Epidural Headache

Some Useful Facts About the Spinal or Epidural Headache

The epidural headache is an extremely rare occurrence that can come about following either spinal or epidural anesthesia. Also known as a spinal headache or post-dural puncture headache (PDPH), pregnant women are the group most commonly affected by this complication because the spinal and epidural are frequently used during childbirth. But, again, it is a highly unusual condition that occurs in just 1 percent of anesthetic treatments of this kind.

The epidural headache is caused by a leakage of cerebrospinal fluid that can happen after administration of the spinal or epidural anesthesia. When anesthesia is given via the spinal tap, the tiniest of needles is inserted into the lower back to administer the medicine. Since the hole is almost microscopic, a leak of cerebrospinal fluid is highly unlikely, but it does happen in a very small number of cases.

Cerebrospinal fluid is a protective substance that surrounds the brain and spinal cord, and it is covered by the dura membrane. Whereas the spinal tap actually leaves a tiny hole in the dura, an epidural is not intended to pierce the dural at all. On very rare occasions, the epidural needle will, in fact, puncture the dura in what is known as a “wet tap.” If this occurs, the chance arises for a leak of cerebrospinal fluid.

While there is only a 1 percent chance of the wet tap occurring at all, when it does happen, the chances of suffering from an epidural headache increase to 50-70 percent. This is because the needle that is used for an epidural is much larger than the needle used in a spinal, so the hole created is that much bigger.

The symptoms of an epidural headache are pretty much the same as any other headache, although it may be a bit more severe – more like a migraine than an average run-of-the mill tension headache. Some sufferers find that the pain is worse when they are sitting upright or standing, and then the pain is reduced when they are lying down.

Other symptoms of the epidural or spinal headache may include nausea, neck pain, some hearing problems and short-term disturbances in eyesight, like double vision and being more sensitive to light. Anyone who has suffered from migraines will recognize these as typical symptoms of a migraine headache.

While painful and inconvenient, an epidural headache is not a serious condition and does not require medical treatment or hospital care. This type of headache will generally go away within a couple of days. The most effective treatment is to deal with the symptoms as they come and try to get as much rest as possible. When your head is throbbing and you feel sick to your stomach, bed is usually the favored place to be so this treatment path is fairly easy to go with.


Over-the-counter pain relievers can also be effective to alleviate the headache pain. This includes any brand of acetaminophen or ibuprofen. Some people say that caffeine can also diminish the pain, and they drink caffeinated beverages like coffee, soda and tea when they are stricken.

In very extreme cases when the epidural or spinal headache does not go away on its own, the doctor may recommend an epidural blood patch. This is a relatively simple procedure where the hole in the dura is sealed. Although this is only required in a very small number of cases, it is highly effective in eliminating the headache symptoms.