Pleurisy

Pleurisy is inflammation of the tissue between the lungs and ribcage (pleura).

It's easy to treat and usually gets better in a few days. But it can sometimes be a sign of something more serious, such as pneumonia.

Symptoms of pleurisy

The most common symptom of pleurisy is a sharp chest pain when you breathe.

Other symptoms include:

• shoulder pain
• pain that gets worse when you cough, sneeze or move
• pain that is relieved by taking shallow breaths
• shortness of breath
• a dry cough

What happens at your GP appointment

Your GP will listen to your chest. Sometimes pleurisy can cause a dry, crunching sound in your chest.

They may refer you for more tests to check if it is pleurisy.

Tests may include:

• blood tests
• chest x-ray
• an ultrasound scan
• a CT scan
• a biopsy - a small sample of pleural tissue or lung tissue is removed and checked under a microscope

Causes of pleurisy

Pleurisy is usually caused by a virus, such as the flu virus.

Less common causes include:

• bacterial infections, such as tuberculosis or pneumonia
• a blood clot in the lungs (pulmonary embolism)
• injury - if your ribs are bruised or fractured, the pleura can become inflamed
• lung cancer
• autoimmune conditions, such as rheumatoid arthritis and lupus

COVID-19 and pleurisy

Symptoms of COVID-19 and pleurisy are similar. But there's no evidence that COVID-19 directly causes pleurisy.

COVID-19 causes conditions that can lead to pleurisy. For example, respiratory infections and pneumonia.

Treating pleurisy

Treatment for pleurisy usually involves:

• relieving pain
• treating the underlying cause

If treated quickly, pleurisy often gets better without causing any lasting lung damage.

Treating chest pain

You can usually ease the pain with non-steroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen.

If NSAIDs are not suitable for you, your GP may prescribe another painkiller.

Try to find a comfortable position when you are resting. Lying on the side of your chest that hurts can help reduce the pain.

Treating the underlying cause

Pleurisy will usually get better on its own after a few days if it was caused by a viral infection.

If it was caused by a bacterial infection, you'll need antibiotics.

If your symptoms are severe or you already have poor health, you may need to go to hospital.

Treating pleural effusion

Sometimes pleurisy causes a build-up of fluid around the lungs called pleural effusion.

Pleural effusion can lead to shortness of breath that gets worse.

This is more likely if pleurisy is caused by pulmonary embolism or a bacterial infection.

The fluid may need to be drained if:

• pleural effusion does not clear up as your pleurisy is treated
• you're very short of breath
  

This can be done under general anaesthetic (you will be asleep) or local anaesthetic (numbs an area of your body).

The fluid is drained by inserting a needle or tube through the chest wall. You may need to stay in hospital for a few days if there is a lot of fluid to be drained.