Megan is a writer and mom of two. She enjoys cooking, running, and gardening.
One day in October, I woke up with a stiff neck and a headache that would not go away. I thought maybe I had slept funny or pulled a muscle the day before—and I tried to ignore how I was feeling. As the day went on, my headache and neck pain got worse. I decided to take my family to a park and get some fresh air. By the time we were walking back to our car, I was in so much pain I could barely walk, and I had come down with a high fever.
That night, I ended up in the E.R. Against my better judgement, I drove myself to the hospital because I didn't want to have to wake up my sleeping kids and husband. I barely made it there—I couldn't move my neck side to side and was violently shaking.
In the E.R. I was told I likely had meningitis, and a blood test was taken. After the blood test results were inconclusive, they suggested a spinal tap. Not sure what was going on, I conceded.
The spinal tap was nowhere near as painful as I expected—it was over quickly and I hardly felt a thing. I was told casually that I should lie on my back for at least 15 minutes following the procedure, and in my dazed state, they had me sign a consent form.
I received a probable diagnosis of viral meningitis and was instructed to follow up with my doctor the next day. (Viral meningitis is usually much less severe than the life-threatening bacterial meningitis). After getting IV fluids and pain medication, and while still lying down, I began to feel a little better. The nurse returned about 20 minutes after the procedure and said I was okay to go home. I told her I had driven myself, and she said I was fine to drive back home.
On the way home I quickly discovered I had made a mistake. I felt even more ill than I had when heading to the hospital. I developed a headache that I had never experienced before—it felt like my head was literally going to explode. When I finally did make it home, I collapsed on my front steps, screaming in pain.
The following week can only be described as a nightmare. I was unable to work, take care of my kids, or barely even lift my head long enough to get out of bed. It turns out, I had developed a spinal headache, which is a complication of spinal taps and epidurals. Although spinal headaches can happen regardless of the precautions taken after the spinal tap, I found out later that my case was most likely caused by what I did and didn't do afterwards. Had I had been advised to stay laying down longer, and not to drive myself home, I might not have had to endure the week of pain that I did.
After several trips to the doctor, and being prescribed three different pain medicines and told the headache would likely go away, I finally was able to get a blood patch procedure done to cure the headache. I was never more thankful for life and good health than I was at that moment. I had become so depressed during the week that I was not able to take care of my two daughters, and had to depend on my parents and husband for help.
I'm writing this article because I never want anyone to have to go through what I did. Whether you have meningitis or another disorder that calls for a spinal tap as a diagnosis, you definitely don't want this headache on top of everything else. Find out what to watch out for and how to avoid going through what I had to.
What is a Spinal Tap, and Who Needs One?
A spinal tap, also known as a lumbar puncture, is a medical procedure through which cerebrospinal fluid is extracted from the spinal canal to be tested for certain diseases. While other conditions might be tested for via lumbar puncture, the most common reason a doctor may order one is to help diagnose meningitis, a serious infection of the meninges (protective membranes around the spinal cord) that can lead to permanent disability or death if not treated immediately. If someone arrives at a hospital with symptoms indicative of meningitis, such as sore neck, severe headache, and high fever, a spinal tap will probably be done right away.
Other Tests May Make a Spinal Tap Unnecessary
Lumbar punctures can confirm a meningitis diagnosis, and can aid in deciding what is the appropriate course of treatment. There are other ways, however, for medical professionals to determine whether or not meningitis is likely. Simple physical tests can often indicate whether certain flu-like symptoms may actually be something more serious. Doctors may test for Brudzinski’s sign, in which your hips and knees flex automatically if a stiff neck is manually forced to turn side to side. Another physical test used is Kernig’s sign, where if you attempt to extend your leg, you experience pain in your thigh.
Often times, a blood test will be done when you arrive to the hospital with signs of meningitis. Sometimes the combination of a high white blood cell count and severe enough symptoms, doctors will begin treatment for meningitis without the confirmation of a spinal tap. In many of these cases they are reasonably certain the disease is present, and treating without waiting for other testing is deemed appropriate in order to save the patient’s life.
Usually, tests such as these, along with an evaluation of other symptoms, is done first when you arrive at the hospital. If you have some symptoms of meningitis but not others, and score negative on both physical tests along with no elevated white blood cell count, your doctor may be able to reasonably rule out the disease. Some may order a spinal tap even if not all arrows are pointing to meningitis, just to cover all their bases.
If You Do Get a Spinal Tap, You Need to Do These Things
If you do end up getting a lumbar puncture procedure, it is extremely important to understand it, what to do afterwards, and what the potential consequences may be. Spinal taps often bring frightful images to mind. Contrary to their reputation for being extremely painful, the procedure itself usually hurts about the same as a standard blood test. You may feel weakness in your lower body and a sense of pressure, but it is over with relatively quickly.
