Each year, nearly 50 million Americans complain of headaches, but only about 8 million end up seeing a doctor because, most of the time, sudden pain in the head that radiates to the neck or other nearby areas is a temporary inconvenience. However, if it’s a recurring issue, it’s time to find out why. A possible source not on most people’s radar is an issue with the spine. The good news is most spinal (post-lumbar puncture) headaches go away on their own. Should this not be the case, here’s what you need to know about potential causes and treatments.
What Causes Spinal Headaches?
First of all, your headache is probably not spine-related if you haven’t had a spine procedure recently. Spinal fluid leaking through a puncture hole is what causes spinal headaches. The puncture occurs in the dura mater, which is a thick membrane that surrounds the spinal cord. When a leak happens, a pressure imbalance in the fluid flows from the brain to the spinal cord, and the result is a headache.
The most common cause of a dura mater puncture is a spinal tap or a similar procedure in the same area. In fact, approximately 40 percent of patients who have a spinal tap or spinal anesthesia administered will likely experience a dura mater puncture. Symptoms associated with spinal headaches include:
- Pain that becomes worse when sitting or standing
- Throbbing sensations in the head
- Nausea and dizziness
- Discomfort that ranges from mild to debilitating
- Ear ringing (tinnitus) or light sensitivity (photophobia)
How Are Spine-Related Headaches Diagnosed?
Initial diagnosis usually involves asking a patient questions and performing a general examination. If a dura mater puncture is suspected, an MRI or similar image test may be performed to rule out other potential headache sources and confirm a leak has occurred.
What Are the Treatment Options?
Oftentimes, patients will be asked to wait and see if the puncture heals itself. However, this doesn’t mean discomfort can’t be managed. It typically takes a few days for the puncture to heal and cerebrospinal fluid balance to be restored. While waiting to see if the issue resolves itself, headaches and related symptoms may be managed with conservative treatments.
Non-surgical options include the use of over-the-counter pain relievers, moderate coffee consumption (caffeine may ease the headache pain), or drinking more water to increase circulation and promote healing. If these efforts aren’t helping, two possible options may be recommended:
- Caffeine delivered by IV – Caffeine directly released into the bloodstream constricts blood vessels in the head and eases symptoms. Relief is usually noticed within a few hours.
- Epidural blood patch – A small amount of blood is injected into the affected area to promote the formation of a blood clot that covers the hole from the puncture.
If you’ve recently had a spinal tap, received spinal anesthesia, or had surgery in the neck area, let your doctor know if you suddenly experience headaches. It’s especially important to see a Los Angeles spine surgeon if your headaches start within a day or two after a spine procedure and symptoms last for 24 hours or more. While anyone can get spinal headaches under the right circumstances, they’re more likely to occur in people between the ages of 18 and 30 and those with a small body mass.
Contact The Spine Institute if you’re interested in learning about your options for fusion surgery or back fusion alternatives. Los Angeles residents can call 310-828-7757 to schedule an in-person evaluation.