PLEURITIC CHEST PAIN: WHEN YOU BREATHE, COUGH, OR SNEEZE, YOUR CHEST PAIN GETS WORSE 

When you breathe in and out, your chest will feel sharp, stabbing, or scorching pains. This is known as pleuritic chest pain. The most frequent significant cause of pleuritic chest pain is pulmonary embolism, which affects 5% to 21% of patients who come to an emergency department.

The inflammation of the pleura, the thin, double-layered membrane that lines the chest cavity and surrounds the lungs, is the hallmark of the disorder known as pleurisy, also known as pleuritis. The visceral pleura, which covers the lungs, and the parietal pleura, which lines the chest wall, comprise the pleura’s two layers.

Usually, an underlying illness like a respiratory infection like pneumonia or a viral infection like the flu leads to pleurisy. Other possible causes include autoimmune diseases like lupus or rheumatoid arthritis, pulmonary embolism (a blood clot in the lung), chest trauma, specific drugs, or tumors.

Causes of Pleurisy

  • Pleurisy can be brought on by bacterial, viral, or fungal infections of the respiratory system. Respiratory illnesses resulting in pleurisy include pneumonia, TB, bronchitis, and respiratory viruses such as the flu.
  • Autoimmune Disorders: Pleurisy can develop as a complication of some autoimmune diseases. Pleura inflammation can be brought on by illnesses such as systemic lupus erythematosus (SLE), rheumatoid arthritis, and systemic sclerosis.
  • Deep vein thrombosis, also known as pulmonary embolism, is a condition in which a blood clot forms in the deep veins of the legs and travels to the lungs. This obstruction in the pulmonary arteries may bring on pleurisy symptoms.
  • Trauma to the Chest: Pleurisy can develop as a result of any injury or trauma to the chest, such as a rib fracture.
  • Pleurisy may occasionally result from lung cancer. Inflammation and pleuritic chest pain may be brought on by the presence of a tumor in or close to the pleura.
  • Pleurisy can also be brought on by specific drugs, including some antibiotics and heart medicines. Idiopathic pleurisy is the name given to the condition when it happens occasionally without a known cause.

Effects of Pleurisy

  • Pleuritic Chest Pain: Chest pain is the primary sign of pleurisy. The discomfort frequently radiates to just one spot on the chest and is acute. Usually, the discomfort gets worse when you breathe, cough, sneeze, or make any other movements that involve your chest wall. The back, shoulder, or abdomen may also experience radial pain.
  • Breathing Problems: Pleura inflammation can make breathing painful or uncomfortable, causing shallow or fast breathing. Breathing problems can occur for some people, especially during vigorous exertion.
  • Dry Cough: A dry cough may accompany pleurisy. Typically, no phlegm or mucus is produced by the cough.
  • Other Respiratory Symptoms: Depending on the underlying reason, other respiratory symptoms including wheezing, fast breathing, or a feeling of chest congestion may also be present in pleurisy patients.
  • Low-grade fever: Pleurisy sometimes has a relationship with low-grade fever.
  • overall Symptoms: People with pleurisy may additionally have symptoms like weariness, loss of appetite, weight loss, and overall discomfort, depending on the underlying reason and the level of inflammation.
Effects of Pleurisy

Treatment for Pleurisy

  • Taking Care of the Underlying Cause: The underlying cause of pleurisy will determine the exact treatment. Antibiotics or antiviral drugs may be provided depending on whether an infection, such as viral or bacterial pneumonia, is the underlying cause. Corticosteroids and other immunosuppressive treatments may be utilized to treat pleurisy if an autoimmune illness is an underlying cause.
  • Pain relief: Controlling pain is a crucial part of treating pleurisy. Ibuprofen and naproxen are two examples of nonsteroidal anti-inflammatory medicines (NSAIDs) that are frequently used to treat pain and inflammation. More potent pain drugs may be provided in more severe instances.
  • Rest and Activity Modification: Getting enough sleep is critical so the body can recuperate. Refraining from painful activities like strenuous activity or deep breathing may be advised until symptoms subside.
  • Applying hot or cold packs to the affected area of the chest may help reduce inflammation and relieve pain. Warm compresses can provide relief for some people, whereas others prefer cold packs. Try both to see which is more comfortable.
  • Deep Breathing Exercises: Once the pain begins to lessen, deep breathing exercises might be helpful in avoiding problems like pneumonia or lung collapse. These workouts aid in lung growth and lung function improvement.
  • Thoracentesis or Pleural Drainage: Thoracentesis may be carried out if there has been a considerable accumulation of fluid in the pleural space. It entails using a needle or tube to remove the extra fluid, which can improve symptoms and assist in determining pleurisy’s underlying cause. To drain the fluid over a longer period of time, a chest tube may occasionally be implanted.
  • Supportive Care: Adopting good lifestyle habits, getting enough sleep, and keeping hydrated can all help with recovery and general well-being.
Treatment for Pleurisy

Natural remedies for Pleurisy

  • Warm Compress: Applying a warm compress or heating pad to the chest area that is afflicted by pleurisy may assist to lessen the pain and inflammation that is brought on by the condition. Use the compress for brief periods of time at a time, making sure it’s not too hot.
  • Turmeric: Turmeric is well-known for reducing inflammation. The symptoms of pleurisy may be relieved by taking turmeric supplements or adding turmeric powder to your diet. To determine the proper dosage, speak with a medical expert.
  • Ginger: Ginger contains natural painkilling and anti-inflammatory effects. It could help to consume ginger tea or include ginger in your meals. Ginger can thin the blood if consumed in large amounts, therefore it’s crucial to use it sparingly.
  • The antibacterial and anti-inflammatory effects of garlic are well established. Garlic may aid in the fight against infections and the reduction of inflammation whether consumed in food or as supplements. For advice on the right dosage, go to a medical expert.
  • Honey and Lemon: A warm water solution with a blend of honey and lemon juice may help calm a cough brought on by pleurisy. It may offer comfort and function as a natural cough suppressant. If you have diabetes or a honey allergy, you should stay away from this cure.
  • Eucalyptus Oil: Breathing easier and clearing up congestion can be achieved by inhaling steam that has a few drops of eucalyptus oil added to it. It might offer short-term symptom alleviation for pleurisy. Keep in mind to adhere to the safety precautions when using essential oils, and seek medical advice if you are unsure about anything.
  • Rest and deep breathing exercises: Recovery from pleurisy requires a sufficient amount of rest. Following a healthcare professional’s advice and performing deep breathing exercises can assist to maintain and improve lung health.