What you need to watch out for is what can happen immediately after a spinal tap, and in the following days and weeks. If proper care is not taken afterwards, you could be setting yourself up for serious medical problems, whether or not your test confirms meningitis.
The following two guidelines must be adhered to immediately after the procedure:
Lay down flat on your back immediately following the procedure, and stay that way for as long as possible.
Some literature given during discharge at hospitals says it’s only necessary to lay down for 20 minutes, but it is best that you stay on your back for at least an hour. For the 24 hours following the spinal tap you should only get up to eat and drink or to use the restroom. Do not drive yourself home from the hospital, do not go to work the next day, do not attempt to take care of small children by yourself. Rest for at least one full day, even if you are feeling good.
During the spinal tap a small puncture was made in the membranes surrounding your spinal cord, and cerebrospinal fluid can slowly leak from that hole. Staying as hydrated as possible can ensure that pressure is maintained to make up for that small loss of fluid.
What is a Spinal Headache?
Unfortunately, these two guidelines are not always followed. Even when they are adhered to, a spinal headache may still occur after the test. A spinal headache, or post-dural headache happens when the puncture made during the spinal tap remains open, and small quantities of cerebrospinal fluid leak through the hole. The headache can vary in severity from mild to debilitating. It is characterized by being much worse when standing upright, and almost completely disappearing while laying down. This is because of the change in pressure of cerebrospinal fluid: when standing up the pressure drops, and when lying down the pressure is normalized. It is estimated that over 40% of patients who receive a spinal tap end up suffering from a spinal headache.
Watch Out for These Symptoms
Some spinal headaches can appear later, up to 5 days after the spinal tap, but most start within a half hour of the procedure. You’ll know it’s coming on if:
- You feel fine while laying down, but have a severe headache when upright
- You begin experiencing migraine symptoms such as stiffness and sensitivity to light
- Pain medication is of little to no help
If you do experience these symptoms following a spinal tap, especially a headache that gets immediately better while lying down, call your doctor right away. You probably have a spinal headache.
Complications – What Happens if it is Left Untreated?
Some spinal headaches go away left untreated. Over the course of a few days the puncture in the spinal membrane closes and the fluid pressure returns to normal. A large number do not heal on their own. Because most of these headaches are quite severe and interfere with normal everyday functions, most patients whose headache does not go away will end up seeking treatment within a few days or weeks. In the case that someone waits too long to see if the headache will get better on its own, devastating consequences can result. Leaking cerebrospinal fluid can lead to brain hemorrhage, blindness, and in some cases, dementia.
Treatment with a Blood Patch Procedure
The most common effective treatment for spinal headaches is called a blood patch or epidural patch. This procedure is actually more invasive, time consuming, and uncomfortable than the original spinal tap. To perform a blood patch a medical professional, in many cases a pain management specialist, will draw blood from your arm, and then inject it into the area on your back where the original puncture was. The goal is for that blood to form a clot or “patch” that is able to plug the leak and seal the original puncture, thus preventing further loss of cerebrospinal fluid. This procedure is usually done using only a local anesthetic, but some patients may opt to be fully asleep.
After the procedure, many people experience lower back discomfort and difficulty turning or walking for the first 12-24 hours. Relief from the headache, however, is sometimes immediate. Some who have been suffering for many days from the spinal headache describe the procedure as a “miracle” cure because they are able to feel the results so quickly.
How to Cope While Waiting for the Blood Patch
Sometimes you may not be able to get an emergency blood patch done, and may have to schedule it out a few days. For patients with extremely severe spinal headaches, this can be devastating. To help make it through those painful hours or days until you can have the procedure done, the following suggestions may offer some relief:
- Pain medication: Some prescription pain relievers may numb the effects of the headache. Talk to your doctor if you absolutely cannot stand the pain.
- Caffeine: Caffeine shrinks the blood vessels, lessening the severity of some headaches. It can provide some relief for a spinal headache if used in conjunction with these other guidelines. Many discharge paperwork from hospitals after a spinal tap was done actually encourage caffeine intake to be increased to stave off the headache.
- Stay laying down: This is the single most effective way to alleviate a spinal headache in the short-term.
- Rest in a dark room: A dark, quiet room can calm you and allow you to rest.
- Hydration: Taking in as many fluids as possible can help replenish some of the leaking cerebrospinal fluid.
- Arrange child or pet care.
Hang in there if you have to wait for the blood patch. Severe spinal headaches can cause depression or even suicidal thoughts if you are enduring pain you absolutely can’t stand. If you simply cannot bear the pain, or have thoughts of harming yourself, seek emergency medical help.
If you find yourself with symptoms of meningitis, you need to seek medical attention as soon as possible. Diagnosis and treatment early on can help save your life. If meningitis cannot be ruled out and you must undergo a spinal tap, proceed with extreme caution and follow the above guidelines to avoid the painful spinal headache.
