Spinal headaches occur in up to 40 percent of those who undergo a spinal tap (lumbar puncture) or spinal anesthesia. Both procedures require a puncture of the tough membrane that surrounds the spinal cord and, in the lower spine, the lumbar and sacral nerve roots.
During a spinal tap, a sample of cerebrospinal fluid is withdrawn from your spinal canal. During spinal anesthesia, medication is injected into your spinal canal to numb the nerves in the lower half of your body. If spinal fluid leaks through the tiny puncture site, you may develop a spinal headache.
Most spinal headaches — also known as post-lumbar puncture headaches — resolve on their own with no treatment. However, spinal headaches lasting 24 hours or more may need treatment.
Spinal headache symptoms include:
Spinal headaches are often accompanied by:
When to see a doctor
Spinal headaches are caused by leakage of spinal fluid through a puncture hole in the membrane that surrounds the spinal cord. This leakage decreases the pressure exerted by the spinal fluid on the brain and spinal cord, which leads to a headache.
Spinal headaches typically appear within 12 to 24 hours after a spinal tap or spinal anesthesia. Sometimes epidural anesthesia may lead to a spinal headache as well. Although epidural anesthetic is injected just outside the membrane that surrounds the spinal cord, a spinal headache is possible if the membrane is unintentionally punctured.
Risk factors for spinal headaches include:
Preparing for your appointment
If you've recently had a spinal procedure and develop a headache that lasts 24 hours or longer, your doctor can help you determine the seriousness of your condition. Here's some information to help you get ready for your appointment, and to know what to expect from your doctor.
What you can do
Preparing questions can help you make the most of your time with your doctor. For a spinal headache, questions you might ask include:
Don't hesitate to ask any other questions.
What to expect from your doctor
Tests and diagnosis
The doctor will ask questions about your headache and do a physical exam. Be sure to mention any recent procedures — particularly a spinal tap or spinal anesthesia.
Sometimes the doctor will recommend a magnetic resonance imaging (MRI) to rule out other causes of your headache. During the exam, a magnetic field and radio waves create cross-sectional images of your brain.
Treatments and drugs
Treatment for spinal headaches begins conservatively. Your doctor may recommend bed rest, fluids, caffeine and oral pain relievers. If your headache hasn't improved within 24 hours, your doctor may suggest one or more of the following treatments:
Last Updated: 2012-04-25
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