A headache can make your head feel like it's about to burst from too much pressure. But for spinal headaches, the opposite situation may literally be the cause.
Spinal headaches are the result of low spinal fluid pressure. Spinal fluid is a liquid that acts as a protective cushion for the brain and spinal cord. The brain is supported by this fluid in a bag-like membrane inside the skull.
Spinal headaches occur when small amounts of spinal fluid leak out of this membrane or out of the spinal cord. If enough fluid leaks out, the reduced spinal fluid pressure may allow the brain to sag. This can stretch the supporting membranes and press on the nerves that line the brain, resulting in headache pain.
Most spinal fluid leaks are the result of testing or treatment that requires insertion of a needle through the membrane surrounding the spinal cord. During a spinal tap or lumbar puncture, a needle is used to remove a very small amount of spinal fluid for testing.
During spinal anesthesia such as an epidural used to relieve a woman’s pain during labor and delivery, medication is injected into the spinal fluid to numb the nerves in the lower body.
Approximately 40 percent of people who undergo either a spinal tap or spinal anesthesia experience a spinal headache, according to the Mayo Clinic. Spinal headaches are more common if the treatment needle accidentally nicks the covering of the spinal cord called the dura.
Although most spinal headaches occur after a spine puncture, they can also develop from no recognizable cause. Some spinal headaches have resulted from a violent sneeze or cough, or other minor trauma to the neck or back.
Symptoms of a spinal headache include:
• Dull throbbing pain that can vary from mild to excruciating.
• Headache that gets worse when sitting or standing and improves when lying down.
• Headache that gets worse the longer you are upright or out of bed.
Spinal headaches may also be accompanied by neck pain, nausea, dizziness, ringing in the ears or sensitivity to light.
Most spinal headaches occur within 48 hours after a spinal treatment, but a spinal headache can take up to five days to develop.
Most spinal headaches go away on their own within 24 hours. Headaches lasting longer than 24 hours may require treatment to help seal the leak the restore normal spinal fluid pressure.
Treatment typically begins with bed rest, plenty of fluids to make sure you are well-hydrated, caffeine to constrict blood vessels in your head, and pain relievers.
If a spinal headache does not go away, your doctor may perform an epidural blood patch. During this procedure, a vial of your own blood is drawn and then injected into your spinal fluid.
The goal is to create a small blood clot that will patch the hole and prevent more spinal fluid from leaking out. Once the leak is sealed, spinal fluid pressure will return to normal and the headache will go away.
If you have questions about headaches or about potential side effects of a spinal tap or epidural, talk to your health care provider.
Reviewed June 30, 2016
by Michele Blacksberg RN
Edited by Jody Smith