The Blood Patch: Info You Can Use

| April 20, 2013 | 123 Comments

Updated: July 29, 2016

So you are getting a blood patch for a spinal headache.  What is a blood patch?

This is a procedure performed by anesthesiologists to help relieve a spinal headache, or a “post-dural puncture headache”. The spinal headache is classically described as postural in nature.  When the patient assumes a sitting or standing position, the headache is present or gets worse.  When they are laying down, the headache goes away or is significantly improved.

There are several theories as to why a spinal headache occurs, but it usually is seen after a lumbar puncture or spinal anesthesia.  It can occur after an epidural placement as well.

The thought is that the hole made in the dura to inject spinal medicine or remove spinal fluid for testing, can continue to leak spinal fluid.  This is then thought to cause the brain to “sag” when a patient sits or stands up.  And this phenomenon can translate into a horrible headache.

Another thought is that when a patient assumes a vertical position, there is more pressure in the spinal space, more spinal fluid leaks out, and the vessels in the brain increase in size to compensate.

Regardless of the mechanism of a post-dural puncture headache, if your doctor believes you have a spinal headache, a blood patch may help.

During a blood patch, a small volume of blood drawn from an iv is injected into the epidural space to “patch” the hole in the dura.  I will not attempt to quote statistics, but a blood patch usually helps right away.

This is if the headache is truly a post dural puncture headache.  If the blood patch doesn’t work, it may mean that the headache is from a multitude of other potential causes.

I don’t mention this to downplay the significant discomfort caused by a spinal headache, but rather to alert you that there may be other causes.  And the post dural puncture headache may be hurting you on top of another type of headache as well.

The process for placing a blood patch is similar to that for the placement of a labor epidural.  The added step is that blood is drawn from your iv to be placed into the epidural space.  When the blood is used as the patch, it often will cover the dural hole until it can close on its own.  And hopefully by the time your body absorbs the blood clot that was used as the patch, the hole in the dura will be closed up.

If you have had a post dural puncture headache, or a blood patch, let us know what your experience meant to you.  The hope is that we can learn from you and others can hear what worked for them.

Thanks for stopping by  Please feel free to leave a comment below, contact us, or visit the forum.

Stay healthy!

What General Anesthesia Side Effect have you experienced, if any?

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Category: Anesthesia Topics, Obstetric Anesthesia, Regional Anesthesia

Comments (123)

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  1. jennmeadows says:

    My husband had an epidural for a bulging disk on Monday 2/11. Shortly after his severe headache, neck pain and left shoulder pain started. We were not informed of any possible complications. On Tuesday 2/12 I googled his symptoms and came up with dural puncture so we immediately went to local ER. They performed a blood patch. Gave him Reglan, Lortab 5 and Naproxen to take home. The pain lessened and we returned home. The whole time he stayed in the bed and drank lots of caffeine. The pain increased and on Thursday we returned to the ER. They stated another blood patch could not be performed so they gave him Morphine and Phenegran injections and we went home again. The pain continued and was worse upon sitting and standing since it began. Continued with take home meds and even tried Excedrin Migraine and Goodys powders. Also sporadically taking muscle relaxers. Pain continued through weekend and on Monday 2/18 had an appt with family doctor. He stated pain should be better so direct admit to another hospital. Once admitted they did ct scan that showed no issues. Gave dalaudid, robaxin and lortab in between with no relief. Worse pain than at home. On tuesday 2/19 the did an mri with no issues. Another blood patch was done today. Pain still severe after patch. Hurts to eat sandwich. Not sure why no relief. Please help with answers.

    • Dr Dave says:


      I am sorry to hear about the problems your husband is having after his epidural. And I’m sorry to hear about the “informed consent” issues.

      Let me start off by saying I can’t give you any specific medical advice regarding your husband. But I can try to provide you with some more general medical information so that you can better understand the situation.

      Post dural puncture headaches, although rare, can occur following epidural placement. These headaches are typically postural in nature: they get worse on sitting-up/standing and get better when lying flat.

      Something like 90% of spinal headaches improve following a blood patch. That number jumps to about 95% after a second blood patch.

      And these headaches typically improve on their own, even without a blood patch, within about two weeks.

      If two blood patches have not been successful, it may mean that the headache has a different cause. The CT scan and MRI are sometimes helpful in figuring that out.

      Have his physicians mentioned anything about meningitis? If they were concerned about this, they may decide to do a lumbar puncture. This is a procedure where they take and examine some of the cerebrospinal fluid for signs of infection.

      I am assuming there isn’t a previous history of neurologic disease that could explain some of what’s going on.

      I am also assuming an epidural steroid injection was performed to help with the pain from the bulging disc.

      I’m not sure if you are aware that there was an outbreak of fungal meningitis last fall in patients that had epidural steroid injections. You can read more about it on the CDC’s website here:

      I don’t want to scare you and I am not suggesting that this is what is going on with your husband. It’s impossible for me to know that over the internet.

      But it sounds like you are looking for more information, and that’s what I’ve tried to provide.

      I hope this information is helpful to you. Your husband is in my thoughts and prayers. Please update us on his condition.

      Dr. Dave

      • gwen winkel says:

        Dear Dr. Dave, I’m lying in the hospital in Holland. 9 days ago I had a lumbal punction. One day later my head almost exploded. A strange pressure in my head and on my ear drums occurred. I phoned my neuro surgeon and he said after 5 days to come for a blood patch. They performed bloodwork to look for infections. Had none. The blood patch didn’t release me from the pressure headache and I received a terrible other headache on top of it. Also nerv pains and numbness in face and legs aswell as heat. Now we are on day 10 and it seems that the headache is getting a bit less but the pressure and nerve pains remain. They did a mri with contrast fluid but nothing seemed wrong. No I have to leave the hospital feeling like this. What is wrong with me??? Help me please. Kind regards Gwen

        • David Draghinas says:

          I’m sorry to hear you are doing so poorly.

          Unfortunately, we can not give any specific medical advice through this site.

          It sounds like you have doctors there that are trying to give you good medical care.

          You are in my prayers. I hope you make a full recovery soon.

