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Follow on Google News | Dr Les Bailey phd,DO,acopm,apta(int part) discusses PLEURISYPleurisy is of great concern to the physical therapist in diagnosis of the thoracic spine says Dr Les Bailey
By: Dr Les Bailey 
P1000869smalll Dr les Bailey phd,DO,acopm,apta( Pleurisy (PLUR-ih-se) Between these layers of tissue is a thin space called the pleural space. This space is filled with a small amount of fluid—about 4 teaspoons full. The fluid assists the two pleural layers of the pleura flow smoothly next to each other as you inhale and exhale. Pleurisy happens when the two layers of the pleura become inflamed. Rather than gliding smoothly over each other, they literally scrape together every time you inhale. This action causes sharp pain both in the chest and,of a diagnostic concern to us therapists,the thoracic(dorsal) Many diseases can cause pleurisy, but mainly viral infections.However we should look at other pleural disorders. Other Pleural Disorders...For example... Pneumothorax Gas can build up in the pleural space. If this occurs, it's called a pneumothorax (noo-mo-THOR- Some surgical procedures may also cause a pneumothorax. including lung surgery, drainage of fluid on the lung via needle, bronchoscopy (bron-KOS-ko- Sometimes the onset of a pneumothorax cannot be diagnosed The most frequently found symptoms of a pneumothorax are sudden pain in the lung , shortness of breath,and an UPPER BACK PAIN. The air in the pleural space can put pressure on the lung and cause lung collapse. Pleurisy and Pneumothorax A minor pneumothorax may disappear without any treatment. A more serious pneumothorax usually needs a procedure to remove air from the pleural space. A serious pneumothorax can halt blood flow through your chest and cause hypotension. This is termed tension pneumothorax. Pleural Effusion In certain cases of pleurisy, too much fluid collects in the pleural space. This is known as a pleural effusion. A large amount of fluid can push the pleura against the lung until the lung, or a portion of it, collapses. This causes difficulty breathing. If the extra fluid were to get infected,this becomes an empyema pleural effusion can occur even if there is no pleurisy, eg in cases of pneumonia, (nu-MO-ne-ah) Hemothorax Blood can also flood the pleural space. This condition is known as a hemothorax (he-mo-THOR- A hemothorax puts pressure on the lung and causes collapse. A hemothorax may also cause shock. With shock, there is a lack of blood or oxygen to the lungs. prognosis Dependent on causes,pleurisy may be serious. If the condition that precipitated the pleurisy is treated early,generally the outlook is good. So where do we come into this as physical therapists or osteopaths you may ask? I have seen many cases over the years where a patient consults with thoracic pain ,and the diagnosis is easily confused with dermatomal irritation into the chest from the thoracic area. However one must enquire as to onset,particularly where there has been an acute or chronic cold or cough.The tendency can be to assume the thoracics have lesioned due to the coughing.This must be kept firmly in the therapists mind when making a diagnosis. Although shortness of breath can occur with thoracic impingement,always be on your guard for pleurisy. Should you perform manipulation to the thoracics,missing signs of pleurisy,it will cause a short term exacerbation of the pleurisy symptoms as the manipulation causes a movement/irritation to the pleural lining. This is nothing to worry about,but pre empts a visit to the patients GP/physician.This is why I usually do a follow up call to the patient later in the day or evening to enquire about outcomes and advise accordingly. http;//www.drlesbailey.com Dr Les Bailey phd,DO,acopm,apta( Dr Les Bailey Dr Les Bailey works in the banstead/surrey area of england Dr Les Bailey phd,DO,acopm,apta (int part) is a regular writer of internet articles and is author of "the laymans guide to foot and heel pain" End
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