Pleurodynia is a term used for a certain kind of sharp pain in the side or chest area. The pain can start very suddenly and is sometimes accompanied by particular muscular inflammation. It’s a side-effect of a viral infection and can be accompanied by a number of other symptoms.
What Is Pleurodynia?
Pleurodynia is specifically a form of viral myalgia — a particular complication from certain viral infections. It comes with a collection of symptoms — including chest pain — that are caused by different viruses. The pain associated with this condition isn’t related to your heart. Unlike many heart conditions, pleurodynia isn’t life-threatening.
It’s commonly referred to as epidemic pleurodynia when it occurs with muscle inflammation — or pleurisy — that’s a direct result of a viral infection.
Other names for the condition include Bornholm syndrome and devil’s grip.
What Causes Pleurodynia?
A number of viruses can cause pleurodynia. They almost all fall into a group called coxsackieviruses. This includes some kinds of human enterovirus B. The human enteroviruses include various disease-causing agents — including the polioviruses that cause polio.
For pleurodynia, doctors typically look for infection by non-polioviruses. Coxsackievirus B is the most common causal virus.
All enteroviruses incubate for certain time periods in your intestines before spreading out to attack other areas of your body. Coxsackievirus B typically incubates for a week before spreading to your skeletal muscles and your central nervous system.
The viruses are mostly spread from contact with fecal matter. The virus can remain on your hands and could be transferred to your mouth.
Researchers still don’t know the exact reason why the spread of certain viruses throughout the body causes only some people to develop pleurodynia symptoms. In some cases, the symptoms may be linked to inflammation in your chest muscles. But this isn’t always the case.
Who Gets Pleurodynia?
Anyone who’s infected with a virus — like coxsackievirus B — is at risk for developing pleurodynia.
Males are more likely than females to become infected with coxsackievirus B. This virus also more commonly infects children than adults. Most cases are seen in children under 15 years. Approximately 30% of all cases affect children under the age of one. Infections are very rare in people who are 60 years and older.
But of all people infected with coxsackievirus B, adults are far more likely to develop pleurodynia symptoms than children. Less than 10% of the people who experience pleurodynia are younger than 20 years.
Pleurodynia is more commonly reported in some parts of the world than others. For example, it’s rarely reported as a cause of chest pain in Southeast Asia.
How Is Pleurodynia Diagnosed?
Pleurodynia should always be considered when a patient appears with chest pain in an emergency room or other medical setting. One of the steps to diagnosing pleurodynia is for your doctor to figure out what viral infection you have. You can’t develop pleurodynia without an underlying viral infection.
Many enteroviruses — including coxsackievirus B — can be isolated from your stool. But this isn’t conclusive because virus can be present in your stool longer than the infection itself.
It’s important for your doctor to distinguish this condition from heart-problem-induced chest pain and other non-heart-related causes. They may order various laboratory and imaging tests before they can reach an official diagnosis.
What Are Pleurodynia Symptoms?
The main symptom of pleurodynia is pain in your chest or side. It’s usually present in your lower ribs and on both sides of your body.
The pain can appear suddenly and is often described as intense and even excruciating. One attack can last anywhere from a couple of seconds to a minute. These attacks are separated by a variable amount of time — anywhere from minutes to hours. In between these periods of severe pain you’ll likely feel a constant dull ache in the area.
Pain from pleurodynia is specifically linked to:
- Coughing and sneezing
- Laughing
- Taking deep breaths
You may experience this pain anywhere from one to four days. But there has been one reported case of the pain lasting for more than 45 days.
Although the pain is the main symptom, the condition can also be accompanied by a number of other symptoms, including:
- A sore throat and other upper respiratory symptoms — seen in 85% of people with pleurodynia
- A headache — in 50% of cases
- Fevers — in 97% of cases
- Nausea, vomiting, and diarrhea — in 50% of cases
- Pain in your testicles — in 10% of male cases
- Dermatitis — in 25% of cases
What Are Pleurodynia Treatments?
There isn’t a specific treatment for pleurodynia. Your doctor will likely recommend some form of medication to help you manage the pain. The same treatments can help with muscle inflammation if you have that as well.
The most common types of recommended medication are non-steroidal anti-inflammatories (NSAIDs) — like ibuprofen — and some peripheral nerve blockers.
There are several antiviral treatments that are currently being tested in animal models, but none of these are approved for human use. Talk to your doctor to find out if any new treatments are available or if there are any ongoing clinical trials.
What’s the Prognosis for Pleurodynia?
Most people recover entirely from pleurodynia. You may feel weak and tired for a short time but you should gradually recover your energy and can quickly return to your normal activities.
Complications are also rare. But you may experience shortness of breath as a result of the pain. There are no reported deaths linked to pleurodynia.
Most people will also make full recoveries from infections with coxsackieviruses — including coxsackievirus B. But children and infants may die from severe infections.
What Are Differential Diagnoses for Pleurodynia?
The pain from pleurodynia can be startling when it first happens. You may immediately think that you’re experiencing a heart problem when the chest pain begins. But a wide variety of medical conditions that don’t involve your heart can lead to chest pain.
Other non-heart related causes of chest pain that could be confused with pleurodynia include:
- Rib fractures
- Shingles
- Pulmonary embolisms
- Metastatic disease
Your doctor will need to carefully determine the actual cause of your chest pain before diagnosing you with pleurodynia.