An epidural headache occurs after you have received an epidural injection. It is also known as spinal headache or post-dural puncture headache (PDPH).
Epidural injections are not just related to childbirth. Healthcare professionals may administer them for several reasons, such as pain management, anesthesia before surgery, spinal cord stimulator placement, and more.
Although the headaches occur as a side effect of the injections, they are not usually serious and go away fairly quickly.
Let’s look at epidural headaches in detail to see how you can deal with them:
What Causes Epidural Headaches?
The spinal column of the body is a massive network of veins, nerves, arteries, and fat, all protected by the spinal bones.
Because of this, healthcare professionals can only inject in either the epidural or subarachnoid spaces.
A needle will have to pass through several layers of skin and muscle, with the epidural space containing mostly air, while the subarachnoid space holds the cerebrospinal fluid (CSF).
The goal behind epidural injections is to access the epidural space without puncturing the dura or the subarachnoid space.
Coming into contact with the dura can lead to leakage of CSF into the spine.
So, an epidural headache is caused by a healthcare professional accidentally puncturing the dura, causing leakage of CSF.
Symptoms of Epidural Headaches
Not everyone gets a headache from an accidental dural puncture.
However, the people that do usually experience:
A headache that becomes worse once they stand up
A dull, throbbing regular pain in the head
Headache symptoms that become intense while lying down
The headache can severely limit your movement but become very difficult to deal with if you’re giving birth and require epidural injections to deal with pain.
Treating an Epidural Headache
The most common treatment for an epidural headache involves transporting blood to the epidural space.
While it may sound odd, an epidural blood patch (EBP) can help relieve pain by taking some blood from a vein and injecting it into the epidural space.
Performing this second epidural injection helps relieve headache symptoms in 61 to 98% of cases, depending on which study you look at.
Furthermore, the relief after an EBP is almost instant, with minimal chances of the headache coming back.
Doctors don’t know why an EBP helps treat epidural headaches.
The most recent theory on EBPs suggests that they increase CSF pressure, which helps heal the puncture faster.
