Definition

What is a spinal headache?

A spinal headache is a headache following a spinal procedure with needles, such as a lumbar puncture or spinal tap test, or epidural anaesthetic.

If the epidural needle accidentally passes through the dura containing spinal fluid, cerebro-spinal fluid (CSF) can leak out. A headache that develops after this problem is called a post dural puncture headache. When a headache occurs after a lumbar puncture it is the result of too much fluid leaking out of the small hole that was made in the dura during the procedure.

How common is a spinal headache?

The risk of headache after an epidural or spinal anaesthetic is estimated to be between 1 in 100 and 1 in 500, and the headache may occur a day after or up to a week after the procedure. Please discuss with your doctor for further information.

Symptoms

What are the symptoms of a spinal headache?

The common symptoms of a spinal headache are:

  • Dull, throbbing pain that varies in intensity from mild to incapacitating
  • Pain that typically gets worse when you sit up or stand and decreases or goes away when you lie down

Spinal headaches are often accompanied by:

  • Dizziness
  • Ringing in the ears (tinnitus)
  • Light sensitivity (photophobia)
  • Nausea
  • Neck stiffness

There may be some symptoms not listed above. If you have any concerns about a symptom, please consult your doctor.

When should I see my doctor?

Tell your doctor if you develop a headache after a spinal tap or spinal anesthesia — especially if the headache gets worse when you sit up or stand.

Causes

What causes a spinal headache?

Spinal headaches are caused by leakage of spinal fluid through a puncture hole in the tough membrane (dura mater) 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 48 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

What increases my risk for a spinal headache?

There are many risk factors for a spinal headache, such as:

  • Being between the ages of 18 and 30
  • Being female
  • Undergoing procedures involving the use of larger needles or multiple punctures in the membrane that surrounds the spinal cord
  • Having a small body mass

Diagnosis & treatment

The information provided is not a substitute for any medical advice. ALWAYS consult with your doctor for more information.

How is a spinal headache diagnosed?

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 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.

How is a spinal headache treated?

The first course of treatment for spinal headaches involves supplying adequate hydration to try to increase cerebral spinal fluid (CSF) pressure. Sometimes intravenous fluids (fluids administered into the veins) are given; other times the person is advised to drink a beverage high in caffeine. Strict bed rest for 24-48 hours is also recommended.

In addition, if a person develops a spinal headache following a procedure, the anaesthetist can create a blood patch with the person’s blood to seal the leak. To administer a blood patch, the anaesthetist inserts a needle into the same space as, or right next to, the area in which the aesthetic was injected. The doctor then takes a small amount of blood from the patient and injects it into the epidural space. The blood clots and seals the hole that caused the leak.

Lifestyle changes & home remedies

What are some lifestyle changes or home remedies that can help me manage a spinal headache?

Please discuss with your doctor for further information.

If you have any questions, please consult with your doctor to better understand the best solution for you.

Hello Health Group does not provide medical advice, diagnosis or treatment.

Review Date: November 14, 2017 | Last Modified: November 14, 2017

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