« National Invisible Chronic Illness Awareness Week | Main | Obsessing Over Headache or Migraine Triggers »
Spinal Tap (aka Lumbar Puncture) to Diagnose Headache Disorders
By Kerrie | September 11, 2007
A common headache diagnostic tool, the thought of a lumbar puncture (often called a spinal tap) may terrify you. The length of the needle used is surprising, but the procedure is not that bad. At least, it wasn’t for me and I was needle-shy at the time. Many people have shared similar experiences with me.
Why Lumbar Punctures Are Used
Lumbar punctures are used to check for an underlying condition, like meningitis, hydrocephalus or subarachnoid hemmorage. They can’t diagnose migraine or tension-type headache, but are used to rule out other possibilities.
What the Procedure is Like
Before the needle is put in, you are given local anesthetic. The anesthetic will sting or burn initially, but you’ll be grateful for it during the next step. After the anesthetic takes effect, the needle to draw the fluid will be inserted. You’ll feel a hard pressure in your back when the needle goes in and might have a few seconds of pain as it goes through the tissue. You may feel pressure while the fluid is being drawn.
The entire procedure takes about 30 minutes, but the part where the needle is in your back only takes a few minutes.
The Dreaded Lumbar Puncture Headache
I’d be lying if I said that spinal headaches following a lumbar puncture are uncommon. However, they are usually gone within 48 hours after the procedure. They are easily treated with pain relievers, lying flat, and drinking a little caffeine and lots of water and are usually gone within 48 hours.
If the headache lasts longer than 48 hours, most doctors will recommend a blood patch. For this, blood is drawn from your arm and then injected in the lumbar region. The blood then forms a clot to seal the puncture hole.
Nearly everyone has relief after a blood patch. Because I’m so special, I became a baseball fan during the three weeks following my lumbar puncture. The odds that you’ll have the same trouble are so low that I’ll spare you the details.
Tips For Your Lumbar Puncture
- Schedule the procedure for a Friday so you can rest over the weekend.
If you can send the kids to stay with Grandma and Grandpa, great! - If you can stomach it, ask the doctor to explain each step as you go along. Knowing what to expect relieves some of the fear.
- Have someone drive you to your appointment so you don’t have to drive home. Even if you’re not in pain, you may feel woozy or “off” from nervousness.
Learn More About Lumbar Punctures
- Mayo Clinic: Spinal Headaches
- MedlinePlus: Cerebral Spinal Fluid (CSF) Collection
- WebMD: Migraines and Headaches — Making the Diagnosis — Spinal Tap
Topics: Treatment |
September 11th, 2007 at 9:50 am
I had 4 spinal taps in 6 months last year. Never did I get the dreaded “spinal tap headache.” Instead I got a severe backache after each tap. Each backache lasted about a week. Would I trade the backache for the headache? I don’t know. The backache was no fun and the only remedy was time.
******
Four in six months??? The backache sounds horrible.
Time is such a frustrating remedy.
Kerrie
September 11th, 2007 at 11:59 am
I was surprised at not seeing PTC or IH (pseudo-tumor cerebri or intracranial hypertension) mentioned.
My 3 LPs were to determine if my head pain was attributed to IH, which is characterized by a high level of cerebral spinal fluid pressure. The only way to diagnose this is via an LP.
My LPs were uneventful. I did feel pressure but no pain. I did not experience spinal headache nor a back ache afterwards.I now take a CSF diuretic to combat my slightly high CSF pressure.
*******
Thanks for pointing out pseudo-tumor cerebri or intracranial hypertension. They skipped my mind, but are so important for this topic. They certainly deserve attention in their own right, too.
Kerrie
September 11th, 2007 at 8:22 pm
Approximately one in four patients develop a spinal headache. The risk of developing a headache can be reduced by using either a thinner needle or a needle with a rounded tip. However, thinner needle does not give accurate prssure measurement which is needed to diagnose intracranial hypertension.
******
Thanks for the information. It’s good to know the trade-offs.
