What is a Spinal Headache?
A spinal headache is a type of headache that can occur after certain minimally invasive medical procedures involving the spine. Spinal headaches are also known as post-dural headaches.
Your spine and brain are key parts of the central nervous system, which is also made up of the following:
- Spinal cord, which runs from the base of your skull down through your spine.
- Dura mater, the outermost membrane around your spinal cord and brain.
- Subarachnoid space, the space between the layers of protective membranes. This is where cerebrospinal fluid (CSF) is located.
The protective, tough membrane, or dura, holds the CSF in place. CSF cushions and protects your spinal cord and brain from damage.
During procedures like a lumbar puncture, also called a spinal tap, a needle may puncture the dura, allowing CSF to leak out. When this happens, you’re more likely to develop a spinal headache.
Why Does a Spinal Headache Happen?
A spinal headache typically occurs when there is a drop in the pressure of the CSF around your brain and spinal cord. This happens when some has leaked out of its normal space. The reduced pressure can cause the brain to shift slightly downward. This leads to pain that often intensifies when you are sitting or standing and eases when you’re lying flat.
The procedures most commonly associated with this type of headache are.
- Lumbar puncture or spinal tap
- Epidural anesthesia
- Spinal anesthesia
Approximately 1 to 5% of people who receive an epidural or spinal anesthesia may experience it.
Spinal Headache Symptoms
A spinal headache often presents differently than a typical tension headache or migraine. Common signs include:
- Pain that worsens when sitting or standing upright and improves significantly when lying down.
- Dull, throbbing, or pressure-like pain in the front or back of the head that can extend to the neck.
- Neck stiffness or tenderness.
- Photophobia, which is light sensitivity.
- Nausea or vomiting.
- Ringing in the ears.
How is a Spinal Headache Treated?
Some people find relief by lying flat and drinking extra fluids. While complete bed rest is not always recommended, resting in a horizontal position can reduce headache intensity.
Pain relievers like ibuprofen, acetaminophen, or prescription pain medication can help manage discomfort until the CSF leak seals and pressure is normalized.
Caffeine can temporarily raise CSF pressure and may lessen headache pain, so you might be advised to drink caffeinated beverages, too.
Epidural Blood Patch
If your headache persists and conservative measures aren’t enough, an epidural blood patch can be highly effective.
A small amount of your own blood is taken, usually from your arm. It is then injected into the epidural space. The epidural space is located just outside the dura and near the site of the leak. The blood clots, forming a patch that seals the hole in the dura. The patch prevents further CSF leakage.
Most people experience rapid relief from an epidural blood patch, often within hours. In some cases, a second patch may be necessary if the first one doesn’t fully resolve the headache.
Not everyone who experiences a spinal headache will require an epidural blood patch. However, you should contact your doctor if:
- Your headache is severe or getting worse instead of better.
- You can’t carry on your regular activities due to pain.
- The pain doesn’t improve after a couple of days of conservative management.
If you have a fever, stiff neck, or chills, it could mean there is an infection. Get medical help right away.
Get Expert Care
Suffering from any form of headache or back pain can make your life difficult. Get expert care from an experienced neurosurgeon or physiatrist and get back on track.
Don’t continue to live with pain – schedule an appointment today!
