There are several medical procedures that can put individuals at risk for spinal headaches. These medical procedures include a spinal tap also called a lumbar puncture, having spinal anesthesia given to you before an operation or like in having an epidural while in labor.
These medical procedures require that a puncture be placed into the tough membrane that surrounds the spinal cord. When someone has a spinal tap, a sample of the fluid that surrounds the spinal cord is withdrawn. This fluid is called cerebrospinal fluid.
Post Lumbar Puncture Headaches
When someone is having spinal anesthesia before a surgical procedure or to relieve the pains of childbirth, a medication is injected into the spinal canal in order to numb the nerves in the lower half of your body.
When spinal fluid leaks out through the tiny puncture site during the procedure, the leakage of fluid may cause you to have what is called, a “spinal headache”.
This type of headache is also called a “post-lumbar puncture headache”. Usually these headaches resolve on their own without any medical treatment.
If the spinal headache lasts longer than 24 hours, you should seek medical treatment for the headache. One thing that you can do to immediately relieve the spinal headache is to lie down flat.
The spinal headache can vary in intensity from mild to severe enough to be incapacitating. The headache usually worsens when you sit up or stand. The pain will decrease if you lie down.
Other symptoms you may have besides the headache are:
- Visual changes
- Ringing in the ears
The spinal headache happens because when the spinal fluid leaks out it causes a decrease in the pressure exerted by the spinal fluid on the brain and spinal cord. This decrease in pressure leads to a headache.
The individual will usually first feel the spinal headache within 12 to 24 hours after the spinal procedure.
Typically when receiving an epidural anesthesia the injection is given outside the membrane so technically a headache should not result BUT if the technician giving the epidural accidentally punctures the membrane, than fluid can leak out and a headache result.
Spinal headaches are more common in women than men, and in those who are between 20 and 40 since they are the ones typically having spinal punctures and epidurals for childbirth. Anyone male or female, young or old can have a spinal tap as it is used to diagnose certain diseases such as meningitis.
You should always tell your doctor if you experience a headache after receiving a spinal procedure, especially if you notice any of the above symptoms. When calling the doctor remind them that you had a recent spinal procedure done.
Your doctor will ask about the duration and intensity of your headache and when it started. Usually all that is needed is an exam. Some doctors will know what it is as soon as you tell them about your spinal procedure.
Treatment for a spinal headache is to lie flat on a bed or other flat surface, to rest and take oral pain relievers. If the headache does not improve after taking this measure and within 24 hours the doctor may decide to give you an epidural blood patch.
This is when a small amount of your blood is injected into the space over the puncture hole in order to form a clot to seal the hole, which will restore the normal pressure in the spinal fluid and bring you relief from your headache.
Sometimes caffeine is delivered directly into your bloodstream, because caffeine relieves spinal headaches within just a few hours. Caffeine constricts the blood vessels within your head. Haven’t we all dreamed of having a caffeine drip when we are overly tired?
Sometimes the doctor will inject saline solution into the space outside of the membrane that covers the spinal cord in order to put pressure on the lumbar puncture site and therefore stopping the cerebrospinal fluid leak that is causing the spinal headache. This treatment is not always successful because the body absorbs saline quickly so your headache may return.