          Dr Dave

        • Charlie-Mae says:

          Hello I’m wondering how you are now with the pressure and nerve pain? I had a blood patch two days ago… but I can’t lay on my back without pain from the pressure also bottom lip and hand keep going numb and I’m also getting heat like you have explained my email is [email protected]
          If you have 5min I would really appreciate a reply

          Thank you x

    • Melissa says:

      So what happen? How did he recover?
      Same problem here. Blood patch did not work

    • I had a spinal tap 1/20/17 here it is 1/26/17 I have been in massive amounts of been 2 er trips no pain medication sent home cause of the drug epidemic we are in got pain meds there. One doctors visit and tomorrow a blood patch. I can’t stand or sit I just want to scream that’s how bad the pain is. So I hope this blood patch works I haven’t eaten since 1/20/17 cause of the pain. Making a trip up to the bathroom is very painful. Crossing fingers that my guardian angel is with me and something gives.

      • David Draghinas says:

        Praying you feel better soon.

        Dr Dave

      • Traci says:

        How are you now? I’m at Day 6 now and feel slightly better than days 1-4 (which were awful) but still must lie down often. I’m still waiting to improve, but wondering if the blood patch is going to be what I have to do eventually.

  2. I got a spinal headache after 2 out of 3 c-sections. The pain! Wow! I was wearing sunglasses in the hospital room and all lights had to be off and shades drawn, everyone and everything seemed so loud, my head hurt so bad. The sound of my babies crying was enough to bring me to tears too. The second spinal headache was a little different than the first so I didn’t know what was going on until it got very painful and included all of the symptoms (it started with a slight headache which I attributed to surgery and ringing in my ears vs. light sensitivity and instant, major headache of my first one).

    I requested a blood patch both times and while the anesthesiologists weren’t thrilled about doing them, they went ahead and preformed the procedure. I laid down for 25 minutes and the headache vanished! It was like heaven opened up! I was able to bond with my babies better and enjoy lights and sounds again. I had some pain in my thighs after my second blood patch, which stayed for a couple months and was kind of weird feeling; but it was soooo worth it!

    I always wondered if I got the spinal headache because they had a hard time placing the needle before those 2 c-sections. They had to try quite a few times. The only c/s I didn’t get one was when the anesthesiologist got the placement perfectly after 2 tries.

    I always tell my friends if they feel like they are getting one, ask immediately for the blood patch!

    • David Draghinas says:

      Thank you for sharing your experiences. I’m sorry to hear that you’ve had difficult spinals, spinal headaches, and blood patches. Yes, difficulty placing spinals with multiple attempts does increase the chances of getting a spinal headache afterwards.

      And if someone does indeed have a spinal headache, a blood patch is extremely effective in improving the symptoms of the spinal headache.

      Thanks again for your detailed comment.

      Dr. Dave

  3. Irma Hernandez says:

    I have had four epidurals and one blood patch. My headache start during my delivery about 30 mins after the epidural. I gave birth on 3/4 and get the blood patch until Friday 3/7, my headache was so bad I could hardly walk without feeling that my head was going to fall because it felt so heavy, the light and sound bother me. The only thing that made me feel better was laying down complete flat and placing the pillow and covers on my face. The doctor had me drinking caffeine pills coke , Mountain Dew, and tea but that didn’t really help just gave lots of gas which is a little uncomfortable especially after giving birth. So on Friday I finally got the blood patch which I most say took away my headache immediately during the procedure but it was one of the worst pains I have ever felt You feel the blood entering you body the pain goes down your leg and down to your knee. But I guess that the pain was only for no more than 5 mins and the headache was gone however I most say that you do stay with bCk pain or discomfort. Today is Sunday 3/9 and I have feeling back pain and tenderness on my lower back hopefully all of this goes away soon.
    But ladies the blood patch is pain is better than a epidural headache any day!!!! I hope this helps I just want to share what I’m feeling not make it seem as if it were painless

  4. Bobbie Flener says:

    I has an LP done on 8/8/2014 and today is 8/12-2014 and I’m on my way to have a blood patch done. My question is.., is it gonna hurt just as bad as the LP

    • David Draghinas says:


      My hope is that you will have a better experience this time.

      LPs are often performed by physicians other than anesthesiologists. And a different type of needle is typically used for LPs as well.

      Epidural blood patches are performed by anesthesiologists, with a different kind if needle.

      You should see immediate improvements to your spinal head ache with the blood patch.

      Please let us know how it went.

      Dr Dave

  5. Michelle says:

    My son had an LP on 8/14 and still has a headache today. He plays college football. Do you recommend the blood patch? Is it safe? Are there major risks?

    Thanks, Michelle

    • David Draghinas says:

      Hi Michelle,

      An epidural blood patch is the best and fastest-working treatment for a spinal headache. It tends to work almost instantaneously in a vast majority of patients.

      After evaluating your son, if the anesthesiologists believes he has a spinal headache, he/she will offer an epidural blood patch. It has the side effect and risk profile of epidurals. Risks are pretty small for healthy people.

      The difference with a blood patch is that about 20 ml of the patient’s own blood will be sterilely placed in the epidural space.

      As parents, we are always concerned about our children’s health (regardless of their age). In medicine, we always have to consider risks, benefits, and alternatives. If he is still experiencing these headaches, it is worth being evaluated and considering a blood patch.

      Please let us know of any updates. He’s in my thoughts and prayers.

      Dr. Dave

  6. I got an epi (epidural) 5 days ago and have has this head ache for 4 days now! My first epi didn’t work so I ended up getting 2 and im not sure that one even worked because I ended up pushing soon after it was done and still could feel a lot of my birth. They have me 3 bags of fluid in the hospital and it helped until the next day. In my release day I told my doc it was back and I was told to wait it out and come back if it got worce. I went home and could not even sit up long enough to breast feed my baby. I was so sick I couldn’t breath or talk from the pain. I went to the E.r. and got the blood patch done. That worked for 1 day and it was back agen! When I got the patch done they too missed the first time. So I now have 4 epi holes in my back. Last night the head ache got unmanageable once more so I went back to the E.r. And got meds though an iv. That only worked over night. Im so annoyed and just want to be able to enjoy our new baby and relax at home. Im loosing all hope that this is fixable!

    • Jordyn Jones says:

      Hi, I’m reading through all of these comments to see if anybody went through what I’m currently going through and your case is almost identical to mine!! I know it’s been almost a year for you but how long did the pain last? I’m losing all hope that I will never get better!

      • Rachael says:

        I’m in your same boat too. A really bad epidural, followed by a second attempt – a blood patch the next day & a second needed 4 days later.
        For months I had pain pouring in diff areas of my head as I looked up or down or to the sides too long. I drank tons of caffeine & water- which helped but didn’t fix.
        After 5 months I tried a few days without caffeine. It was terrible- my neck felt so sore & locked in place- with searing pain in my neck/shoulders/head anytime I looked anywhere but straight ahead.
        I begged ER for third blood patch. It was tough the first couple weeks- dizzy/pressure, lower back pain from that 5th hole, etc. but it helped.
        After 3rd patch, Still not back to normal but can look other directions longer. Pain still there but lighter. Soreness in shoulders & neck not as constant as it was….maybe another patch could help you some too?
        Looking forward to when someone writes – they found the answer to being completely normal again!

        Thanks again Dr Dave for giving us a place to connect with others!

        • Jordyn Jones says:

          Thank you so much for your reply! I’m beginning to get depressed because all I want to do is take care of 2 little girls and I can’t and I’m sick to my stomach about it…I’m going to call tomorrow and beg the them to do just 1 more blood patch at this point I am willing to do anything to feel better!

          • Rachael says:

            I so understand exactly how you are feeling.
            I should warn you- for me the 3rd was a tougher recovery, sore across my whole lower back & a lot of dizziness & pressure in my head for the first week or so. But to be any better, it was well worth it to me…just wish it could have gotten me all the way there. Praying you get to 100% Jordyn!!!

        • David Draghinas says:


          Thank you for sharing your experience with the rest of the community here. I am sorry to hear yours was such a tough recovery.

          Dr Dave

        • Kelly says:

          Any relief yet???? My story matches your exactly!! Going on 3 weeks after my second blood patch and still have the pressure and pain when turning my head. Please let me know if you’ve had any relief. I’m starting to think there is no hope.

  7. Kim says:

    Has anyone ever been sedated during blood patch or is it even an option?? I have yo be sedated during epidural injections and same with the lumbar puncture I just had for a myelogram….thanks

    • David Draghinas says:

      Hi Kim,

      Patients are not sedated during epidural blood patch placement. The procedure is very similar to someone getting an epidural for labor, except the patient’s own sterile blood is given into the epidural space once it has been reached.

      Your anesthesiologist will likely want to communicate with you during the epidural placement.

      Dr. Dave

  8. Bridgette says:

    I had my son 4 days ago, while recieving my epi the dr punctured my dura…immediate numbness in my lower body and headache. They told me to just try and relax and it would more than likely fix on its own. He came back after the birth and did a blood patch with 10ccs of my blood and told me to stay in one position for 30 mins. About 6 hours later severe headache came back along with pain in my neck and ringing in my ears. The anesthesiologist came back and performed a second blood patch. This time with 20ccs of my blood and I had to lie completely flat for 3 hours. Relief came and the only thing left was the ringing which went away by the end of the day. Then starting this morning the headache is back and so is the ringing and discomfort in my neck…I’m thinking that it’s still just healing because the pain isn’t as near as bad as the other night. Should I be concerned that the second patch didn’t work either?

    • David Draghinas says:

      I’m sorry to hear about your difficult experiences, Bridgette.

      The first blood patch is successful in something like 90% of the time. The success rate goes even higher after the second blood patch.

      Hopefully, you are feeling much better by now. I know having this kind of head ache and trying to care for a newborn can be so hard.

      You are in my thoughts and prayers.

      Dr. Dave

  9. R E French says:

    I hope you can help. I had a PDPH after having my first child last year. I had three unsuccessful blood patches and needed up having to lie horizontal for two weeks before the headache improved and I could sit up. It was really unspeakably painful. Anyway I am due to have my second baby in January. Will the same thing happen if I have an epidural or will I have the same chance as I did the first time? There is possibility I need to have a c section and I am worried again that if epidural is needed for this I will be flat on my back with the headache again. Are you more likely to have a puncture if you have already and had failed blood patches? I look forward to hearing your reply. Many thanks

    • David Draghinas says:

      Spinal headaches following epidurals is pretty rare, typically less than 1% risk. I can’t speak specifically to your case as I’m not sure what caused the PDPH in the first place.

      If you have a scheduled c/s, your anesthesiologist may choose spinal anesthesia. A spinal is placed with a smaller and different kind of needle. They rarely lead to spinal headaches.

      Best of luck to you, and be sure to let your anesthesiologist know about all the difficulties you’ve experienced in the past. I am praying for a safe and smooth experience this time around!

      Dr. Dave

  10. Sara W. says:

    Hi Dr. Dave,
    I had a bed side lumbar puncture in Jan 2014 where the doctor poked me no less than eight times. I had never had a lumbar puncture so was not aware at the time that this is not good. The next day the hospital neurologist ordered a CT Myelogram and big surprise, it showed five bilateral leaks from L1 all the way to S1. Fast forward almost a year, two more myelograms and three blood patches later and I am still suffering with orthostatic headaches and host of neurological symptoms. Could one of the punctures not have healed but is not showing on diagnostic imaging any longer? Sara

    • David Draghinas says:

      Hi Sara,

      So sorry to hear about all the difficulties you’ve been having. It could be possible that one of the leaks is not showing up on imaging. And I’m sure you understand the other neurologic symptoms complicates the medical picture.

      The best course is probably to work with a physician that knows you very well and give him/her a detailed history of all the symptoms you are experiencing.

      You are definitely in my thoughts and prayers.

      Dr. Dave

  11. Muzna says:

    I got c sections. 1/25. The anesthesia dr was having hard time he poked 2-3 times and than told me there is a bulge between my disc. 1/26 hospital staff told me get up move around and there was the killer headache. I was prescribed pain meds for c section but those meds were having no effect on headaches. Finally spoke with anesthesiologist night of 1/26 he recommended laying flat for 6 hours with pain meds and it should go away and if it doesn’t than they can do spinal. So 1/27 in morning I felt better after sleep but as I got up it was still there. Got blood patch in afternoon 1/27 and laid in bed for 3 hrs. It’s definately better but still eyes are little sensitive to light and little pain in neck but nothing compare to what I had. I m thinking. May be my migraine got triggered. Or the spinal pain was so bad that it’s taking time to go away.

    • Joe Jackson says:


      I’m glad you were finally able to get some relief. It certainly sounds as if you may have had a post dural puncture headache which was at least partially treated with a blood patch. Also, it is possible that you experienced a headache from other causes such as a migraine.

      How are you feeling now? How long did it take for the headache to resolve? How is your baby doing?

  12. Jenny says:

    Hi. I hope I’m in the right forum. I had two ESI’s on January 12, 2015. One @ T9-10 and one caudal approach at L5-S1. One week post injections I developed a headache. Two days later, dizziness, ringing in my ears, and nausea. Dr suspected Csf leak. Did an EBP at Thoracic level. Headache went away 2 days later but all other symptoms still remain. The ringing in my ears and dizziness are horrible. I’ve required help for 3 weeks to care for my boys. I’m scheduled for another EBP next Wednesday. The reason for the wait is that I have a cold and the dr was concerned about the blood injection if I was ill. Am I on the right path with doing another blood patch? and should we repatch the thoracic or just attempt lumbar this time? Any info would be appreciated. Thank you.

  13. Sana says:

    I gave birth to my first baby on aug 31 ,2014, had epidural with success, no complications. But since december i have been having excruciating pains in my head! They gelt like migraine cuz they were on left side only. But for the last 15 days they have involved the right side, both eyes ears n my nevk as well! My neurologist thinks i may have a chronic epidural leak! Is it possible? Like after almost 5.5 months post delivery?? She wants me to get evaluated for a blood patch, im afraid of the procedure by reading all the reviews of this procedure:/ plus i have no help with the baby i dont think il be able to lie still for 24 hours or so, im also travelling bck to my country by end of march im afraid! Bug i so want to get rid of these headaches!!! Im seriously bed ridden for the last 3 days please guide me

    • Jenny says:

      Sana- I’m so sorry you’re going through this. I know how hard it is. Yesterday was the first somewhat normal day I’ve had in six weeks. In my opinion, it does sounds like a possible CSF leak. If I were you, I’d ask your neurologist to order an MRI of the brain with contrast. I’d do that for a few reasons: your brain will show characteristics of low pressure/Csf leak (and you’d know if you need the patch), and it will rule out anything major that could be going on and you don’t have to lie flat for 24 hours.

      Blood patches are great if they work. I had 2 with no success. But many people have had great results with them. Personally, I’m not afraid of them, even after they didn’t work. My neurologist said that he has had patients with the same symptoms as ours for over a year. Scary, I know. But at this point you’ve got 3 options: 1. Brain scan with contrast, 2. Try the blood patch, 3. Wait it out.

      Let me know if you have any other questions. I’m happy to walk with you in this process. Hang in there.


      • Sana says:

        Hey Jenny,
        Thanks for the reply first of all, it feels great to have people who truly understand what you are going thru. Yes its confirmed now that i do have the epidural headache or as they say LOW CSF PRSSURE HEADACHE! My God these are painful as hell. Went to another neurologist n he prescribed naproxen n caffaine for 7 days plus hydration, but he says il have to get a blood patch if conservative management fails :/ im startimg the meds right now, n will be praying hard that it works.
        Thanks, i did have MRI with contrast n MRA last sunday, both came back normal, no evidence of low csf, may be my csf volume aren’t that low to be visible on mri, but they sure are giving me a hard time living a normal life.
        Will post my progress, for now can you please tell why you think your blood patches dint work? Are these painful? And whats your current management? I have heard people need several if one doesn’t work so if your neurologist is sure you have a leak you should get another patch done, its a blind procedure you never know when it hits the right spot!
        Feel better 🙂

        • Jenny says:

          Hey! Are the meds helping at all?? Hopefully they are taking the edge off. Glad you had the MRI to be on the safe side.

          I don’t think the blood patches worked for me because my symptoms remained. I do, however, recommend you give the blood patch a try if the meds don’t work. I think they are highly successful for most people. For me, there was no pain with that procedure at all because I requested sedation with both patches. As far as it being a blind procedure, from what I understand to be true, I believe as long as you inject at or below the original injection site, it will cover any leaks throughout the spine. For example, people with a cervical leak, get injections at the lumbar level and get relief.

          I’m still experiencing some of the weirdness in my head and behind my eyes and some nausea. But, my headaches are completely gone. So it’s hard to know for sure, but I think time is my alliance. Each day gets a little better. If the meds aren’t working, I really think you should try the patch. Praying for you!

  14. Sana says:

    So today’s my last day of the medications my neurologist prescribed, n fortunately im
    Feeling much better(not completely ok tho) but yes 70-75% better than before, the pressure over my eyes n ears is gone completely, and the headache is now confined to just one side(left side of my head where it actually started in december) m taking caffaine lots of fluids n laying in bed all the time n its helped alot. Still waiting for my MRV to be done, i hope it comes back normal. I still don’t know what to do :/ can’t afford a blood patch as il be travelling to my country by the end of this month, i fear what if it failed , seriously m at a loss

  15. Sana says:

    Plus jenny do ask your doctor if he can prescribe you FIORICET. One of my friends worked at sloan kettering hospital nyc, she said they used thia with success in a pt with two failed blood patches. It has acetamenophen n caffaine with some barbiturate drug. Im going to discuss this alternative with my neurologist n pain specialist. I want to be normal again 🙁 missing out on life alot including my 6month baby :/
    Good luck to us!

  16. Tristan says:

    I had a blood patch yesterday after an LP and felt almost immediate relief. Today i look a nap and when I sat up the spinal headache hit me again. Im not sure if i should seek another blood patch or if this is normal

    • David Draghinas says:


      Sometimes a second blood patch is necessary. It is kind of up to you and how debilitating your headache is for you.

      Dr. Dave

  17. candace says:

    Hi. I had a blood patch after my second baby in September of 2014 due to an epidural and spinal leak causing headaches and here almost 7 months later I have headached along with back pain. didnt know if blood patches can come undone and if it would still affect me this long after?

    • David Draghinas says:


      It would be very atypical to have a spinal headache this far out.

      Remember, spinal headaches usually get better when lying flat and get worse upon standing. You may want to discuss your symptoms with your physician to figure out what’s going on.

      Dr. Dave

    • Rachael says:

      First off -thank you Dr.Dave for giving us a place to go to discuss all this, and responding to each of us!
      Candace – if misery likes company it sounds like you & I are together. I’m Rachael from below.
      I actually wrote my last entry after days of constant soreness in my neck & shoulders & pain pouring in my head in diff places every time I looked down or turned my head to the sides. My husband didn’t let me wait for a response on here – after 4 1/2 months of dealing with this in diff levels of soreness & pain – he dragged me to the ER to beg for a blood patch. After a lot of other tests, they let me give it a try. When I sat back up…it was diff. The constant ache in my neck & shoulders gone, & the pain replaced by pressure & dizziness in my head, and of course my back hurt like the dickens from the injection.
      The first week after was a lot of pressure & dizziness & some of the old pain.
      The next 2 weeks have been…better. I wish I could say it’s gone-it’s still there- but it’s less. Less soreness in the shoulders & neck. Shorter waves of pain in my head, less often. I can’t guarantee it’ll be the answer…but it did help me a lot. It took a good 4 days of healing for my back & for the dizziness to subside. Prob cost a couple thousand in that ER visit factoring in the MRI & all the other tests, and now I’m glad I did it. Though I’m still not 100% – it got me to better.
      Hope this helps you! 7 months is too long. I understand!

