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Pleurisy causes sharp chest pains due to inflammation of the tissue between the lungs and ribcage, called the pleura. We explain the main causes of pleurisy and how it's diagnosed and treated.

What is pleurisy?

Pleurisy means inflammation of the pleura, a membrane made up of two thin layers of tissue – one lining the chest wall and one covering the lungs. When these layers become inflamed, they rub against each other as the lungs expand and cause discomfort in the chest.

Pleurisy symptoms

The main symptom of pleurisy is a sharp pain in the chest when you breathe. You may feel this in different parts of the chest, depending on which part of the pleura is inflamed.

Other possible symptoms include:

  • Sharp, stabbing pain which gets worse when you cough, laugh or sneeze

  • Pain that may spread to your shoulder or back

  • Shortness of breath

  • Cough

  • Fever

Causes of pleurisy

The most common cause of pleurisy is a virus (e.g. the flu virus).

Other possible causes include:

  • Pulmonary embolism – a blood clot in the lungs

  • Bacterial infections, like pneumonia

  • Chest injuries - if the ribs are bruised or fractured

  • Lung cancer

  • Autoimmune conditions, like rheumatoid arthritis and lupus

Is pleurisy contagious?

Pleurisy itself is not contagious, but it's often caused by contagious infections, like flu.

Who is affected by pleurisy?

People of all ages can get pleurisy, but it’s more likely to affect you if you have an underlying medical condition (like an autoimmune disease) or if you’re over the age of 65.

How is pleurisy diagnosed?

If you experience sharp, stabbing pains in the chest, talk to a doctor as soon as you can. They will ask you questions about your symptoms to get a better idea of the type of pain you’re experiencing. They will also listen to your chest to see if they can detect any unusual noises made by the pleurae rubbing against each other.

Usually, this will be enough to diagnose pleurisy, but various other lung disorders can cause similar pain to pleurisy, so you may need to have some other tests to be sure.

These could include:

  • blood tests

  • imaging tests, including chest X-rays, ultrasound scans and CT scans

  • a biopsy – taking a small sample of pleural or lung tissue for further testing

When to get medical help

If pleurisy is diagnosed and treated quickly, it generally clears up with no long-lasting damage, but sometimes it can lead to more serious complications.

If you experience any of the following warning signs it’s important to get immediate medical attention:

  • Coughing up blood

  • Breathing difficulties or unusual shortness of breath

  • Severe chest pain, especially if you also feel sick or sweaty

Pleurisy complications

Pleurisy can cause a build-up of fluid around the lungs, called pleural effusion. This can make it difficult to breathe and can get worse over time. Pleural effusion is more of a risk when pleurisy is caused by pulmonary embolism or a bacterial infection.

Other, more serious complications include:

  • Atelectasis – when the lungs are blocked or can’t expand easily

  • Empyema – when there’s pus in the pleural cavity

  • Sepsis – a severe reaction to infection, which can be life-threatening

Pleurisy treatment

Treatment for pleurisy is used for two reasons – to help reduce the pain and, if necessary, to treat the underlying cause. Painkillers and non-steroidal anti-inflammatory drugs (NSAIDs), like ibuprofen, usually ease the pain.

If further treatment is needed, the medication will depend on what’s causing the pleurisy. If it’s caused by a viral infection, it’s likely to get better on its own within a few days. Antibiotics may be needed if it’s caused by a bacterial infection.

If there’s a build up of fluid around the lungs caused by pleural effusion, it may be treated with water pills called diuretics, or the fluid may be drained with a thin needle that’s inserted into the pleura. This will be done under general or local anaesthetic, and you may need to stay in the hospital for a few days to have the procedure.

How to recover from pleurisy

The best route to recovery is to take lots of rest and practice deep breathing to help stop mucus from becoming trapped in your lungs. Lying on the side that’s causing you pain may also help ease the pain.

Reviewed by:

Dr Rhianna McClymont

Lead GP at Livi

Last updated: