Pleurisy is an inflammation of the thin layers of tissue that covers the lungs and the chest wall.
The outer layer of the pleura lines the inside of the chest wall, and the inner layer covers the lungs. The small space present between the two layers is called the pleural cavity. This cavity normally contains a small amount of lubricating fluid that allows the two layers to slide over each other when you breathe.
When the pleura become inflamed the layers come in together further causing chest pain. This is known as pleuritic pain.
What causes Pleurisy?
In young and healthy people, an infection of the lower respiratory system by a virus or bacteria may cause pleurisy. Pleurisy generally lasts for a few days to 2 weeks. In very of the rare cases, the virus or bacteria may spread and cause pleurisy in others.
Some of the other causes of pleurisy may include air leaking into the pleural cavity from a hole in a lung (pneumothorax), injury to the chest (such as a broken rib), tuberculosis or different infections, or a tumor in the pleura.
Other conditions may also cause pleurisy. These can involve rheumatoid arthritis, lupus, sickle cell crisis, pulmonary embolism, or pancreatitis. Pleurisy may also develop as a complication of heart surgery.
What are the symptoms of Pleurisy?
The some of the common symptoms of pleurisy are chest pain and difficulty in breathing. The chest pain generally starts very suddenly. Mostly people describe it as a stabbing pain, and it generally gets worse with breathing. The pain:
- can always be present but it generally gets worse when you breathe. You may avoid deep breathing to prevent the pain.
- Generally is on only one side of the chest.
- Can extend to a shoulder or the belly.
- Is generally worse when you cough, sneeze, or suddenly move.
- Can ease when you hold your breath or press on the painful area.
However, this sort of chest pain can be caused by conditions that do not affect the pleura, like chest muscle strain and costochondritis.
If your pleurisy is caused by a viral infection, you may or may not have common viral symptoms, like fever, headache, and muscle aches.
Sometimes, the inflammation of the pleura causes fluid to build up in the pleural cavity. You may have less pain after this happens, because the fluid prevents the two layers of the pleura from rubbing together.
Sometimes, if there is a large amount of fluid present, it can prevent the lung from expanding when you breathe in. This can make it hard to breathe. Other symptoms of pleural effusion may include fever, chest pain, and a dry cough.
How is pleurisy treated?
The treatment for pleurisy depends on the cause. Just like, if a bacterial infection is the cause, you will probably need an antibiotic. If a pulmonary embolism is present, you can get medicine to dissolve the clot or to prevent future blood clots (anticoagulants).
For most cases of pain caused by pleurisy, your doctor will suggest that you use aspirin, ibuprofen, or another non-steroidal anti-inflammatory drug (NSAID).
Do not prescribe aspirin to anyone who is younger than 20 because of the risk of reye syndrome. If you are having severe pain, you may need prescription cough or pain medicine. You may also be able to relieve pain by lying on the painful side or pressing a pillow against it.
If you are having pleural effusion, you may need to have the fluid drained through a tube that the doctor inserts in your chest.
In some cases of pleural effusion, you may need pleurodesis. At the time of this procedure, a medicine is placed into your chest cavity, which triggers an inflammatory reaction over the surface of the lung and inside the chest cavity.
This causes the surface of the lung to stick to the surface of the chest cavity, which prevents more fluid from building up or reduces the amount of fluid.