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Spinal Headaches

A spinal headache (or a low-pressure headache, or post-lumbar puncture headache) is usually experienced as a persistent headache, often with neck stiffness, that is worsened by remaining upright and markedly improved by lying flat or even elevating the legs and body above the head height.

The Cause of Spinal Headaches

This headache is due to low pressure in the (cerebrospinal) fluid that surrounds the brain. Because of this reduced pressure, the brain sags slightly and this pulls on the membranes that cover and hold the brain in place (known as the meninges). This causes pain in the head and neck.

The most common reason for getting a headache of this sort is undergoing a spinal tap (lumbar puncture) during which fluid is removed with a needle from the spinal canal in the lower back. In about 20% of cases, after the procedure is completed, the fluid continues to very slowly leak out of the spinal canal, and leads to spinal headache symptoms.

Rarely, spinal headaches may develop spontaneously due to the development of a spontaneous leak somewhere along the spinal canal or sometimes after significant body trauma, like falling from an extreme height or a car accident.

Treating Spinal Headaches

Treatment of spinal headache depends on the duration of symptoms and the cause.

For spinal headaches that result from spinal taps, it’s recommend you drink plenty of fluids, increase caffeine intake as well as laying down. Laying down reduces the stretching of these membranes involved in the spinal headaches and can therefore reduces the degree of pain.

If this is not sufficient, other treatments include caffeine by IV and medications used to treat migraines.

In extreme cases, a patient can undergo an epidural blood patch. This procedure involves drawing blood from the patient and re-injecting it where the cerebrospinal fluid was originally taken from. The blood clothes clots where it is placed sealing the hole from which the fluid was leaking. This procedure is very effective and headache symptoms can resolve within an hour.

Fortunately for most people, spinal headaches resolve themselves within 24 hours of occurrence. If your symptoms persist or worsen over time, contact your doctor or seek emergency medical care.