      • David Draghinas says:

        Thanks again for sharing your experience, Rachael.

        We are praying for your full recovery.

        Dr Dave

  18. Rachael says:

    In having my 5th baby I had a 40 min attempt at an epidural that didn’t work. They gave me a second epidural that was great – til they tipped me up- throwing up- dizzy- jack hammer in my head. I got a blood patch which immediately helped but didn’t heal completely. 24 hours later it was back in full.
    I drank fluids, laid flat for 3 days with my newborn & made no improvement. Had second blood patch, which helped tons-I was able to stand up again, but still wasn’t normal.
    I’ve been trying the ‘time will heal’ drinking caffeine & water & taking it easy for over 4 months now, and it’s still there. Some days better than others – but if I turn my head to the sides or look down I’m dizzy, pain pours into my head, my neck & shoulders continue to get sore, and it throbs near my epidural site.
    What do you think? A third blood patch?

    • David Draghinas says:

      Hi Rachael,

      I’m sorry you had a difficult epidural experience.

      I’m not sure your current symptoms are related to a spinal headache. It would be best to discuss these issues with a physician that knows your medical history well.

      I hope you feel better soon!

      Dr. Dave

  19. Jessica says:

    I had an LP to rule out meningitis due to a severe headache, stiff neck and a fever on 4/16/15. All testing came back negative, thankfully. I was discharged from the ER and sent home very medicated and a script for dilaudid. Within 24 hours my original headache/migraine was gone but I then developed a spinal headache. I went back to the ER on 4/20 and was there from 6pm until 2am. The ER manager called the on call anesthesiologist to do a blood patch and he refused and said I just needed to wait until tomorrow. The actual doctor called him to ask him personally to come in, and again he refused. So I was discharged and asked to returned in the morning. I called and was told to go in at 9am to the same day unit. He started doing the blood patch and I instantly felt a sharp pain from my lower back down my left leg to my knee. So he stopped and repositioned the needle, at this point I’m literally screaming and crying from the horrible pain. He then must’ve hit a nerve on right side but this time he didn’t reposition the needle and proceeded to inject 30cc’s of my blood. The entire time I was begging them (my hubby and the nurses) to make him stop. Once it was done, he told me I needed to stop stressing. He informed the nurse to watch me for 20 minutes and then I could be discharged. I kept telling the nurse and the Dr that my entire lower back all the way to my knees were in pain. Nothing was done but telling me to stop stressing because I was making it worse. OK so now I’m 8 days post blood patch and I still have pain that radiates down either both sides at a time or sometimes just one side. If I move a certain way or bend a certain way or if the wind blows the wrong way I’m in pain. When will this pain go away? Any advice or recommendations is greatly appreciated.

    • David Draghinas says:


      I’m sorry to hear about your traumatic experiences. This is definitely not typical behavior.

      Not typical behavior of anesthesiologists refusing to come and perform blood patches. And not typical to have the type of pain you describe during and after the epidural blood patch placement.

      I pray and hope for your full recovery.

      Dr Dave

      • Jessica says:

        Thank you Dr. Dave, almost a month out and I still have back pain that radiates down my right side with an occasional pain down my left side. The LP site is still tender to the touch also. I don’t know what to do.

  20. Michellr says:

    I recently ( 6 weeks) went to chiropractor and had a neck adjustment – bad call. I since have has a blood patch after 51/2 weeks and it was done in the lumbar spine. Mri/mra did not show exactly where the leak was but the dr is certain it’s in the neck. He did 25cc of a blood patch hoping it would be enough to reach the area. Day after I still had a headache though not as severe. By the third day the headache is gone however I still feel clogged in my ears and just not right. Can a blood patch take this long to clot and can the symptoms take longer to go away? I was told and read ” immediate” relief but am wondering if that depends on where the tear is and how long etc? I don’t want to go through a ct mylogram and another patch of this can take longer to feel all the affects.
    Thank you

    • David Draghinas says:

      Hi Michelle,

      I am not familiar with blood patches being used after chiropractor neck adjustments.

      Are you getting a lumbar (low back) epidural blood patch to treat a possible cervical (neck) dural leak?

      • Michelle says:

        Sorry- neurology and dr thinks the chiropractic adjustment caused the neck leak.
        I’ve had a lumbar blood patch of 25 cc hoping to reach the neck. I’ve had some relief but not complete instant relief that i read about. Does this sometimes take more time for complete relief and also I’ve read that a second patch possibly will do the trick ?

        • David Draghinas says:

          Hi Michelle,

          I don’t have experience with blood patches trying to fix cervical leaks. Part of our understanding of how blood patches work, however, is the concept that the blood patch “plugs” the leak.

          I imagine this is more difficult to accomplish with a cervical leak, and may explain your partial relief.

          I hope you feel better soon.

          Dr Dave

  21. Lisa Simmons says:

    I had a caudal spinal injections May 14th that resulted in a spinal headache. I have had numerous injections with no issues. But this time was different. I went into the ER and had the first of 2 blood patches which resulted in almost immediate relief. After about 2 days, the headache returned at which time I had the second blood patch with no relief. I was hospitalized and numerous test ran. MRI’s, blood work, and lots of meds. Test results were all normal. But to this day I still have intermittent headaches. I have returned to work and I seriously hope that they eventually go away. I was told that my headache was possibly a migraine. But, I have never had migraine headaches nor did I have headaches previous to the procedure. I’m seriously considering going to see another neurologist for a second opinion. The headaches aren’t severe like they were but they haven’t completly gone away.

  22. K says:

    Just now coming across this site and thought I’d share my blood patch story. On April 22, 2014 I had a scheduled csection. I allowed a student to administer the epidural and I remember him taking a while and an anesthesiologist asking him if he was okay. I didn’t think anything of it though.

    My daughter was born at 2:00 and by 6:00 or so I got this crazy headache. I was told it was from all the drugs and coming off of anesthesia. The next morning when the nurses got me up to shower I started feeling nauseous and realized I was about to pass out. Once again, they blamed the anesthesia. From there on, I would feel nauseous any time I stood up and the headaches would come and go. But light didn’t bother me. I did not get to walk that day as I was supposed to. The nausea and headaches continued and the nurses said there was no way it could’ve been a spinal headache. I was told it was very rare.