Kerrie
September 27th, 2007 at 8:58 am
I had a spinal 2 weeks agot today to determine whether I had MS or Guillian- Barre Syndrome (thankfully its was GBS!). Anyways, got the most terrible spinal headache afterwards that was only barely lessened by the patch. the headache is finally gone after 2 weeks and more percocet than I’d like to admit, but it does go away. Let me tell you, i would take the backache over the headache any day!!!
December 8th, 2007 at 9:53 am
Thankfully, I escaped the headache after my LP but I have a harsh backache that’s getting worse…
There’s varying info on the ‘net about having a warm bath, due to the puncture site becoming infected. Is this safe?
Also, at what point should I seek medical attention?
Thanks!
*******
I’m not sure about the warm bath. I’d definitely contact your doctor ASAP.
Kerrie
December 22nd, 2007 at 4:34 am
I had an epidural injection 3 wks ago, back ache from that no headache. 3 days ago had a mylerogram done (injected dye in the spine) wow I got the spinal headache and the back ache. Yesterday had to go to the er for the blood patch and IV of caffine. It worked, but didn’t take it 100% away. My back is hurting and my head is feeling better. I’ll take the back pain over the headache.
June 19th, 2008 at 8:08 pm
My daughter had a spinal this past Monday to check for psuedo tumor cerebri. On a good note, she does not have it. On a bad note, she does have the horrible spinal headache. Two days of hydrocodone afterwards and she was incapacitated with the pain and had to taken to the ER. They did a blood patch, but now a little over 24 hours after the patch she is still in terrible pain. The patch helped some of her back pain issues, but the headaches are still uncontrollable even with oxycodone this time round. The neuro suggests just waiting it out, but I’m sitting her with a child who is crying in night almost 24/7 and don’t know if I should take her back to the ER. Can any of you give me an idea how long this took to heal on its own for you?
June 20th, 2008 at 6:31 am
Laura - You might want to post your question in the forum part of the site. People with this experience are more likely to be able to find your question there than here in the comments. I sure hope your daughter’s spinal headache clears soon! I had one after an epidural, but mine only lasted a few hours. Good luck!
- Megan
September 30th, 2008 at 4:41 pm
I was diagnosed with swine flu in 1971, I was 21 yrs. after having a spinal tap, diagnosed with Guillain-Barre Lindry Syndrome, recovery was 9 months, suffered massive headaches for 3 yrs. thereafter, then diagnosed again as meningitis, headaches lessened only when lying in bed, got released onto emergency flight, diagnosed again for spinal headaches, the blood patch worked. It is now 2008, Mother of 3 and Grandmother of 5. This is m story.
October 18th, 2008 at 12:14 pm
I just had a lumbar puncture done yesterday. Let me say this. I HATE needles! That being said, the procedure was no sweat.
I lied down on my belly and the doctor took an X-Ray of my lumbar area to look for a possible injection site.
Then they mark the area on your back where they are going to insert the needle and apply Betadine to clean the skin.
The puncture site is numbed with Lidocaine first. Lidocaine burns a bit when it is injected, but the burning lasts less than 10 seconds. Almost immediately you can feel a numbness spread around the area as your muscles absorb the drug. It’s a pretty neat sensation actually.
After that the needle is inserted through your skin and muscle, between your vertebrae, and into the dura to extract the CSF. This procedure is absolutely painless. I am a big wuss, so when I say painless, I mean it. I felt NOTHING during the entire procedure.
My procedure took about an hour because, for some reason, my CSF just trickled out.
When the doctor was satisfied with the amount, the needle was withdrawn and he put a band-aid over the injection site. Absolutely painless.
