Pleurisy and Pleuritic Pain

What is the pleura?

The pleura is a thin membrane with two layers. One layer lines the inside of the chest wall. The other layer covers the lungs.

Between the two layers of pleura (the pleural cavity) is a tiny amount of fluid. This acts like lubricating oil between the lungs and the chest wall as they move when you breathe.

What is pleurisy?

Pleurisy means inflammation of the pleura. Pleurisy, or other problems that affect the pleura, can cause a 'pleuritic' chest pain. This is usually a sharp stabbing pain.

You may feel a pleuritic chest pain anywhere in the chest depending on the site of the inflammation, or problem with the pleura. The pain is made worse by breathing-in, or coughing, as this causes the two parts of the inflamed pleura to rub over each other.

You may have other symptoms depending on the cause of the pleurisy.

What are the causes of pleurisy

A virus infection
This is probably the commonest cause. An infection can cause some inflammation in part of the pleura which causes the pain. If you have 'viral pleurisy' you are not usually very ill. You may also have a cough, cold, fever, or flu like symptoms caused by the virus. However, the pleuritic pain can be quite severe.

The immune system will usually clear a virus infection. The pain typically lasts a few days, and then goes as the virus clears away and the inflammation settles.

Other causes of pleurisy and pleuritic pain
There are other more serious, but less common, causes of pleurisy. Anything that causes inflammation or damage at the edge of the lung next to the pleura can cause pleuritic pain. For example, pneumonia, blood clots in the lung, chest injuries, a collapsed lung (pneumothorax), tumours of the lung, and inflammation associated with some forms of arthritis. All these conditions are likely to have other symptoms, and the pleuritic pain is just part of the problem.

See a doctor if any of the following occur with a pleuritic chest pain.

• Pain that develops slowly over several days or weeks.
• Pain that does not ease and go after a few days.
• Breathlessness (shortness of breath) or other breathing difficulties.
• Coughing up blood.
• Any other symptom that you are unsure of, or cannot explain.

If you have a viral pleurisy, take painkillers regularly until the pain eases.

If you have other causes of pleuritic pain (such as pneumonia, etc), the treatment depends on the cause.

© EMIS and PIP 2006   Updated: June 2006