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Dan asked...

I've had an aching pain in my shoulder blade. I'm coughing loads and have shortness of breath, I do have flu-like symptoms and I smoke, but I'm only 21, could you help me please?

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The Answer

There are two reasons why you could be experiencing this pain in your shoulder:

  • Flu causing the ache or making you cough
  • If you are short of breath you may have a chest infection. Smokers are much more likely to get regular chest infections. Chest infections can sometimes cause chest pain or shoulder pain, known as pleurisy.

Pleurisy is a condition where the two thin covers that separate your lungs and ribcage – the pleura – become inflamed. The most common symptom is a pain in your chest but it can also be felt in your shoulders. A shortness of breath and dry cough is also a symptom.

You need to be examined by a doctor urgently. Your GP will listen to your chest – pleurisy has a very distinct, dry sound – and decide if you need antibiotics or not. Do not delay in getting some urgent medical attention and get well soon.

The causes of pleurisy

Here are some of the causes of pleurisy:

  • An infection, most commonly a virus. Flu, glandular fever and croup are all viruses known to cause pleurisy
  • A bacterial infection, such as pneumonia, throat infections, some skin infections, food poisoning, blood poisoning and MRSA
  • If something goes wrong with your immune system, such as lupus
  • An injury to the ribs
  • A blood clot in the lungs. This is also known as a pulmonary embolism and is not a common cause
  • Lung cancer and mesothelioma – some cancer treatments, such as chemotherapy, can also cause pleurisy
  • AIDs and HIV.

Treatment for pleurisy

Ibuprofen is usually used to treat the pain of pleurisy, if you can take it. If not, paracetamol or codeine will help.

Then you need to treat the cause of your pleurisy. For example, if you have a chest infection you will need antibiotics. If your pleurisy is caused by a virus, these usually clear up by themselves.

In severe cases you may need to be admitted to hospital so you can have the support you need to get better.

Call 999 for an ambulance immediately if you develop sudden, severe chest pain. This is particularly important if

  • your chest pain feels heavy, like a weight is pressing on it, or tight.
  • you have pain that lasts longer than 15 minutes
  • the pain spreads to other parts of the body such as your arm, neck or jaw or
  • if you have other symptoms such as breathlessness, nausea, sweating or coughing up blood.

Answered by the Health at Hand nurses  

Further Reading

Pleurisy

Chest infection

Lung cancer causes and symptoms

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