May 5th, 2009 at 3:51 pm
I have had several punctures, and my neurologist now prescribes a blood patch with the puncture as one procedure to avoid the need to go back for the patch. I am surprised to read about people saying it was not very painful, mine have all hurt like crazy, especially the last two when they hit a nerve and I felt like I was electrocuted all the way to my toes and dread the thought of another one. My first couple had high opening pressures, so I have been diagnosed with pseudo-tumor cerebrei. There does not seem to be a good prognosis for this, they try to manage the pain, but I have a headache every minute of every day. I would (and have done most) anything that might work. My doc wants to do a shunt, but that is scary. I am on them about trying the occipital nerve stimulator as I have heard this helps. I do know that cranial sacral therapy and traction do help some, but get expensive. My husband tries to do the traction by gently pulling up using the occiputs as a place to dig his fingers in to pull upwards (traction) and that tends to help a little till his hands get sore.
May 6th, 2009 at 7:45 am
In the summer of 2007 I had a Spinal Tap performed to rule out MS or infection…It was the WORST headache AND back ache I have ever experienced! I immediately went home but for 5 to 7 days after that I had the dreaded headache and back pain. I hate to sound crazy, but each day the back pain would creep further and further up my spine. Its hard to explain, it was like one day the pain would be in my lower back, then the next day it moved to my middle back, and so on and so on. Horrible! I had a internship in NY that began the monday after my procedure…and lets just say I didn’t make a good first impression! Once I explained to my boss what was going on she sent me home to lay down for the rest of the week!
So glad its over with….god bless whoever has to get one, I feel for you.
May 10th, 2009 at 10:16 pm
i just had a spinal tap done two days ago and am in so much pain with my back that seems to be getting worse and even have pain goin down my left leg and through my foot this is horrible i already had the migraine or whatever before they did it and that was their reason for doing it and i felt bad pain during the procedure was i not supposed to be in horrible pain?
September 23rd, 2009 at 5:13 pm
I had a spinal tap last wednesday, it was not painful to have done, but i did get the spinal headache and returned on friday for a blood patch, it is now Wednesday of the next week and I am having nausia, can’t keep food down. I’m very weak, and tired. Triing to drink lots of water and rest..and eat… Wondering how long this is going to last…?
October 7th, 2009 at 1:15 am
My daughter had a spinal tap and she said it hurt terribly…She cried and screamed.I don’t think her doctor gave the numbing agent enough time to work. She is 18 and I am 49 and I wouldn’t get one of those, they would have to knock me out.
November 8th, 2009 at 10:23 am
I had a spinal tap 6 days ago and still have a severe lumbar backache which radiates down my thigh.
Prior to the spinal tap, I experienced sciatica when walking, but the pain never kept me awake as this does. It is better when I lie down.
Given the good advice from writers above, I will “lie low” until I can reach my internist tomorrow.
I wasn’t aware of the actual procedure (having finally been diagnosed with transient global amnesia). It would have been helpful if the medical staff had inquired about my backache prior to discharge. At first I thought the backache was due to lying in a hard hospital bed
but became concerned as the ache seemed to worsen and awakened me in the middle of the night.
January 8th, 2010 at 7:03 pm
I had a spinal done 3 months ago to test for psuedo-tunor, now I have to have another done because the doctor read the first 1 wrong!! He read a 0 pressure and my nuero says this is IMPOSSIBLE!! I did have a terrible headache for about 18 hours and a backache for a few days but all in all(except for the flub-up) it was’nt that bad!
February 11th, 2010 at 5:43 pm
I was dx with PTC and Arnold Chiari in 2007. I have been fit and healthy all of my life and so I don’t fit the typical middle age, child bearing years, over weight patient associated with PTC. Since 2007, I have lost track of how many lumbar taps I have had done, over 30 I believe. Just had one recently and my pressure was over 600. I have two VP shunts and have had to have numerous revisions since 2007. I live with daily headaches that are excruciating and very debilitating. I had to file for disability and left my wonderful career behind because of my condition. Now I have to have decompression surgery for my Arnold Chiari. This is when the brain stem becomes herniated through the opening in the skull. So for me, LPs are nothing compared to all that I have already endured! Sad, there is no cure for this, no amazing fund raising events or foundations that pour millions of money into research. The condition is listed as a rare disorder in the NIH website. Doctors are inexperienced and have very little knowledge on how to even treat the symptoms.