Pleurisy: Sharp Chest Pain When You Breathe, Causes and Treatment

Pleurisy is inflammation of the lining around the lungs. When the two layers rub together, every breath can feel like a knife in the side. It’s often caused by a viral infection and settles with treatment, but it can also be a sign of something more serious, so it should always be checked.

Imagine a week after a flu-like illness, you feel a sharp, stabbing pain in the side of your chest every time you take a deep breath. You find yourself taking shallow breaths to avoid it. Lying on the painful side somehow helps. You’re not sure if it’s a pulled muscle or something worse.

Symptoms

• Sharp chest pain that worsens with breathing, coughing, sneezing or moving
• Pain that can spread to the shoulder or back
• Shortness of breath, partly from shallow breathing
• Sometimes fever and cough, depending on the cause

Common causes

Viral infections are the most common cause. Others include pneumonia, a blood clot in the lung (pulmonary embolism), tuberculosis, autoimmune conditions such as lupus and rheumatoid arthritis, chest injury and, rarely, cancer.

Treatment

Treatment depends on the cause. Anti-inflammatory painkillers such as ibuprofen are often used for viral pleurisy if they’re suitable for you. Bacterial infections need antibiotics, and other causes need specific treatment. Your doctor may arrange a chest X-ray, blood tests or a scan.

But when is chest pain an emergency?

Call your emergency number if chest pain comes on suddenly with breathlessness, coughing up blood, a fast heartbeat, feeling faint, or blue lips, or if you’ve recently had surgery, a long journey, are pregnant or have a swollen calf. These can be signs of a pulmonary embolism. Crushing or heavy chest pain may be a heart attack.

Sources: NHS (Pleurisy), US National Heart, Lung, and Blood Institute, British Lung Foundation (Asthma + Lung UK). This guide is for general information and does not replace advice from your own nurse, doctor or emergency services.