    On the fourth day the anesthesiologist came to speak with me, but was not convinced I needed one bc he thought the light should be bothering me and I should be in terrible pain. It was up to me though. I was going to be discharged that day and was given my meds and then the nausea started up again. I left the hospital miserable thinking it was all because of the medicine.

    When we got home I did not take any pain meds. But my headaches were worse and I started feeling pressure in my head. Like my ears needed popping. My midwife was concerned and had me return to the hospital. After ruling out pre-eclampsia (my blood pressure was up when I called her) I got the blood patch. I felt immediate relief.

    It was very painful, but it was so worth it. Unfortunately my c section recovery was a long road. I believe that spinal headache set me back as I had the hardest time becoming more mobile again. It took me six weeks to where I started to feel good, bending and walking faster.

    I do have a bulged disc in my lumbar region from a car accident. Is it possible that could’ve been why this happened in the first place? I can’t blame the student because I think it could happen to anyone. This whole time I thought I was a big whimp and that’s why my recovery was so slow, but I’m starting to think otherwise. Other friends with recent c sections bounced back right away. What’s the likelyhood of this happening again?

  23. Jordyn Jones says:

    My epi turned into a spinal tap and omg was that painful!! The next morning was when all the horror started! I had the absolute worst spinal headache of my life! I couldn’t even sit up to breast feed! The nurse had to take care of my new born which made me feel AWFUL! Woke up the 3rd day not able to move! Only relief I got was laying down so they agreed to do a blood patch on me which gave me immediate relief and I was so happy! I didn’t take it easy the next day like I should have I went right back to being a mommy to a toddler and a newborn! I stayed very busy which was a bad idea because that night my legs buckled and shooting pain took over my back! My blood patch came unplugged and I woke up at 3am not being able to handle the pain I was in so I made my husband rush me to the ER! They drugged me up and gave me another blood patch…this one didn’t give me immediate relief but later started getting better! The next morning my headache was right back along with awful back pains! I know it’s the spinal headache because I only get relief laying down! Will I heal up on my own? I really want to avoid going down to the pain center and getting an MRI as the doc said would probably have to happen if it didn’t get better! I just want this pain over with I want to be mommy again I absolutely hate not being able to take care of my kiddos 🙁

    • David Draghinas says:


      I am sorry to hear your experience has been so miserable.

      Spinal headaches can be very debilitating. Eventually, they do heal. My hope is that you get back to normal as quickly as possible.

      You’re in my thoughts and prayers.

      Dr Dave

  24. rob09766 says:

    I had a ct myelogram to better image nerve compression from some bulging lumbar discs. After 2 days, the burning headache on top of head when vertical. It added painful pressure and ringing in my ears, and eventually shaky hands.
    After 2 blood patches worked for only about 3 days, and several er visits as new symptoms mimic stroke and they don’t resolve completely, I’m now over a month in. Ive been given gabepentin and told to be as active as possible, but lay when neuroligical symptoms hit.
    I can’t be vertical more than 20 minutes at a time for 0-3 hours total a day. On bad days symptoms never fade completely, and I have attacks where the headache is 10/10 and half or all of face and body will be numb/burning for 10m to an hour.
    Lately every day is a bad day. I’m afraid to move as it triggers pain. Hellish month. At er they do nothing.
    So much bedrest, caffeine, Gatorade water, pain, and concerning neurological symptoms!

  25. D A S says:

    I had my hip replaced in july & it went well , but after coming home 2 days later I developed an epidural leak . I went to local ER. And they transfer me back to the hospital that did the surgery for a blood patch to fix . The issue is the same Anastasiaolgst that did the surgery preformed it without reading my chart first to see I was givin heprin a blood thinner 4 hours before he gave me the patch! I am now battling all kinds of nuralogical symptoms that nobody knows how to fix! This has been a nightmare & I feel alone!

    • DAS says:

      An update on my epidural leak & blood patch . I ended up starting to have seizures and was diagnosed with ninth nerve damage , I take seizure medication 3 times a day & still have neurological symptoms today . I go to therapy once a week & would say I’m 80% of what I was before this happened to me . The damage to my nerve is a rare condition & my neurologist has no idea why it happened. I know it happened from the blood patch given to me while on blood thinners .

  26. Kendal says:

    Hi! I had a blood patch done two days ago and I did receive some relief. I left the hospital yesterday and woke up in the middle of the night with what seems like a pressure headache and ringing in the ears.are these pretty common side affects from having a spinal leak that will deminish in time? The headache is not severe like I had and when I take motrin it pretty much goes away but does return when the medicine wears off. I just don’t know if this is normal or should I attempt a second patch?

    • Cami says:

      Kendal my story is exactly like yours I had a lumbar puncture and got extreme bad spinal headaches, I had an epidural blood patch 5 days ago my ears feel stuffed and my head hurts when I sit or stand but taking excedrin help and it’s only when the medicine wears off it I feel it again was this normal for you and did it go away if so how long or did you attempt to second patch

  27. Dave says:

    Had a LP done Tuesday to check for possible meningitis when I arrived at the ER with migraine/sinus pressure. I left the ER feeling ten times worse than what I had upon arrival. It was “sinus disease” as my diagnosis. After two more visits to the ER from the headaches they gave me a blood patch was done on Friday. I immediately felt relief and could move my neck and head. I was told to go home and lay flat and rest. I have since done so but I am still feeling mild to moderate headaches after day 1 in the same areas as before and am unsure if this means the patch did not take or it needs more time. I also can not sit or stand up without becoming light headed and wanting to pass out. Since I was sedated I don’t know a lot of what to expect or what to do I just wish they had never given me the LP/spinal tap and am honestly scared and wish I knew what to do or expect next since the headaches are coming back already.

  28. Miranda says:

    I had a lumbar puncture on 12/29/15 and suffered from a post-dural spinal headache two days later. They did a blood patch while I was in the ER but it had little effect, so I was admitted so I could get complete bed rest. I had to drink lots and lots of caffeine, they treated me with Percocet and had to lie flat on my back. I was in the hospital for a solid week. My dr’s kept discussing whether or not to do another blood patch but they never did. They just monitored me. I started having real bad dizzy spells while in the hospital and I’m still having them. I’ve been asked if its vertigo, but it’s not because the room doesn’t spin. (I’ve experienced that before.) I just get real dizzy and light headed a lot. It also feels like I have a bulge inside my back where they did the blood patch and it is extremely painful. I didn’t realize my back would be this sore this long. I’ll be glad when these dizzy spells and the pain in my back goes away, but I’m definitely thankful that massive headache is gone!

