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Forum Name: Miscellaneous Chest Diseases

Question: Right lung pain


 brennyh - Sun Nov 18, 2007 11:02 am

I am a 45 yr old female. I have been Dx with APS. I am also borderline lupus. I have severe pain in my right lung when I lay down at night and turn on my left side.I have had this for atleast the past 7 years since I had plursey. The plursey was also in this exact same spot.
 Dr. Tamer Fouad - Sat Nov 24, 2007 11:36 pm

User avatar Dear brennyh,

I am truly sorry to hear about your pain. I am not an expert in Lupus or antiphospholipid syndrome. However, I would like you to note several points. Are you saying you have had continuous pleuritic pain for 7 years?

Pleuritic pain characteristically increases with deep inspiration. While it is not categorized as pain that changes with position, your description of pain on the right side that increases on lying down on the left side is characteristic. What happens here is that by sleeping on the right side you would tend to feel more comfortable because you are decreasing the amount of thoracic expansion on your right side. When you sleep on the left side your right side expands more freely and hence causes more pain.

Acute pleuritic pain is generally treated by analgesics and anti-inflammatory drugs. However, if as you describe this is a continuous problem lasting for a long period of time you may wish to discuss other pain control options (e.g. nerve block) with your doctor. This could provide you with permanent relief and if appropriate to your condition would have no side effects.

Please let us know if you would like to inquire about anything else.
 brennyh - Sat Dec 08, 2007 7:48 am

Thank you for your reply Dr Fouad.
I do have 1 other question. Is it at all possible to have pain at the pleurisy site on palpation. I am very tender on the (R) side right at the site of the pain I feel when I lay on my (L) side. I recently had Bronchitis and aggravated the pleurisy. I had SOB and pain on deep inspiration. Of course I had to go to the ER to make sure I didn't have a PE - I didn't, I was again Dx with Pleurisy. With my follow up with my PCP, he felt it was a muscle strain and not Pleurisy. Is it possible that for all these years it is a muscle strain and not pleurisy related?
 brennyh - Fri Dec 14, 2007 7:35 am

Posted: Sat Dec 08, 2007 7:48 am Post subject:

--------------------------------------------------------------------------------

Thank you for your reply Dr Fouad.
I do have 1 other question. Is it at all possible to have pain at the pleurisy site on palpation. I am very tender on the (R) side right at the site of the pain I feel when I lay on my (L) side. I recently had Bronchitis and aggravated the pleurisy. I had SOB and pain on deep inspiration. Of course I had to go to the ER to make sure I didn't have a PE - I didn't, I was again Dx with Pleurisy. With my follow up with my PCP, he felt it was a muscle strain and not Pleurisy. Is it possible that for all these years it is a muscle strain and not pleurisy related?
 John Kenyon, CNA - Fri Jul 18, 2008 10:53 pm

User avatar Hello brennyh -

While muscle pain can follow or accompany pleurisy, it wouldn't last for this long. You still can have muscle pain for other reasons of course, but pleurisy can also, as I believe Dr. Fouad mentioned earlier in the thread, become chronic. In cases like this a pain management strategy needs to be set up. And while it is sometimes possible to elicit pain by manual pressure where there is also pleurisy, it is also possible (and more likely) that this pain is caused by either muscle pain or perhaps costochondritis, which often is found in the company of a chronic problem like pleurisy as both are inflammatory and are treated by the same methods.

I hope this helps.

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