Lumbar Puncture - How long should it hurt

I am seeing a great Neurologist, Dr. I. Cherches at St Lukes in Houston.  He checked me over and did some tests where he electrocuted and pushed needles in my arms, hands, legs and feet.  He said I have neuropathy. My previous MRI's had shown lesions.  So, the next day he ordered a LP and EEG at the hospital as outpatient, to be followed by multiple MRI/MRA scans of my head and neck and spine.  All that has been completed.

The question is I still have major severe headache and neck pain 72 hours after the lumbar puncture.  I have been lying on my back and drinking lots of water.  I have been taking Excedrin Migraine and Tylenol Extra strength.  Nothing seems to alleviate the severity of the pain.   It seems to be getting worse.  Should I go to the ER or call the doctor.  This is Sunday, should I wait until Monday.  What?  The pain on a scale of 1 to 10, is a 12.

[wguimb]

I forgot to mention, since the LP Friday morning, I have vomiting and have severe diarrhea. No fever, just terrible pain.

[wguimb]

Nevermind, the doctor said I have to go to ER immediately.

[theasian]

Yot most probably still had a leak that's why drinking lots of fluids didn't help. I had to get a blood patch done to fix mine. Hope they can patch you up

[humangirl]

I have had a total of 37 lumbar punctures so I can sympathize with you.  I'm assuming that you get the headache either right before they finish the lumbar puncture or pretty much immediately thereafter.  The headache is called a spinal headache and are extremely violent.  I personally don't think anyone understands how violent a spinal headache is unless they have experienced one.  They will literally knock you to your knees and make you vomit.  

It was explained to me that when they do a lumbar puncture, they are draining the spinal fluid.  Your body needs to replenish your spinal fluid and you will have a spinal headache until that time.  The key to a spinal headache is to lay flat ... not flat on your back with a pillow under your head but completely flat.  This is the quickest way to replenish the spinal fluid.  Once you lay flat, the headache will subside and go away, however, once you sit up or stand the headache will return immediately and be just as violent.  It takes a good 8 hours for the spinal fluid to replenish itself and the headache to go away completely when you lay flat.

I hope this helps.

[jojo19419]

i would judt like to thank you all for your feed back and help, and m sorry people are going through what i am at the moment,
i went into hospital with blackouts,and headaches and dizzieness, the decided to do a cat scan and while waiting on my results the also did a lumber puncture! omgg this has been the worst decision i have ever made. i have a very high pain threshold but this pain is knocking me for six!!! when they did my lb they tried at least 6xs before being able to complete the procedure i was told i may have worse headaches, and was to lie flat, which i did, now 5 days later i have been back to hospital with the 24/7 pain and headaches if i lie flat they seem to ease a little but as soon as i stnd the pressure in my head is horiffic, ive now been bed bound for 5days and im worried sick it is never going to end, i just want a pain free day and its really getting to me now i just wonder how much more i can take!   big thanks to you all xxx

[wguimb]

Thanks for the replies.  I just got home from the hospital this evening. I can understand the pain that some of you have endured after LP.  I went in to the ER Sunday morning (5/16/10).  They said my vitals looked ok, but I was going through the most excruciating head and neck pain I have ever experienced. I should say it was non-relenting and so overwhelming I could not focus on anything but relief.  They admitted me and gave my morphine, which did not even dull the pain.  They gave me Dolotin IV, which seemed to dull it somewhat. It gave some relief.  I was begging for more, but I had to wait 4 hours between doses.  Three days of that medicine and 10 pounds of IV fluids and I became very sick with nausea and vomiting. They weaned me off Dolotin but the head and neck pain was still unbearable.  They gave me something, not sure what it was, but it really brought the pain intensity down a few notches. As I type this I am still experiencing migraine like headaches.

[wguimb]

Wanted to add they sent me home with Fioricet for the pain.  

[wguimb]

Neurologist called today and said all my tests were negative. He reversed his earlier observations that I had Neuropathy and balance problems.  I still have original symptoms which prompted the tests in the first place  and of course head and neck pain from the LP ordeal I just experienced.  The positive test results are great news but I am left with confusion and my original symptoms, as documented in two different MRI scans made over a month ago.  

[wguimb]

Update: One week after LP and I still have head and neck pain.  

The medicine I referred to in my original posts 'Dolotin' was actually Dilaudid.

I have learned a lot about Post-dural Puncture Headache (PDPH) since getting out of the hospital.  It can occur after a Lumbar Puncture (and accidentally during an Epidural procedure) if the dura is penetrated. The needle size, type and technique used by the doctor can influence the outcome and severity of the headaches.  The headaches are mainly caused by a leak of the CSF (spinal) fluid from the puncture site leading to a drop in the cerebrospinal fluid pressure. For severe cases of PDPH, a "blood patch" can be performed to help restore the pressure and provide relief from the pain.  This patch involves Injecting epidural blood into the site of leakage.  \

The blood patch was not administered to me. Information on preventing PDPH and treatments such as the patch have been available for decades. Yet, it appears many in the medical community are not too concerned about the torture PDPH can be for the patient.  I have and continue to suffer enormous pain since the LP was done.

[CassieVee]

It seriously would have helped your headache had they performed the blood patch on you. I went into the hospital for a headache, after having an lp 3 days previously, that was unlike anything I had every experienced in my life. After giving my tons of liquid caffeine through an IV and percocet and fioricet all night long, the blood patch was performed early the next morning and I immediately started to feel a little relief.

However, it has now been 6 days since the blood patch and I am still having the most excruciating pain in my lower back. I don't know if this is caused by the fact that it took 7 attempts in my first lp to get the fluid out, or the fact that the pressure felt during the blood patch was unbelievably horrible. I do know, however, that I am going to have to follow up with my doctor as I cannot keep dealing with pain that even percocet 10 won't knock out.

Best of luck to you! Hope you are feeling better!!

[henerforner]

I had the worst headache ever which sent me to the ER where they tried to do the spinal tap and stuck me 6 different times unsuccessful they admitted me in the Hospital and I then had another LP with an
XRAY so they could see and that took three tries. Ended up I had Viral Meningitis with my White blood cell count in my Spinal Fluid being 307 and normal being 0-8. I was in the Hospital for 6 days as all the cultures came back negative and the diagnosis was definative. The pain was unbearable and I was on alot of pain meds and Anti Virals aswell as antibiotics and the Morphine didn't put a dent in the pain. It's now been 4 weeks since the begining and I still have pain in my neck on and off and alot of Pain in my  lower back where they did the LP anytime I bend over or stand up or sit down. Worried about all this. Anyone else feeling the same.  

[Britt0389]

I am a 21 year old female and about three weeks ago I want to the ER with a headache that could kill a horse. I was sick to my stomach and everything else. The done a CT to rule out a hemorage or a mass. Then they proceeded to give me a lumbar puncture the first doctor could not get it so i had to go back four hours later to get it. I laid on the table with a radiologist for an hour and a half while the procedure was performed. Of course everything was negative. A couple days later I was at a different er they could not figure out what was wrong, now not only did i have a migraine that would have made Hitler cry and beg but i also had pain in the back of my head and neck. I was also given morphine which only made me itch. They put me on hydrocodone and sent me home. Two days after that I was back in the ER because the pain was so intense I was vomitting. This time they told me it was due muscles, they gave me Nsaids and muscle relaxer and finally relief from the headache. As for the pain with the lumbar puncture you will always have some kind of pain associated with it. I had a epidural two years ago when I gave birth and it still kills me, especially since two spinal taps in 24 hours..

[momo271439]

yes im in pain all the aft a spinal tap. its been 2 mos. no memory.