Overview

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During a spinal tap, a sample of cerebrospinal fluid is withdrawn from your spinal canal.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, severe spinal headaches lasting 24 hours or more may need treatment.

Symptoms

Spinal headache symptoms include:

  • 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

When to see a 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

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

Risk factors for spinal headaches include:

  • 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
April 03, 2015
References
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  2. Miller RD. Miller's Anesthesia. 8th ed. Philadelphia, Pa.: Saunders Elsevier; 2015. http://www.clinicalkey.com. Accessed Jan. 22, 2015.
  3. Post-dural (post-lumbar) puncture headache. International Headache Society. http://ihs-classification.org/en/02_klassifikation/03_teil2/07.02.01_nonvascular.html. Accessed Jan. 22, 2015.
  4. Post-lumbar puncture and other low-pressure headaches. The Merck Manual Professional Edition. http://www.merckmanuals.com/professional/neurologic_disorders/headache/post%E2%80%93lumbar_puncture_and_other_low%E2%80%93pressure_headaches.html?qt=&sc=&alt=. Accessed Jan. 22, 2015.
  5. Waldman SD. Atlas of Uncommon Pain Syndromes. 3rd ed. Philadelphia, Pa.: Saunders Elsevier; 2014. http://www.clinicalkey.com. Accessed Jan. 21, 2015.