Spinal Tap (aka Lumbar Puncture) to Diagnose Headache Disorders

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

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Posted in Treatment. Tags: . 10 Comments »

10 Responses to “Spinal Tap (aka Lumbar Puncture) to Diagnose Headache Disorders”

  1. baldsue Says:

    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. šŸ™‚

    Kerrie

  2. Leslie Says:

    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

  3. Alexander Mauskop (Headache NewsBlog) Says:

    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

  4. Kim Says:

    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!!!

  5. authorgirl Says:

    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

  6. Jill Says:

    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.

  7. Laura Says:

    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?

  8. Megan Says:

    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

  9. Alohagirl Says:

    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.

  10. Steve Says:

    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.


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