Pleurisy Treatment

Written by Sylvia Davis
Medically Reviewed by Shruthi N, MD on October 29, 2024
5 min read

Pleurisy,  which is inflammation in the lining of your lungs (pleura) that causes pain when you breathe, doesn't always need treatment. But you should always see a doctor if you have chest pain or think you may have pleurisy. Sometimes pleurisy is a sign of a more serious issue, like pneumonia. And chest pain can be a sign of a life-threating condition, such as heart attack or blood clot.

Call your doctor if you have:

  • Sharp pain in your chest or shoulder when you breathe in, especially when you take a deep breath
  • Shortness of breath
  • A cough that doesn't produce mucus

Your chest pain might feel worse when you cough, sneeze, or move your upper body. You may be able to ease it by breathing shallowly.

Seek medical help right away if you have:

  • Intense chest pain for no known reason
  • Chest pain along with symptoms like nausea, sweating, or coughing up blood
  • Trouble breathing or a blue tinge to your skin 

 

 

Pleurisy is most often caused by an infection, autoimmune disease, or lung condition. If your doctor diagnoses pleurisy, they'll also try to figure out what caused it.

Your doctor will likely start by asking about your symptoms. They'll also listen to your chest with a stethoscope as you breathe. This  may reveal a pleural friction rub – the abrasive sound of the pleura's two layers sliding against each other. The pleura is a thin layer of tissues that surrounds both the outside of your lungs and inside of your chest cavity. A pleural friction rub produces a scraping, raspy sound at the end of your inhalation and the start of your exhalation.

You may need other tests to see how serious your pleurisy is and what caused it. These can include:

Blood tests. These can tell  your doctor whether you might have an infection. They can also show whether you have an autoimmune disorder like lupus or rheumatoid arthritis 

Chest X-rays. These can show whether your lungs are inflating properly, if you have pneumonia, or if there's air or fluid between your ribs and lungs. Fluid around the lungs is called pleural effusion. They may use other imaging tests, such as a CT scan or ultrasound.

Thoracentesis. If your doctor finds a lot of pleural fluid, they may take a sample of it for analysis. They'll find the exact location of the fluid, inject you with a local anesthetic, then use a needle to extract the fluid. They often use ultrasound to guide them during this procedure. Your doctor will do tests on the sample to find the cause of the fluid buildup.

Electrocardiogram (EKG). For this test, your doctor attaches electrodes to your chest that monitor your heart. This helps them rule out heart problems as the cause of your chest pain.

Thoracoscopy (pleuroscopy). Your doctor inserts a tube with a tiny camera, called a thoracoscope, through a cut in the wall of your chest. This lets them look inside your chest to see what's causing your pleurisy and/or take a tissue sample for a biopsy. 

Bronchoscopy. This is similar to thoracoscopy, except that the doctor puts the tube with the camera through your nose or mouth and down into your lungs. This allows them to look inside  your airways.

Biopsy . Your doctor can order a biopsy to get a sample of your pleural tissue tested in a lab. They can get the sample with a thoracoscope, a needle, or through a small cut in your chest wall.

The treatment for pleurisy depends on what's causing it. Pleurisy that was caused by a viral infection may go away on its own within a few days. 

Pleurisy treatment may include:

Antibiotics. Your doctor may prescribe antibiotics for pleurisy that was caused by a bacterial infection. 

Nonsteroidal anti-inflammatory drugs (NSAIDs). NSAIDs like ibuprofen or naproxen can ease mild chest pain and inflammation.

Steroids. If your pain and inflammation are more serious, your doctor might recommend corticosteroid drugs.  

Cough syrup. Sometimes, doctors will prescribe a codeine-based cough syrup to control a cough that makes pain worse.

Fluid drainage procedure. If lots of extra fluid builds up in your chest, or if the fluid gets infected, your doctor can insert a needle or tube to drain it. 

If a health condition like cancer or an autoimmune disease caused your pleurisy, you'll need treatment for that condition. Some illnesses that cause pleurisy, like tuberculosis or a pulmonary embolism, may require treatment in a  hospital. 

 

You can't predict whether a health condition or injury will cause pleurisy. But you can help protect your lung health and prevent infections by: 

  • Not smoking
  • Getting the vaccinations your doctor recommends, such as the flu vaccine and pneumonia vaccine
  • Washing your hands well and often
  • Following your doctor's treatment recommendations for any health conditions you have
  • Reaching and staying at a body weight that's healthy for you

 

Pleurisy is inflammation in the lining of your lungs (pleura) that causes pain when you breathe in or cough. Pleurisy treatment may involve antibiotics or pain relievers. You might need treatment for a condition that caused it. See your doctor whenever you have unexplained chest pain, because some of the things that cause it are very serious.  

 

What helps pleurisy go away?

Pleurisy caused by a viral infection may go away on its own. For pleurisy caused by a bacterial infection, antibiotics can help. If you have excess fluid around your lungs (pleural effusion), your doctor may need to drain it. When you have pleurisy due to a health condition like cancer or an autoimmune disease, getting treatment for that condition can help ease pleurisy. 

Can antibiotics help with pleurisy?

Antibiotics can help to clear up pleurisy caused by a bacterial infection. But it won't help with pleurisy that results from a viral infection or another health issue.

Is pleurisy an emergency?

Pleurisy isn't usually an emergency. But get medical help right away if you have:

  • Serious chest pain 
  • Chest pain along with nausea, sweating, or coughing up blood
  • Trouble breathing 

 How long does pleurisy last?

Depending on what caused it, pleurisy could last anywhere from a few days to a few weeks.

Does a hot bath help ease pleurisy?

While you recover from pleurisy, applying a heat pack could help ease chest pain. A hot bath might have the same effect. You might also try lying on the side of our chest where you feel pain.  

Does pleurisy show up on an X-ray?

Your doctor can't actually view pleurisy on a chest X-ray, but they can see things like infection or extra fluid that can help them understand what's causing your chest pain.

What should I not do if I have pleurisy?

If you have symptoms of pleurisy, don't:

  • Ignore them. It's important to see a doctor if you have unexplained chest pain.
  • Smoke. Smoking harms your lungs and can increase coughing, which makes pleurisy pain worse.  
  • Do strenuous exercise. Moving your upper body can increase your pain.