30 Oct The Epidural Blood Patch As Pain Management For Spinal Headaches
Anyone undergoing a spinal tap or spinal anesthesia is at risk for a spinal headache. This type of headache is usually sudden and severe, requiring pain management in most cases.
The unpleasant complication occurs in roughly 40% of patients and is caused by cerebrospinal fluid leaking from the puncture. The low pressure in the spinal fluid sac causes a severe headache. The issue may also appear in patients that develop a spontaneous leak, without prior invasive procedures.
Women, patients undergoing procedures with multiple or large needles and patients between 18-30 years of age tend to be at higher risk for developing headaches after a lumbar puncture or epidural. A history of this type of complication can also increase risk.
Unfortunately, spinal headaches can appear up to five days after a procedure, so it takes nearly a week before a patient is in the clear.
Primary Treatment for Spinal Headaches
Bed rest is a common treatment, as lying down relieves the headache somewhat. The doctor may insist on bed rest for at least 24 hours, if not longer.
It is important to stay hydrated. Drinking plenty of liquids will help balance the pressure in your spine. Drinking caffeinated beverages is often helpful, as well.
In most cases, the issue will resolve itself within 24 hours, but if the headache persists,
further intervention may be necessary. Each of the other options is somewhat invasive, but can provide relief from the intense pain.
Epidural Blood Patch Procedure
If other methods are not functioning, an epidural blood patch may be the best choice for pain management. The procedure is relatively simple. Blood is taken from the patient’s arm and injected into the puncture site or near it. The patient will need to stay still until the blood has a chance to coagulate and block the leak. A blood patch is effective 90% of the time. When it fails, a second patch is effective 95% of the time.
A patch can be done as an outpatient procedure, as long as someone else is responsible for transportation. The patient will need to rest for at least a day after the patch and should not lift anything heavy or do any strenuous exercises.
Care will also need to be taken to ensure the injection site does not develop an infection. Any type of infection near the spinal cord can be very dangerous. For this reason, the doctor will refuse to do the procedure if the patient is ill.
Other possible methods of easing the pain include injecting saline into the spine, just outside the membrane or giving the patient caffeine via IV. The caffeine constricts blood vessels and relieves pain within a few short hours. The saline injection provides only temporary relief by compressing the spine and blocking the leak. However, the solution is usually absorbed rapidly into the body and the pain starts up again.
A spinal headache is an extremely unpleasant side effect of invasive spinal procedure. Even minor procedures may result in spinal fluid leaks and low pressure. When standard treatments don’t work, the best pain management option is a blood patch.