Your lungs are wrapped in a thin layer of tissue called pleura. They fit snugly within your chest, which is lined with another thin layer of pleura.
These layers keep your bare lungs from rubbing up against the wall of your chest cavity every time that you breathe in. There’s a bit of fluid within the very narrow space between the two layers of pleura to keep everything moving smoothly.
When you’re healthy, you never notice your pleura at work. But if your pleura has a problem, there’s no doubt you’ll feel it.
When the pleura are swollen and inflamed, they rub against each other in a very painful way each time that your lungs expand as you take a breath. When you inhale deeply, cough, sneeze or laugh, you’ll likely feel a sharp, stabbing pain in the area of this inflammation.
Most of the time, it happens because of an infection. If your doctor treats your infection, that can make the pleurisy -- and the pain -- go away.
Some other things that can cause pleurisy to strike are:
- Lung cancer
- A blood clot in the lung
- Other types of cancer that affect the lungs or pleura
- An autoimmune disease, such as lupus or rheumatoid arthritis
The chest pain that’s due to pleurisy has telltale signs that often make it easy for your doctor to know that you have it. You’re likely to notice these things:
- A sharp, stabbing pain causes you to take small, shallow breaths, because it’s worse when you try to breathe deeply.
- Pain is spreading to your shoulder or back.
- You’re coughing.
- You have a fever and chills.
- You’re losing weight without trying to.
Your doctor will want you to describe the type of pain you feel when you breathe or cough, and he’ll ask whether it gets better or worse as the day goes on. He’ll listen to your lungs with a stethoscope to see if they’re making any strange noises. (Doctors often can hear the pleura rubbing against each other.)
You may also need to have tests done, such as:
- Imaging. If your doctor wants to rule out other problems besides pleurisy, he may send you for an X-ray, a CT scan, or even an ultrasound. These images can show if it’s pleurisy that’s causing your pain.
- Blood tests. These may suggest whether an infection is the culprit. It may also reveal if you have an autoimmune disease like lupus, or another problem.
- EKG. An electrocardiogram of your heart might show that your chest pain is caused by a heart problem, not pleurisy.
In order to treat your pleurisy the right way, your doctor first must find out what’s causing it:
- If it’s bacteria, antibiotics can make you better.
- If it’s a fungus, he’ll likely prescribe an antifungal drug.
- If it’s a virus, you’ll improve without the help of drugs.
Some people with pleurisy have too much fluid built up between their two layers of pleura. Your doctor may need to remove some of the fluid. He may insert a thin needle into the space between your pleura to do this.
Painkillers can help to curb the pain that you feel while you’re getting better.
If coughing hurts too much, your doctor might prescribe a drug (codeine) that can reduce the amount that you cough.
You may feel better if you lie on the side that’s causing you pain.
As the pain starts to go away, try to breathe more deeply and cough up any phlegm that you have. You’ll get better more quickly.