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What is pleurisy?

Pleurisy is a medical condition that affects the thin tissues that surround your lungs - these are called pleura. These tissues can become inflamed and swollen, usually due to a viral infection, and cause a severe stabbing pain when you breathe in or cough.

Is pleurisy serious?

These days, the condition isn’t as common as it used to be because the illnesses that can cause it (we’ll cover this later on) are more easily treated. Pleurisy can cause intense pain, and while the condition itself is not serious, if whatever is causing it is left untreated it can lead to complications.

If you have other serious symptoms, such as those of a heart attack, or if you are coughing up blood, you should seek help urgently.

What are the symptoms of pleurisy?

The main symptom of pleurisy is severe pain when you breathe in, which can feel like a stabbing pain. You may also feel the pain when you cough, sneeze or sometimes even just when you’re moving around.

  • A sharp, stabbing pain in your chest, often just on one side
  • The pain may radiate to your shoulder or back
  • Shortness of breath
  • The pain may ease if you hold your breath

Depending on what’s causing the pleurisy, you may also have:

What are the causes of pleurisy?

Pleurisy is caused by viral infections in most cases, however, it can be caused by a number of different health conditions. Causes include:

  • A viral infection, like the flu
  • Bacterial infections, such as pneumonia or tuberculosis
  • Pericarditis, which is inflammation around your heart
  • Autoimmune conditions, such as rheumatoid arthritis or lupus
  • Lung cancer
  • Pulmonary embolism, which is a blood clot in the lungs
  • Injury, like rib fractures, bruised ribs or chest wounds
  • Congestion
  • Sickle cell anaemia
  • Glandular fever
  • Pneumothorax, also known as a collapsed lung

This is not a complete list of causes - speak to a GP for more advice.

Pleural effusion

Pleurisy can lead to large amounts of fluid building up around the lungs, and this is called a pleural effusion.

This can sometimes cause the pain to ease off a little, as the fluid gives the inflammation some cushioning, however, you may find it harder to breathe and may need treatment in hospital to drain away the fluid.

How is Pleurisy diagnosed?

Our doctors will ask about your symptoms (be sure to tell them about everything, and not just the chest pain), when they began and how they are impacting your day to day life. They’ll also ask about your medical history, family history and will need to know about any medication you are taking.

You may be referred to a specialist or for further testing, which will include a physical examination, as well as possible:

  • Chest X-rays, to look for any inflammation in your chest and lungs.
  • Ultrasound scans, to look for inflammation or fluid build up.
  • CT scans, so the doctor or specialist can look at what is going on inside your chest.
  • Blood tests, to check for infection and also to investigate autoimmune conditions, like lupus and rheumatoid arthritis.
  • A biopsy of your pleura, to investigate what the cause may be.
  • Thoracocentesis, where some of the fluid is removed and studied to try and find out the cause.
  • Thoracoscopy, where a camera is used to find the inflamed pleura, before a sample is taken to analyse.

What is the treatment for pleurisy?

This will really depend on what has caused the pleurisy - the aim will be to treat the underlying cause, which should then clear up the pleurisy.

First off, the doctor will focus on managing the pain the condition is causing you. You may be recommended the anti-inflammatory drugs called non-steroidal anti-inflammatory drugs, or NSAIDs, which include ibuprofen and aspirin - you can buy these over the counter, or sometimes a stronger painkiller is required, which a GP may prescribe.

Once the cause of your pleurisy is found, a doctor can then recommend the right treatment. For example, if you have a bacterial infection, you’ll be prescribed antibiotics, or if it’s because of a pulmonary embolism, you may be prescribed anticoagulants. If you are diagnosed with a virus, this will usually be left to run its course, as antibiotics are not effective when treating viruses.