  29. Vanity says:

    I had an epidural and intrathecal done, one right after the other, 4 days ago when I had my daughter. Neither worked but I ended up with a spinal headache. I’ve had 4 previous epidurals & never had the issues I’m dealing with now. I got a blood patch the day after I had my daughter and it worked great for 2 days but now the headache is back. I had to go to the e.r. yesterday for pain meds in an i.v. and they helped for a while but the headache is still here. I’m so hurt I’m literally crying in pain..nothing helps, I’ve done caffeine, lots of water, tylenol, etc. I don’t know what to do? I just want to be able to care for my kids. .they need me and I’m here in pain from this miserable spinal headache. I just want relief soon! I’m debating if I should do a 2nd blood patch or see what other options I have? Will this headache ever go away?

  30. Tiffany says:

    I have had two lumbar puctures and both times had to have a blood patch done. Yesterday was my third lumbar puncture and again have the awful headache, they have scheduled me to have a blood patch done again tomorrow. My concern is that my low back is in a lot of pain. Do they ever semi-sedate you so your not in as much pain?

  31. Desiree Fritcha says:

    I know you cannot give medical advice, but suggestions are more than appreciated!! And I apologize for the length, but want to get all the details in.
    On 3/7/16, I awoke with an extremely stiff neck, unable to look very far left or raise my left arm above chest height w/o great pain. I went to my chiropractor, who hooked me up to the tens machine, applied warm heat and did more stretching than any kind of manipulation. By 2pm I felt a migraine coming, took a Relpax, and had my husband take me back to the chiropractor as the neck pain was back and extending around the back of my neck, not just the left side. He worked pressure points and did more stretching, he said I was too tight and didn’t want to make things worse. The Relpax failed to stop the migraine, but maybe delayed the onset for an hour. I went home to a dark, silent room and slept for 3 hours. Upon waking I was “normal”; but w/in 30-45 mins migraine and neck pain were back in full force, plus eventual vomiting. After 4 hours and vomiting 6 times my husband took me to the ER. The migraine was an 8 out of 10. They started IV fluids, Phenergan, flexeril, topamax and benadryl. Dr wanted to relax the left neck muscle as it was rigid and he believed causing my migraine. When the flexeril did not work he pushed dilaudid, and that finally seem to break everything, and I was sent home. For the next 5 days I battled with migraines and vertigo. (I would say for the past 4-6 months prior I estimate I had daily mild headaches 4 days a week; something I attributed to typing, posture, fluorescent lighting, etc… have had migraines, without auras, in the past but hadn’t had one in almost 6 years. After a partial hysterectomy the migraines ceased.)
    I went to my allergist on 3/8, 3/10, an 3/11 for either shots or an IV of the typical migraine cocktail, plus antibiotics and steroids for a sinus infection, even though I had no congestion or pressure in my sinus cavaties.
    On 3/12/16, I again was in the ER with migraines, with auras, vision “fuzziness” for a lack of better description and vertigo. I felt as if my head was 80lbs and trying to make its way to the floor through my neck, while the floor appeared to be coming up at me. I even had issues with speech, it was taking real effort to put my thoughts into words. A CT scan was done and normal. Another migraine cocktail, and I was discharged and sent home with RX’s Tramadol, Zofran, and Meclizine. The ER Dr suggested I follow up with a neurologist; the earliest appt I got was for 4/22. The cycles continued and escalated and I ended up in the ER, in a different hospital, on 3/17/16. Doc said that Neuro Dr would want an MRI when I finally got to him, so let’s do it now. The initial scan found an 8mm nodule on my pineal gland, and the neurosurgeon consulted ordered another MRI w/ contrast, and wanted to see me in his office on 3/22/16. Neurosurgeon said it was just an asymptomatic cyst, which we would monitor, but not my issue. He referred me to a neurologist in the same practice, who saw me the same day. Neurologist said I was suffering from a status migraine, he admitted me to the hospital, and told me not to leave the hospital until I was headache free. 2 days later I went home. By the next day the cycle was back; I would ready ready for work, but less than 2 hours in I was unable to function. Sit or stand and I was toast, keep horizontal and I feel good.
    An MRI of my neck was done, clean.
    On 3/31/16, a LP was preformed and found I had very low CSF. I was on my stomach for the procedure and the table had to be raised to an almost standing position for a pressure reading and sample taken. CSF was clear and normal.
    Like many people, I have had to maneuver and sometimes be very persistent with my neuro office, as they are very busy, and at this particular week, on spring break with their families . After some assertiveness, tears, and having to lay down in their waiting room for an hour, a Dr finally ordered a blood patch for the next day.
    On 4/6/16, I had my patch; due to varying circumstances, including my veins not cooperating, the Anesthesiologist had to insert the epidural needle 3 different times before the procedure was complete.
    Here are my questions (whew, finally, right!?):
    1. No leak location was ever located, they just applied the patch at the LP site. This patch will only be a success IF the original leak was close by, correct?
    2. Could the 3 punctures done at the time of the patch, all appear to be within 1″ of one another, cause another leak to contend with…or would those have been resolved by the eventual successful patch?
    I felt immediate relief, the vision and vertigo were gone and I went home that day with just a plain Jane headache! I have taken it easy, and while the vertigo has not returned, my plain headache is starting to resemble the battle of the past month. It’s typically on the right side, feels like a bowling bowl mated with a vice, and a burning across the back of my head. It’s 4/8/16, and I did an easy trip to the grocery store, no heavy lifting or driving, just walking and basic functions. I had to lay down, I had that slightly intoxicated, detached feeling, along with a headache that burned in the back.
    3. If the blood patch was a success, should I be having these issues again? Did I just do too much?
    4. Am I correct in my understanding that an incorrectly placed patch can provide temporary relieve because the inserted blood creates additional pressure on the spine, sending more CSF to the brain?
    5. If it were you, how long would you give a similar situation before contacting either your neuro or anesthesiologist about another patch or another option?

    Thank you for taking the time to read this, and I appreciate any suggestions!

  32. delilah says:

    Please I need some expert opinion for my case is quite unusual. Now am stuck in Paris by myself almost unable to sit or stand for the ninth week and public health system here is terrible

    they gave me a lumbar puncture on March 7 to be sure I had no encephalitis because of my V1 zoster that started a month earlier. They said no risk whatsoever for a spinal tap.

    two days later I had stabbing in my forehead and five days after I thought was about to have a seizure after hailing a cab and sitting in after walking.the second week I tried bed rest and ever since haven’t been able to stand or sit. As soon as I do my head pulls down from my ears I get tachycardia to 180 that goes down immediately to 80 when I lie back.

