Spinal Headaches

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, he’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.
WebMD Medical Reference Reviewed by Jennifer Robinson, MD on August 27, 2018

Sources

SOURCES: 

Mayo Clinic: “Spinal headaches.”

Thoennissen, J. CMAJ, Nov. 13, 2001.

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