Pleurisy occurs when the double membrane (pleura) that lines the inside of your chest cavity and surrounds each of your lungs becomes inflamed. Also called pleuritis, pleurisy typically causes sharp pain, almost always when you are inhaling and exhaling.

Pleurisy occurs as a complication of a wide variety of underlying conditions. Relieving pleurisy involves treating the underlying condition, if it is known, and taking pain relievers.

Symptoms

The signs and symptoms of pleurisy may include:

1)Chest pain when you inhale and exhale (between breaths, you feel almost no pain)
2)Shortness of breath
3)Dry cough
4)Fever and chills, depending on the cause
5)Loss of appetite, depending on the cause

The sharp, fleeting pain in your chest that pleurisy causes is made worse by coughing, sneezing, moving and breathing, especially deep breathing. In some cases, pain may extend from your chest to your shoulder. You may find relief from pain when you hold your breath or when you apply pressure over the painful area.

When an accumulation of fluids (pleural effusion) is associated with pleurisy, the pain usually disappears because the fluid serves as a lubricant. However, if enough fluid accumulates, it puts pressure on your lungs, compressing and interfering with their normal function, causing shortness of breath. If the fluid becomes infected, the signs and symptoms of dry cough, fever and chills may appear. An infected pleural effusion is called an empyema.

These signs and symptoms point to a problem with your lungs or pleura if the pain occurs with respiration, but may also indicate an underlying illness for which you need prompt medical care.

Causes

A double layer of membranes called pleura separate your lungs from your chest wall. One layer of the pleura overlies each lung. The other layer lines the inner chest wall. The layers are like two pieces of smooth satin rubbing against each other with almost no friction, allowing your lungs to expand and contract when you breathe without any resistance from the lining of the chest wall.

When inflamed, the two layers of the pleural membrane in the affected side of your chest rub against each other like two pieces of sandpaper, producing the pain of pleurisy when you inhale and exhale.

The underlying medical conditions that can cause pleurisy are numerous. Pleurisy causes include:

1)An acute viral infection, such as the flu (influenza)
2)Pneumonia, in those cases in which the infected portion of your lung involves the surface of the pleura
3)Tuberculosis and other infections
4)A clot in an artery of your lungs (pulmonary embolism)

Pleurisy can also occur as a result of trauma to your chest or after heart surgery. Rib fractures also may cause pleurisy. It is possible to fracture a rib in the absence of trauma, such as from a severe cough. In some cases, the cause of pleurisy is unknown (idiopathic).

Cancer involving the lung rarely causes pleurisy. There is no relationship between smoking and pleurisy, but a smokers cough will aggravate the pain of this condition.

Western Medicine Treatment

Treatments used in pleurisy and pleural effusion focus primarily on the underlying cause. For example, if bacterial pneumonia is the cause, an antibiotic may control the infection.

Over-the-counter (OTC) or prescription nonsteroidal anti-inflammatory drugs (NSAIDs) may help relieve some of the signs and symptoms of pleurisy. Prescription codeine may help control a cough as well as the pain. If you have a large buildup of fluid, you may need to stay in the hospital to have the fluid drained continuously through a tube inserted into your chest.

The outcome of pleurisy treatment may depend on the seriousness of the underlying disease.

Adopted from mayoclinic.com