pleurisy at night

Overview

Pleurisy is inflammation of the pleura – the two thin layers of tissue that line the lungs and the inside of your chest. This makes breathing painful. At night, when you lie down, the pain can get worse because the inflamed layers rub together more.

Pleurisy is not a very common condition, but it can affect people of any age. It is more likely to occur after a respiratory infection.

Anyone can get pleurisy, but it is more common in people who have had a recent viral infection, those with autoimmune diseases like lupus, and people with a weakened immune system.

Symptoms

Common symptoms

• Sharp chest pain that worsens when you breathe in, cough, or sneeze
• Pain that may spread to the shoulder or back
• Shortness of breath
• Dry cough
• Fever and chills

Symptoms in children

• Chest pain that makes them cry or avoid taking deep breaths
• Irritability
• Trouble breathing
• Fever

Symptoms in older adults

• Less obvious pain, sometimes just a dull ache or discomfort
• Confusion or unusual tiredness
• Rapid breathing

Causes

Main causes

• Viral infections (like the flu, COVID-19, or a common cold)
• Bacterial infections (such as pneumonia)
• Autoimmune diseases (like lupus or rheumatoid arthritis)
• Injury to the chest (like a rib fracture)
• Blood clots in the lungs (pulmonary embolism)

Risk factors

• Recent surgery, especially chest or heart surgery
• Smoking
• Weakened immune system (from medicines or illness)
• Long-term conditions like kidney disease or diabetes

When to see a doctor

See a doctor urgently if:

• You have sudden severe chest pain or difficulty breathing
• You cough up blood
• You have a high fever with chest pain

Book a routine appointment if:

• Mild chest pain that does not improve after a few days
• You have a lingering cough after an infection

Diagnosis

Your doctor will listen to your chest with a stethoscope and may order tests to see if there is inflammation or fluid around your lungs.

Tests that may be done

• Chest X-ray
• Blood tests to check for infection or inflammation
• CT scan (a detailed imaging test)
• Ultrasound of the chest

What to expect at your appointment

The doctor will ask about your symptoms and medical history. The tests are painless and can often be done within a few hours. You will get results and a treatment plan quickly.

Treatment

Treatment for pleurisy focuses on relieving pain and treating the underlying cause. Most people recover fully with rest and medication. Your doctor will recommend the right approach for you.

Self-care at home

• Rest and avoid heavy lifting or strenuous activity
• Take over-the-counter pain relievers (ask your pharmacist or doctor for advice)
• Sleep in a semi-upright position or on the side that hurts less
• Use a warm compress on your chest for comfort

Medical treatments

Doctors may prescribe stronger pain medicine or anti-inflammatory medicines. If an infection is causing pleurisy, you may need antibiotics or antiviral drugs. In some cases, treatment for an underlying condition like lupus is needed. Always follow your doctor's instructions about any medicines.

When is surgery considered?

Surgery is rarely needed for pleurisy. It may be considered if there is a large collection of fluid (pleural effusion) that needs to be drained or if there is a complication like a lung abscess. Your doctor will explain if this is necessary.

Living with this condition

During recovery, take it easy and listen to your body. Most people feel better within a few days to two weeks. Avoid smoking and secondhand smoke.

Lifestyle tips

• Get plenty of rest
• Avoid activities that make your chest hurt
• Stay hydrated

Diet and exercise

Eat a balanced diet to support your immune system. Light activity like walking is fine if it does not cause pain, but avoid vigorous exercise until you are better.

Mental health and emotional wellbeing

Chest pain can be scary and may cause anxiety. It is normal to feel worried. Talk to your doctor about your concerns and consider relaxation techniques like deep breathing (if it doesn't hurt) or meditation.

Prevention

You cannot always prevent pleurisy, but you can reduce your risk by avoiding respiratory infections and managing chronic health conditions.

Vaccines

Getting vaccinated against the flu and pneumonia can help prevent some infections that lead to pleurisy. Ask your doctor which vaccines are right for you.

Screening programmes

There is no routine screening for pleurisy. If you have a condition that increases your risk, your doctor may monitor your lungs during check-ups.

Complications

If left untreated

• Pleural effusion – fluid buildup around the lungs that can make breathing harder
• Empyema – a collection of pus in the pleural space that needs drainage
• Scarring of the pleura (pleural thickening) that can cause long-term chest tightness

Long-term outlook

With proper treatment, most people recover fully from pleurisy without lasting problems. If caused by an infection, the outlook is excellent. If you have an underlying condition like lupus, treating that condition can prevent pleurisy from coming back.

Find support

External links open third-party websites. Ruqelo Health is not responsible for external content. Listing an organisation does not imply endorsement.