Spinal Headaches

Spinal headaches usually occur in about 40% of the individuals  who undergo a spinal tap or spinal anesthesia.  Theses two procedures require  a puncture of the tough membrane that surround the spinal chord  and, in the lower spine, the lumbar and sacral nerve roots. 

During a spnal tap, a sample of cerobrospinal fluid is drawn from the spinal canal using a needle usually injected between the third and fourth lumbar vertebrae.  In the process of administering spinal anesthesia, medication is injected into the spinal canal in order to numb the nerves located in the lower half of the body. 

A spinal headache will develop when the spinal fluid leaks through the puncture site. Most spinal headaches are also known as post-lumbar puncture headaches, which usually reslove on their own without any treatment. 

However, severe spinal headaches that last for 24 hours or more require treatment.

Signs and symptoms of spinal headaches can be listed as follows:

An experience of a dull throbbing pain that usually varies in intensity from a mild to an incapacitating pain that characteristically worsens when one sits up or stands and gets better when one lies down. 

Spinal headaches are usually accompanied by:

• dizziness,
• ringing in the ears or tinnitus,
• light sensitivity or photophobia,
• nausea,
• neck stiffness.

When a medical appointment is made it is very important to tell a doctor whether the sinus headache was developed as a result of a spinal tap or spinal anesthesia, especially in situations where the headache intensifies when one sits or stands

The cause of spinal headaches is directly linked to the leakage of spinal fluid through a puncture hole through a tough membrane (dura mater) that surrounds the spinal cord. This leakage leakage reduces the pressure exerted by the spinal fluid on the brain and spinal chord, which leads to the headache. 

Spinal headaches usually appear within 48 hours after a spinal tap or spinal anesthesia. In some cases, epidural anesthesia may lead o spinal headaches as well. In this procedure, a headache is possible if the membrane is unintentionally punctured.

Making a diagnosis of spinal headaches is done during physical exam.

A doctor can help one determine the seriousness of their condition if they have developed headaches that last for 24 hour or if if they had recently had a spinal tap. 

The following information can help one get ready for your appointment and to know what to expect from your doctor. What you can doWrite down any symptoms you're experiencing, including any that may seem unrelated to the reason for which you scheduled the appointment. 

Making a list of all medications, vitamins and supplements being taken. Taking a family member or friend along, if possible. Depending on the condition, help may be needed to get to the appointment. And, an extra individual may remember information one might miss or forget. 

Writing down questions to ask a doctor. Preparing questions can help  make the most of the time with a doctor. For a spinal headache, questions you might ask include: 

• What is likely causing my symptoms or condition? 
• Are there other causes? 
• What tests do I need?
• Is my condition likely temporary or chronic? 
• What is the best course of action? 
• What alternatives are there to the approach you're suggesting?
• I have these other health conditions. How can I best manage them together? 
• Are there any restrictions I need to follow? 
• Should I see a specialist? 
• Are there any printed material that I can take? 
• What websites do you recommend? 

Don't hesitate to ask any other questions. 

What to expect from your doctor?

Your doctor is likely to ask you questions, such as:

• When did your headache begin?
• Does your headache worsen when you sit, stand or lie down?
• Do you have a history of headaches? What type?

The doctor will ask questions about your headache and do a physical exam. One must always be sure to mention any recent procedures,  particularly a spinal tap or spinal anesthesia. 

In some cases, doctors will recommend magnetic resonance imaging (MRI) to rule out other causes of the headache. During the exam, a magnetic field and radio waves create cross-sectional images of the brain.

Treatment of spinal injuries begins conservatively. Doctors may recommend the following:

• bed rest,
• fluids,
• caffeine,
• oral pain relievers.

In cases where the headaches does not improve within a period of 24 hours, doctors may recommend other treatments like using an epidural blood patch. 

Injecting a small amount of blood sample into the space over over the puncture hole will often form a clot which can seal the hole to restore normal pressure in the spinal fluid and thus relieving the headache. This is the most common and leading treatment for persistent spinal headaches that do not resolve on their own.

IV caffeine  delivered directly into the bloodstream helps relieving spinal headaches. This is usually done within a few hours by constricting blood vessels in the head.

There are several risk factors of developing spinal headaches.

The main are listed as follows:

• apparently being between the ages 18 and 30,
• being female,
• taking part in certain procedures that involve the use of larger needles or multiple punctures in the membrane that surrounds the spinal chord and having a relatively low body mass.