Pleurisy or pleuritis is an inflammation of the tissues, pleura, surrounding the lungs and lining the rib cage. It is marked by severe chest pain, which can be especially pronounced if someone is breathing hard from exertion. Chest x-ray can confirm diagnosis, though sometimes diagnosis is confirmed by ruling out other causes of chest pain like 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, trapped liquid in the lining of the lungs. It rarely goes unnoticed because of the pain associated with the condition. Pneumonia can be of bacterial or viral origin, but pleural effusions are most commonly associated with some forms of heart surgery, such as the Fontan repair to alleviate single ventricle.
Pleurisy may also be present after a viral infection, when there is no pneumonia. Sometimes, this condition indicates underlying autoimmune disorders like lupus or rheumatoid arthritis. In most cases, however, pleurisy is the result of viral infection. Those who have the condition, as well as other risk factors for autoimmune disorders, should consult their doctor about further testing.
Unfortunately, pleurisy often takes a couple of months to improve. On its own, the condition does not generally cause any other symptoms beyond what some describe as excruciating pain. It can be debilitating, because pain can be very intense, restricting activity, 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 pleuritis. Generally, those with active lupus are on steroids to help with inflammation, and may also be on antibiotics to treat infections. Antibiotics to treat bacterial pneumonia may also reduce swelling of the pleura.
In cases of pleural effusions, hospitalization may be required to keep close watch on respiratory stability. Treatment for pleural effusions often involves a fluid restricted diet, and oral medications like Lasix®, a diuretic that helps to increase fluid output. In addition to treatment of underlying symptoms, when they exist, pain is managed in several ways. Those affected may take steroids or narcotic pain medications. However, the primary goal is to reduce swelling, so most doctors recommend non-steroidal anti-inflammatory drugs, also called NSAIDs.
NSAIDs in low doses are available over the counter as ibuprofen or naproxen sodium. Stronger NSAIDs or higher doses may be required to reduce swelling. Often, prescription strength ibuprofen is prescribed. One can, however, save a little money by asking one’s doctor to direct the proper dosage amounts using the nonprescription forms.
Physicians may also prescribe bed rest, good diet, and time away from work to promote healing. Even with treatment, the condition can still persist for several months, and remains difficult to resolve successfully without considerable pain for those affected.