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Dan asked...

I have an aching pain in my shoulder blade

Tags: Smoking

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 aching shoulder blade, making you cough and giving rise to shortness of breath
  • 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 tissue layers that cover your lungs become inflamed. The most common symptom is a pain in your chest but it can also be felt in your shoulders. Shortness of breath and a dry cough are also symptoms of pleurisy.

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

In the meantime, here’s some more information about the causes of pleurisy and the treatment options available.

The causes of pleurisy

The following conditions may give rise to pleurisy:

  • A viral infection, this is the most common cause
  • A bacterial infection such as pneumonia
  • If something goes wrong with your immune system, such as the condition known as lupus
  • Sometimes certain type of arthritis may lead to pleurisy
  • A fracture to the ribs or a collapsed lung
  • A blood clot in the lungs. This is also known as a pulmonary embolism and is not a common cause
  • Lung cancer and mesothelioma.

Treatment for pleurisy

Ibuprofen is usually used to treat the pain of pleurisy unless this is contraindicated. If you are not allowed ibuprofen, paracetamol or codeine will help.

The management of your pleurisy will depend upon the cause. For example, if you have a bacterial chest infection, you will need antibiotics. If your pleurisy is caused by a virus, these infections will clear up by themselves.

In severe cases of pleurisy, you may need to be admitted to hospital, so that you can receive 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 feels tight or heavy, as though a weight is pressing on it
  • 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  

Sources and further reading

Chest pain from smoking – Ask the Expert

Influenza (Flu) – NHS Factsheet

Chest infection – NHS Factsheet

Pleurisy – NHS Factsheet

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