What is pleurodynia?
In this post I will answer the question, “What is Pleurodynia” and six other FAQs on the topic.
It is the fancy medical name for what was once called Bornholm disease.
- The prefix pleuro- means ‘side’, rib’, ‘lateral’ or ‘pleura’, the lining of the chest cavity.
- The suffix -dynia means ‘pain’.
“According to the articles and case studies, it is unusual and rare. This was not in my experience. It was one of the most common causes of chest pain that I saw as a GP.”
With severe and distressing symptoms, patients feel that they might die from the pain; if left-sided, it can mimic a heart attack.
This justifies the layman’s name for the condition, Devil’s Grip. This sounds like an exaggeration, but having experienced it, it feels like something evil squeezes your chest.
Symptoms of pleurodynia
As I have already mentioned, chest pain is a defining symptom.
Also read: Left side chest pain in women vs men
This is usually one-sided. It classically affects one intercostal muscle (the muscle between the ribs). It is a dull ache with episodic stabbing or spasming pain.
It is worse with movement and breathing.
Patients often cannot get a full breath because of the pain.
It mimics upper abdomen pain if it affects the lower chest wall muscles.
The pain can last from 2 to 14 days, according to Tariq et al. 3, but it was common to last three weeks in my practice.
One or more of the following symptoms may precede the chest pain.
- Sore throat
- Headache
- Cough
- Fever
- Nausea
- Vomiting
- Diarrhea
Often, patients report no other symptoms.
It usually occurs in summer and peaks at changing seasons, late summer into early fall.
Who gets pleurodynia?
It is more common among young adults. Girls and guys are equally affected. 3,4
Kids and older adults do occasionally get it.
What causes pleurodynia?
As early as the 1970s, coxsackievirus B was identified as a common cause. Coxsackie A and other enteroviruses rarely do. 1,4
How do you catch pleurodynia?
Coxsackievirus B is an enterovirus. This means it replicates in the throat and intestines. It is found in the stool.
As a result, There are three possible ways of transmission.
- Direct contact, like kissing
- Through mucous droplets when coughing or sneezing
- Not washing hands after going to the toilet
The incubation period of Coxsackie B infections is 2 to 10 days, and patients are most contagious in the first two weeks of illness. 3
“In my GP practice experience, I rarely saw pleurodynia pass to direct contacts as pleurodynia.”
How is pleurodynia diagnosed?
Your doctor will most often be able to diagnose this by taking a good history and examining you. They will poke and prod you, and that is usually enough to diagnose pleurodynia confidently.
If the symptoms are not classic, or you have risk factors, they might request other tests. This will exclude causes of life-threatening chest or abdominal pain. 2
“Coxsackie B can also be tested for on blood tests. This can show positive antibodies. I did not find this helpful, and it is an unnecessary expense.”
How do you treat pleurodynia?
With patience and painkillers.
It is self-limiting and needs to run its course.
The best medications are anti-inflammatories like ibuprofen or diclofenac. Paracetamol can be taken in addition and helps enhance the anti-inflammatory pain-killing effect.
Holding a pillow against the painful area if you need to cough or sneeze. This supports the affected muscle and helps to reduce the pain.
References
- Assaad, F., & Cockburn, W. C. (1972). Four-year study of WHO virus reports on enteroviruses other than poliovirus. Bulletin of the World Health Organization, 46(3), 329–336.https://pubmed.ncbi.nlm.nih.gov/4537851/
- Hussein, L., & Al-Rawi, H. (2014). Chest wall myositis in a patient with acute coronary syndrome. BMJ case reports, 2014, bcr2014206664. https://doi.org/10.1136/bcr-2014-206664
- Tariq N, Kyriakopoulos C. Group B Coxsackie Virus. [Updated 2023 Jul 10]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2024 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK560783/
- Epidemic pleurodynia. Harvard Health. (2022, March 9). https://www.health.harvard.edu/a_to_z/epidemic-pleurodynia-a-to-z
