Pleurisy
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Overview
Pleurisy, also known as pleuritis, is swelling of the thin lining around the chest cavity and lungs, also known as the pleura. This lining creates a smooth surface so the lungs glide easily in the chest while breathing. When the lining swells, the lungs rub painfully against the chest, causing swelling and chest pain.
In some cases, fluid can collect between the pleura. This is called pleural effusion. When there is no fluid, the condition is called dry pleurisy.
Symptoms
Usually the first sign of pleurisy is a sudden chest pain. The pain may be very mild or very severe. Sometimes the pain is only felt while breathing deeply or coughing. Other times, the pain may be felt all the time and get worse with deep breathing or coughing. Usually the pain is felt in the chest wall over the area that’s inflamed. You might also feel pain in the upper abdominal area, neck, back, and shoulders.
Because inhaling deeply hurts, a person with pleurisy tends to breathe quickly and shallowly. On the side where the pain is, the muscles of the chest move less than those on the other side. If fluid builds up between the layers of the pleura, the chest pain may go away. Large quantities of fluid can make expanding one or both lungs difficult.
Other symptoms may include:
- Fever
- Cough
- Shortness of breath
- Rapid breathing
Causes and Risk Factors
Irritation of the pleura can be caused by:
- Viruses
- Bacterial infections
- Cancer
- Inhaling asbestos or other toxic substances
- The use of certain medications
- Some types of autoimmune diseases, such as lupus or rheumatoid arthritis
Diagnosis
Diagnosis of pleurisy usually starts with a physical exam. Because the pain tied to pleurisy is distinct, it is often easy for the physician to diagnose. Using a stethoscope, the doctor may hear a squeaky, rubbing sound.
Chest X-rays and CT scans are often used to see an image of what is going on inside the lungs and chest. These tests help show if fluid is building up in the lungs. They will also show if the lungs are filling up with air as much as possible.
Other imaging tests may be used, such as an ultrasound or electrocardiogram, to rule out heart disease.
If fluid has begun to build up in the chest or lungs, the doctor may take a test sample of it. This will help determine the cause of the pleurisy and rule out the possibility of cancer.
A biopsy of a small sample of tissue may also be done to rule out the possibility of cancer. To do this, a needle will be used to remove a small tissue sample to be examined under a microscope.
A blood test to detect lupus or rheumatoid arthritis may also be performed.
Treatment
Treatment for pleurisy depends on what caused the condition. The experts at Cedars-Sinai’s Advanced Lung Disease Program can help you find the best treatment plan.
Antibiotics may be prescribed for infections caused by bacteria. If a virus causes the pleurisy, no treatment will be given. If the cause is lupus or an autoimmune disease, corticosteroids often quickly cure the pleurisy. These drugs suppress the immune system, which stops the swelling in the lining.
Nonsteroidal anti-inflammatory drugs, such as aspirin or ibuprofen, help relieve the chest pain. Codeine and other stronger pain relievers should not be used. These medicines can stop you from coughing. Coughing is important because it stops the lungs from collapsing and helps prevent pneumonia.
Holding a pillow against the part of the chest that hurts while coughing or breathing deeply can be helpful. Wrapping the chest in wide, elastic bandages can help relieve severe pain. Wrapping the chest also makes it harder to breathe and increases the risk of a collapsed lung or pneumonia.
© 2000-2022 The StayWell Company, LLC. All rights reserved. This information is not intended as a substitute for professional medical care. Always follow your healthcare professional's instructions.
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A common injury we see in our clinics is acute mid back or thoracic spine pain with referral around into the ribs.
This type of injury commonly occurs during twisting activities and unexpected movements when lifting or even twisting awkwardly when sneezing.
Our patients come in complaining of sharp pain between the shoulder blades, associated with muscle spasm and pain referral. Pain is often increased with deep breathing or twisting motions.
The main cause of this problem is injury to the small joints either side of the spine.
Risk factors for the development of this problem include:
- Poor seated posture – or spending too long sitting.
- Limited thoracic extension – due to slouching posture.
- Reduced mid back rotation – again due to prolonged sitting and not enough movement of these joints.
- Muscle imbalance between the chest muscles and the back muscles.
Physiotherapy treatment for this injury includes mobilization of the stiff and injured joints, massage, dry needling and stretching to help settle the affected area. A rehabilitation program is then devised to treat the risk factors and causes of the injury.
To help prevent this happening to you try these simple exercises.
- Exercise #1: Lie over a rolled up towel on the floor placed horizontally across your back. Stretch your arms up over your head and feel the gentle stretch as your encourage your thoracic to extend. Hold each position for 30 seconds and try to do 3 levels of your back.
- Exercise #2: If you have a job which requires that you sit for more than 20 minutes at a time complete 10 rotations to each side holding for about five seconds moving into your stiffness to loosen up these joints of your mid-back
- Exercise #3: Lie on your back on a Swiss Ball, then relax the arms out to the side at 90 degrees and keep them there for 30 seconds – rest for 30 seconds and repeat three times.
- Exercise #4: Sitting or standing, interlock hands behind head, tip elbow up, other elbow down. Do not allow body to lean.
If you do experience this type of injury please seek treatment as soon as possible, for the earlier treatment is provided – the better chance of a fast and full recovery.
If you need help with your back pain – please give us a call on 8987 0296 and get your problem fixed now so that you can move better and feel better!