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Pleurisy is an inflammation of the pleura surrounding the lungs, causing severe chest pain. It can be caused by pneumonia, pleural effusions, or autoimmune disorders. Treatment involves reducing swelling with NSAIDs and managing pain with steroids or pain medication. Recovery can take several months.
Pleurisy or pleurisy is an inflammation of the tissues, of the pleura, that surround the lungs and line the rib cage. It is characterized by severe pain in the chest, which can be especially pronounced if someone is breathing hard from exertion. Chest X-ray can confirm the diagnosis, although sometimes the diagnosis is confirmed by ruling out other causes of chest pain such as angina, as the condition is not always easy to visualize, even with advanced x-ray technology.
Pleurisy can present with pneumonia, or is sometimes caused by pleural effusions, fluid trapped in the lining of the lungs. It rarely goes unnoticed due to the pain associated with the condition. Pneumonia can be bacterial or viral in origin, but pleural effusions are more commonly associated with some form of cardiac surgery, such as Fontan repair to relieve the single ventricle.
Pleurisy may also be present after a viral infection when there is no pneumonia. Sometimes, this condition indicates underlying autoimmune disorders such as lupus or rheumatoid arthritis. In most cases, however, pleurisy is the result of a viral infection. Those who have the condition, as well as other risk factors for autoimmune disorders, should see their doctor for further testing.
Unfortunately, pleurisy often takes a couple of months to improve. By itself, the condition generally causes no symptoms other than what some describe as excruciating pain. It can be debilitating because the pain can be very intense, limiting activity, the ability to work, and the ability to perform simple tasks.
Where pleurisy is a symptom of an underlying condition, such as lupus, treating the condition can often improve the pleurisy. Generally, those with active lupus take steroids to help with inflammation and may also take antibiotics to treat infections. Antibiotics to treat bacterial pneumonia can also reduce swelling of the pleura.
In the event of a pleural effusion, hospitalization may be required to closely monitor respiratory stability. Treatment for pleural effusions often involves a fluid-restricted diet and oral medications such as Lasix®, a diuretic that helps increase fluid production. In addition to treating the underlying symptoms, when they exist, pain is managed in a number of ways. Those affected can take steroids or pain medication. However, the primary goal is to reduce swelling, so most doctors recommend nonsteroidal anti-inflammatory drugs, also called NSAIDs.
Low-dose NSAIDs are available over the counter as ibuprofen or naproxen sodium. Stronger NSAIDs or higher doses may be needed to reduce swelling. Prescription strength ibuprofen is often prescribed. You can, however, save some money by asking your doctor to indicate the correct dosage amounts using the non-prescription forms.
Doctors may also prescribe bed rest, a good diet, and time away from work to promote healing. Even with treatment, the condition can persist for several months and remains difficult to resolve successfully without significant pain to those affected.
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