Pleurisy: symptoms, causes, treatment and how long it lasts

The main symptom, according to the NHS, is sharp chest pain when you breathe in. The pain may be worse when you cough, sneeze or move around, and it may spread to your shoulders and back. NHS inform calls this pleuritic pain, and says it gets worse when breathing or coughing.

The NHS says you should get medical advice as soon as possible if you think you have pleurisy. It usually gets better by itself, but a healthcare professional can check whether your symptoms are caused by something serious, such as pneumonia.

NHS inform describes pleurisy as inflammation of the layers that cover the lungs (the pleura). It can affect people of all ages, and people aged 65 and over are most at risk because they are more likely to get a chest infection.

If excess fluid builds up between the pleural layers it is called a pleural effusion, and NHS inform says it may need to be drained to prevent breathing difficulties.

The NHS says pleurisy usually gets better on its own in a few days without treatment from a GP. If your symptoms are caused by a bacterial infection such as pneumonia you may need antibiotics, and it is important to finish the full course even if you feel better.

To ease the pain, the NHS suggests taking painkillers such as paracetamol or ibuprofen, and not smoking or vaping because this can irritate the lungs and make the pain worse. NHS inform says non-steroidal anti-inflammatory drugs such as ibuprofen are often used to relieve the chest pain.

You may need treatment in hospital if symptoms are severe or caused by something more serious, such as a pulmonary embolism or tuberculosis (NHS). NHS inform says people who are frail or already in poor health may be admitted to hospital and may take longer to recover.

NHS inform says most cases are the result of a viral infection, such as flu, or a bacterial infection, such as pneumonia. MRSA can cause pleurisy, especially in hospital patients. In rarer cases pleurisy can be caused by conditions such as a blood clot or lung cancer. The NHS names pneumonia, pulmonary embolism and tuberculosis as more serious conditions that can be behind pleurisy.

Pleurisy itself is inflammation of the lung lining, not an infection that is passed from person to person. However, the infections that most often cause it, such as flu and pneumonia, can spread to others.

The NHS says pleurisy usually gets better on its own in a few days. NHS inform says pleurisy caused by a viral infection will often resolve itself and last for a few days. How long it lasts if there is an underlying cause depends on that cause, for example an antibiotic course for pneumonia.

The NHS says to ask for an urgent GP appointment or call NHS 111 if sharp chest pain has not got better after a few days. NHS inform says to speak to your GP if breathlessness is not improving, you have had a cough for more than 3 weeks, or your symptoms are not improving or affecting your daily life.

The NHS says a GP will examine you and listen to your chest, and may refer you to a specialist if they are not sure what is causing your symptoms. NHS inform says pleurisy can usually be diagnosed by checking your symptoms, with further tests to find the underlying cause and how severe it is.

Tests that may be used include blood tests, a chest X-ray, an ultrasound scan and a CT scan. NHS inform also lists blood tests for infection or autoimmune conditions and a biopsy of pleural or lung tissue in some cases.

Chest pain has many causes. The NHS says the symptoms of pleurisy could be a sign of a more serious problem such as a heart attack or a blood clot in the lungs, so do not assume sharp chest pain is only pleurisy.

The NHS and NHS inform pages on pleurisy do not give separate advice for pregnancy or children. NHS inform says pleurisy can affect people of all ages. Sharp chest pain with breathing in pregnancy or in a child should be assessed promptly by a GP, NHS 111 or, if breathing is difficult, by calling 999. The NHS guidance on headaches in pregnancy says to avoid NSAIDs such as ibuprofen unless prescribed by a doctor.

Call 999 or go to A&E if you have sudden chest pain that lasts for 15 minutes or more, sudden chest pain that spreads to your arms, back, neck or jaw, difficulty breathing, or you are coughing up more than just a few spots or streaks of blood. The NHS says these could be signs of a heart attack or a blood clot in the lungs. Do not drive to A&E.

NHS inform adds severe difficulty breathing, lips or skin turning pale, blue or grey, and feeling more drowsy than usual or difficult to wake as reasons to call 999. It says to contact your GP practice urgently for new confusion, palpitations, sharp shoulder pain on deep breaths, a previous DVT or clot, or taking blood-thinning medicine.

On the NHS, pleurisy is assessed by a GP or NHS 111, with a chest X-ray or blood tests arranged as needed, and referral to a chest specialist if the cause is unclear.

Private respiratory clinics can arrange the same imaging and specialist review, often with quicker appointments. Because sharp chest pain can be caused by serious conditions, do not wait for a private appointment if you have any emergency features above.