Symptoms of Pleurisy

  • Chest pain, which is a pleuritic symptom, is a common complaint. A particular region of the chest is frequently the source of acute, localized pain. Any action that involves the chest wall, such as breathing, coughing, sneezing, or any other, tends to make it worse. It may radiate to the back, shoulder, or belly, and the pain might be minor to severe.
  • Breathing Problems: Pleura inflammation may make it painful or uncomfortable to breathe, which can cause shallow or fast breathing. Some people could feel out of breath sometimes, especially when they’re exercising.
  • A dry cough may be present along with pleurisy. Usually, phlegm or mucus is not produced by coughing.
  • Other Respiratory Symptoms: People who have pleurisy may also suffer other respiratory symptoms such rapid breathing, shallow breathing, or a feeling of chest congestion depending on the underlying cause and level of inflammation.
  • Low-grade fever: Pleurisy sometimes has a relationship with low-grade fever. Though it’s not always the case, fever can exist.
  • overall Symptoms: People with pleurisy may additionally have symptoms like weariness, loss of appetite, weight loss, and overall discomfort, depending on the underlying reason and the level of inflammation.

Preventions for Pleurisy 

  • Maintain Good Respiratory Hygiene: Maintaining good respiratory hygiene can help to lower the risk of respiratory infections that can result in pleurisy. This entails routinely cleaning your hands with soap and water or using hand sanitizer, disposing of old tissues correctly, covering your mouth and nose with a tissue or your elbow while coughing or sneezing, and washing your hands using these practices.
  • Invest in a vaccination program: Immunisations can help avoid several respiratory illnesses that might cause pleurisy. Make sure you have received all recommended immunizations, such as the influenza (flu) shot and the pneumococcal vaccine, which offers defense against some types of pneumonia.
  • Quickly Seek Medical Assistance: If you experience a respiratory infection, such as the flu, the common cold, or pneumonia, quickly seek medical assistance and adhere to the recommended therapy. Early infection treatment can reduce the risk of developing problems that could result in pleurisy.
  • Maintain a Healthy Lifestyle: Living a healthy lifestyle helps boost your immune system and overall health, which lowers your chance of infections and diseases that could lead to pleurisy. This involves managing stress, getting regular exercise, eating a balanced diet high in fruits and vegetables, and getting enough sleep.
  • Avoid Smoking: Smoking lowers your immune system and destroys your lungs, making you more susceptible to respiratory infections. Avoid smoking, and if you already do, get help quitting. Moreover, stay away from secondhand smoke.
  • Take Care to Avoid Trauma: Pleurisy can result from chest trauma. Use the required safety precautions, such as using seat belts while driving, following workplace safety procedures, and participating in sports or physical activities while wearing the appropriate safety gear, to prevent such injuries.
  • Manage Underlying Conditions: If you have an underlying disease, such as an autoimmune problem, that raises your chance of developing pleurisy, make sure it is properly addressed with the help of a healthcare provider. Attend routine check-ups and adhere to the recommended treatment schedule.

Complications of Pleurisy

  • Pleural Effusion: A condition known as pleural effusion is brought on by an accumulation of fluid in the pleural space as a result of pleurisy. This accumulation of fluids may put pressure on the lungs, making breathing even more difficult and reducing lung function.
  • Pleural effusion may occasionally become infectious, leading to an illness known as empyema. When bacteria or other infectious agents enter the pleural area and cause a pus buildup, empyema results. It may necessitate surgical intervention or drainage and might result in serious disease and protracted hospitalization.
  • Lung Collapse (Atelectasis): Severe pleurisy or pleural effusion may result in partial or full collapse of the afflicted lung. Atelectasis is the term for this. It happens when fluid or inflammation in the pleural space puts pressure on the lung tissue, preventing it from expanding correctly. Lung collapse can make breathing even more difficult and may call for specific medical procedures to re-inflate the afflicted lung.
  • Pleurisy that becomes chronic can occasionally result in recurring or persistent pleural inflammation. Long-term discomfort, pain, and breathing issues can be brought on by chronic pleurisy.
  • Pneumonia: If a bacterial infection, such as pneumonia, caused pleurisy, the infection may have moved to the lung tissue and resulted in pneumonia. Inflammation and infection in the lung parenchyma are the hallmarks of pneumonia, which can also result in other respiratory symptoms, a high temperature, and overall malaise.
  • Pulmonary Embolism: A blood clot in the lungs, also known as a pulmonary embolism, can occasionally cause pleurisy. A pulmonary embolism can cause life-threatening complications, such as lung tissue damage, heart strain, or even death if it is not rapidly recognized and treated.

*Disclaimer: This article is for informational purposes only and should not substitute professional medical advice. Please consult a healthcare professional for a thorough evaluation of your symptoms and appropriate treatment.

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Author Contribution: Reviewed by Dr. Ram Reddy, MD – General Physician, and Rajeshwar Rao, Pharm D.

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