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Spinal Headaches

Medically Reviewed by Jennifer Robinson, MD on August 09, 2020

A spinal headache is the name for a type of headache that follows a procedure like a spinal tap (lumbar puncture) or epidural block (such as that performed during labor and delivery).

What Causes a Spinal Headache?

During a spinal tap, a needle is placed within the fluid-filled space that surrounds your spinal cord. This creates a passage for the spinal fluid to leak out, which changes the fluid pressure around your brain and spinal cord. If enough of the fluid leaks out, you may get a spinal headache.

Because the design of spinal needles has improved, spinal headaches after you get a spinal tap or spinal anesthesia are rare. The odds are usually low after an epidural, too, unless the needle accidentally punctures the dura mater, a tough membrane that covers your spinal cord.

What Are the Symptoms of a Spinal Headache?

The pain from a spinal headache can:

  • Be dull and throbbing
  • Vary from mild to incapacitating
  • Get worse when you sit up and better when you lie down

You may also notice:

How Are Spinal Headaches Treated?

Without treatment, spinal headaches may go away on their own within 2 days to a couple of weeks.

If the headache requires treatment, it could involve:

  • Hydration: This can help raise cerebral spinal fluid (CSF) pressure. You might need to get fluids through your veins (the doctor will call this intravenous fluids, or IV for short).
  • Caffeine: The doctor might tell you to drink a beverage high in caffeine.
  • Bed rest: You may have to take it easy for 24-48 hours.
  • Medication: If other methods don’t work, your doctor could try drugs like gabapentin, hydrocortisone, or theophylline.
  • Blood patch: If you get a spinal headache after a procedure, the anesthesiologist can create a patch with your blood to seal the leak. To put the blood patch in place, the anesthesiologist will put a needle into the same space as, or right next to, the area where the anesthetic was injected. Next, they’ll take a small amount of your blood and inject it into the epidural space. The blood clots and seals the hole that caused the leak.