This content is accurate and true to the best of the author’s knowledge and does not substitute for diagnosis, prognosis, treatment, prescription, and/or dietary advice from a licensed health professional. Drugs, supplements, and natural remedies may have dangerous side effects. If pregnant or nursing, consult with a qualified provider on an individual basis. Seek immediate help if you are experiencing a medical emergency.
Questions & Answers
Question: Can vertigo be a symptom of meningitis?
Answer: It could be. Meningitis can present itself differently in different people.
Andra on September 05, 2018:
It is scary my sister died from meningitis a month in hospital sad
Janine on November 30, 2017:
I had 3 spinal taps done a couple years back and i have pain running through the back of my neck going all the way to the top of my head can a spinal tap do that to you
Megan Machucho (author) from Milwaukee, WI on October 05, 2017:
Dunnome, is the pain headache pain or pain at the site of the spinal tap? If its a severe headache, blood patch is probably the best option.
dunnome on October 05, 2017:
I did a spinal tap when I was 2009 while i was pregnant to make sure I didn't have bacteria in my blood. I had drove myself to the hospital and they told me I was going to do the spinal tap. I had went ahead and signed the consent form and then they proceeded on. At this Hospital there are students watching and taking notes and doing the procedure. Don't you know what happened they missed on the first try. Then let me know I was going to have to go again. Let them know I had nobody with me and asked if I could call my grandmother in case they paralyze me for this is one of the consent form non-reliable agreements when you put your life in they're hands(so they are not reliable if they paralyze you). Its now 2017 and I'm in severe pain all the time so I am looking at the symptoms and want to know what three best solution for me would be. I have no I.d.,no family, and no insurance. I'm already terrified of my options and am sitting in pain self medicating. Anyone have an idea? I feel there should be a huge lawsuit set hand but need to figure out what I should do...???
Megan Machucho (author) from Milwaukee, WI on September 14, 2017:
RTalloni, you're absolutely right, a lot of this pain could be prevented with proper warning and follow up instructions.
RTalloni on September 14, 2017:
As I was looking over your profile this caught my eye because of my experience. Following a spinal tap my symptoms were classic. Was told to get up immediately, headache hit that day, lying down it was gone, upright it was excruciating. A friend mentioned the blood patch but the doc said they did not do that for their patients. Stuck that way for a week but would have seen a different doc if it had lasted longer. This post should be helpful to many. Being warned ahead of time would have been helpful to me.
Megan Machucho (author) from Milwaukee, WI on September 08, 2017:
Neil, I agree--I hope I never need another one! I hope you feel better, and recover this time without any complications.
Neil on September 08, 2017:
Hi all, been there in same position Megan here in U.K. Ended up 48 hours post LP 6 months ago needing a blood patch. As a nurse I was so taken back how painful it is, the pain even radiating down my back between my shoulder blades. Blood patch in theatre was an immediate relief!
Now 2 days later after having another LP I requested under X-ray guidance only as the previous LP gave me so much complications. Still have wicked lumbar pain today but no headache.
Technique of Dr and their experience in doing them combined with use of a non-traumatic needle is my advice to investigate!
5th one in my lifetime and never want another thank you!!
Megan Machucho (author) from Milwaukee, WI on September 06, 2017:
Jazzmen, I'm sorry to hear that you have been suffering the aftermath of this for so long. Have you ever talked to your doctor about a blood patch?
Jazzmen on September 06, 2017:
I had a spinal tap Wen I was 14 and found out I had spinal meningitis I'm 26 now and I still have severe pain in the area the did the spinal tap. Some days the pain is bearable but other days I can't take it I have headaches every other week since I was 14 but the last 2weeks they are every day non stop no matter Wat I do... IDK if it has to do with my back but wanna know Wat u guys think i should do about my back pain I havnt seen a doctor about it yet I thought it was normal after having a spinal tap after all I was 14 and now I just can't take it
Megan Machucho (author) from Milwaukee, WI on February 04, 2017:
I'm glad you didn't get the headache! I got a spinal tap in October for suspected meningitis and was not given proper follow up instructions. I was allowed to sit up after 15 minutes and told it was OK to drive myself home. After that I had the worst headache of my life for 4 days while I waited for the blood patch procedure. I don't want anyone else to have to go through this!
FlourishAnyway from USA on February 04, 2017:
Ouch I hope you are okay. People undergoing diagnosis for MS must undergo this so I've had the procedure but thankfully not the complications. I was able to read some academic medical research before the spinal test and some of what I read indicated the needle insertion technique made a difference. I took the studies with me and had a conversation with the doctor, asking him about what his methodology was. He thought I was a little intense but I didn't end up with a spinal headache in addition to the MS. I feel very badly for people who do have that complication.