleurisy Causes

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:

• Pneumonia
• Tuberculosis of the lung
• Systemic lupus erythematosus
• Injuries to the chest
• Rheumatoid arthritis
• Liver disease
• Cancer
• Pulmonary embolism
• Reactions to drug

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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.

Diagnosing And Treating Pleurisy

How Is Pleurisy Diagnosed?

Because the pain symptoms of pleurisy are quite specific, a doctor will often be steered towards that diagnosis quite quickly. Using a stethoscope to listen to your breathing will also show whether there is the presence of a pleural friction rub, an abrasive sound of the membrane layers as they rub together. This sound resembles a rasp or scraping sound and it can be heard between the end of an inhalation and the beginning of an exhalation.

Listening with a stethoscope will also help determine whether or not a pleural effusion is present. If breath sounds are quieter and their quality is altered, it can be a sign that there is an effusion present. If the doctor suspects either pleurisy or an associated pleural effusion, the next step in defining the diagnosis is by x-raying the chest. An x-ray will appear normal if there is pleurisy, but will show excess fluid in the lung space if there is an effusion. It is also a method of determining if there is pneumonia present, which could be the underlying cause of the pleurisy.

If radiology tests show a pleural effusion, a sample of this fluid will be taken and sent for analysis to determine if there are bacteria present. A thoracentesis is then performed, inserting a needle into the lung space and draining out the excess fluid. If the underlying cause is not known, and there are specific concerns regarding serious causes, a biopsy of the pleura may be taken and analyzed.

Treating Pleurisy

Treatment for pleurisy will depend on the underlying cause once it is identified. Typical treatment would include antibiotics to treat any infection present, pain medicines and anti-inflammatory drugs to relieve the inflammation. When the pleurisy is due to a viral infection, the only treatment required will be for the management of the inflammation and the pain, as antibiotics will have no effect on the virus. Viral pleurisy will normally resolve on its own over a period of time.

It is important to not only take any medication that is prescribed to you, but to also ensure you get plenty of rest. It can be difficult to find a comfortable position due to the pain, but sometimes it is helpful to use a pillow to prop the side of the body with pleurisy up with. It can take a while to recover from pleurisy, and it’s a good idea not to start overdoing things as soon as you start to feel you are improving. Wait until you are pain free before you go back to your regular activities.

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Conclusion

Pleurisy in itself is not a serious condition, but it is a very painful and tiring one. If you have shallow breathing, you can become quite exhausted, so resting as much as possible is ideal. Most of the time pleurisy is bacterial or viral, so it is easily remedied and recoverable. It is only when there is a more serious underlying cause that there is any need for concern. If you start to experience any of the symptoms described above, go and see your doctor and get them checked out.