Pleurodynia

Pleurodynia is a sharp pain in the muscles between your ribs (intercostal muscles). This condition makes it painful to breathe. Pleurodynia is sometimes described as an iron grip around the rib cage. Pleurodynia attacks are unpredictable.

CAUSES

Pleurodynia is commonly caused by a viral infection. A virus, called coxsackievirus B, attacks the intercostal muscles. However, getting pleurodynia from this virus is rare. Most people infected with coxsackievirus B have no symptoms. In some people, the virus causes a mild sore throat, cough, or diarrhea. Coxsackievirus B can live in body fluids, such as saliva and mucus. It is easily spread from person to person through coughing or sneezing. Coming in contact with the stool of an infected person can also spread the virus.

SYMPTOMS

Symptoms usually start 3 to 6 days after you have been infected with the virus. Very bad chest pain is the main symptom of pleurodynia. The pain is usually felt on one side of the body, along the lower ribs. It starts suddenly and may last from a few seconds to 1 minute. It is hard to breathe when the pain strikes. You might feel pain again a few minutes or hours later. In most cases, the pain keeps coming back for 3 to 5 days. Then it goes away. In some cases, the pain keeps coming back every so often for up to 1 month.

Other symptoms of pleurodynia may include:

  • Fever.

  • Rapid heartbeat.

  • Sore throat.

  • Cough.

  • Headache.

  • Stomach pain.

  • Nausea.

  • Vomiting.

  • Diarrhea.

  • Feeling very tired.

  • Rash.

  • For males, pain in the testicles.

DIAGNOSIS

If you have had very bad chest pain, your caregiver will probably order some tests to determine whether you have pleurodynia. These tests may include:

  • A throat swab. Your caregiver may rub the back of your throat with a cotton swab. The cotton swab can then be tested for coxsackievirus B.

  • Urine and stool samples. These samples will be tested for coxsackievirus B.

  • Blood tests. These tests can tell if you have muscle damage.

  • Chest X-rays.

  • Electrocardiography (ECG). This test checks your heartbeat.

TREATMENT

There is no treatment for an infection caused by coxsackievirus B. However, pleurodynia usually goes away on its own. It may take up to 1 month to fully recover. You may be given nonsteroidal anti-inflammatory drugs (NSAIDs) to control your pain. If your chest pain continues, you may need to see a pain specialist to discuss possibly using nerve block injections to relieve your pain.

HOME CARE INSTRUCTIONS

  • Only take over-the-counter or prescription medicines for pain, fever, or discomfort as directed by your caregiver.

  • Return to your regular activities slowly.

  • Wash your hands often. This helps prevent coxsackievirus B from spreading.

  • Do not smoke.

  • Keep all follow-up appointments as directed by your caregiver.

SEEK MEDICAL CARE IF:

  • You have new symptoms.

  • Your symptoms are getting worse.

  • You develop a cough.

  • You have a sore throat.

  • You have a rash.

  • You have abdominal pain.

  • You vomit.

  • You have diarrhea.

SEEK IMMEDIATE MEDICAL CARE IF:

  • You have very bad chest pain that is getting worse.

  • You have trouble breathing.

  • You have a fever.

MAKE SURE YOU:

  • Understand these instructions.

  • Will watch your condition.

  • Will get help right away if you are not doing well or get worse.