    As if my sinuses are burning and stretching. Had brain and spine rmi 3 and 4 weeks no gadolinium nothing unusual. Am almost handicaped can barely go to the shower for 3 min. Lying all the time going crazy.

    can’t even stay seated more than 5 minutes to go to the airport and fly back home to get a valuable neurosurgical help. Now getting vertigo even lying down and stomach bitterness and electric vision and weird smell in my nose.

    they are offering a blind blood patch next Tuesday 9 weeks post LP Should I go for it?
    Am a pro dancer with an oversensitivebody. So helpless now

    • David Draghinas says:

      As we’ve stated many times, we can not give any medical advice to anyone through this site. This site is informational only. I am praying and hoping you feel better soon.

      Dr Dave

  33. Gary Soloff says:

    So as i read all these posts I am beginning to feel that the 90/95 percent success rate of an EBP is overstated. I have read many case studies and all research is pointing to this but from what I have read and how I feel I am not confident in the research. I had an ESI for a disc extrusion. When I came out of anesthesia my dr said he was unable to do the L5/S1 and approached it caudally. His attempt caused a dural puncture at 5/s1. I have had two EBP’s one on 6/3 at L4/5 16cc at the ER and a second with my pain doc caudally on 6/7 25cc. After second one headache abated as did tinitus breifly, but next day they came back. Dr has said I just need to wait they always heel, meanwhile I am on Fioricet and flat out in bed, so frustrating!

    • David Draghinas says:

      I’m sorry to hear about your experience. Remember, most people that get good relief from an epidural blood patch do not go searching for information online about the procedure. So there’s a bit of a selection bias on the folks who find our site. Praying for you to feel better soon.

      Dr Dave

  34. Ang says:

    Hello. I had a LP done on Wed and immediately had a spinal headache. On Sat they ended up doing a blood patch and the spinal headache immediately went away; however, I am still experience a lot of pressure in the top of my head. If I even slightly bend down I get very light headed. I also have to get up very slowy from a sitting position or I get light headed. Is this normal after a blood patch? I am concerned that something is wrong. Any advice would be greatly appreciated.

  35. Kitty Jimenez says:

    Please some guidance, my 13 year old daughter had epidural pain injections 8/2, followed by severe headaches, then blood patch on 8/5, with some relief, now 8/7 headaches are returning, she has a collagen defficency autoimmune disease, so less clotting abilities, how can I help her? Dr. Didn’t tell her to take it easy but she is not very active as she has compound spinal fractures. Help.. pleSe.

    • David Draghinas says:


      I’m sorry to hear your daughter is not doing well. It sounds like her medical history is complex. Best thing to do is to stay in close communication with her physicians as they know her medical history best and are in position to help her.

      She is in our thoughts and prayers.

      Dr Dave

    • Vanity says:

      She could get a 2nd blood patch but I dont recommend it. At my local e.r. they would not do a 2nd blood patch even though I begged for it. I had to wait it out, my spinal headache lasted a week and finally went away slowly. I know your daughter is in awful pain & its hard to see her suffer but it will eventually go away, just be patient. My dr said doing a 2nd blood patch can cause another spinal headache because you are getting poked again. I hope she finds relief soon. You can read my story above, thankfully I’m completely fine now & back to normal.

  36. Joanne says:

    Hi I have dizziness and sometimes headache, particularly when moving – have been told I have Idiopathic Intracranial Hypertension – which has come on spontaneously. Have been advised to have a blood patch. Is this advisable?

    • David Draghinas says:

      Hi Joanne,

      Lumbar punctures are done to examine the CSF (cerebrospinal fluid) in patients with Idiopathic Intracranial Hypertension. Apparently, serial lumbar punctures are sometimes done as treatment as well.

      I am not aware of blood patches as treatment for this disease, however, I am by no means an expert in this area.

      Best of luck to you,

      Dr Dave

  37. Christine N says:

    I had an epidural done (attempted twice with success the second time) for the labor for my second child. Soon after delivery my headache came on super strong! over the course of the following day the pain extended into my upper back and neck, I could barely move. The hospital told me it was common and I needed a blood patch. I received one hours before I was to be discharged, they had me lay on my back for 30 min and when I got up the headache and backache were gone! No one told me to take it easy. I went home and by the next day I was in pain again, first the head and then the back followed by the next night. I was in so much pain I decided to gon back in to the ER, leaving my newborn at home with my husband and with whatever milk I was able to pump. I got a second blood patch and was told I could not receive a third, that the risks outweigh the benefits at that time. Well the second patch lasted for about a day, k was literally on bed rest, doing nothing and it failed again. Now my headache is back and my head feels clogged, I can’t hear as well on my left side. I’m beginning to wonder if this will ever go away!! I can barely breastfeed my newborn and feel like I am totally neglecting my toddler. My husband has to do everything and I’m worried that this won’t resolve by the time he has to go back to work. Please help!

    • David Draghinas says:

      Hi Christine,

      Spinal headaches can be really debilitating and it sounds like you are unfortunately experiencing that first hand.

      If there’s a silver lining, it’s that spinal headaches eventually resolve on their own. But I know that’s small consolation when you are incapacitated with such a horrible headache.

      Praying you feel better soon.

      Dr Dave

    • Maryam says:

      Hi Christine
      Did your headache go away eventually?

  38. Michelle says:

    I just had an LP done last thursday… I need as soon as I stood up to leave I was gonna get the spinal headache I felt it immediately.. due to having one 15 yrs ago… and Friday morning I had that horrible headache… I went to er they gave me a BP… it didn’t work and I knew b4 leaving it didn’t work… they let me walk out crying cuz my head hurts so bad.. the next day Saturday I went back to same er… I explained what happened with the anesthesiologist on friday… they were not happy with me at all… yes me…. but the new anesthesiologist skeptical saying there is only a 5% chance a 2nd BP wld work… I told him I will take that chance… I have 5 kids at home I cannot be incompacitated…. so he agreed to do another only if we went thru risk factors again… I agreed…. mind u he had alot of problems getting the 2nd one done… but it was done… they gave me a pain medication dilahdid…and told me I have to lye flat for 1 hr b4 I cld go home… ok… no problem…. I did so and my sister made dam sure I did… lol… but now I have a whole lot of nerve pain in my back.. tail bone… buttocks and hips and some times down my legs…I cannot bend over at all … I cannot lift anything heavy nor can I twist my body… so driving is out of the question… uuuggghhhh… but I am walking and slowly attempting to do my daily chores… nothing strenuous…. so beware… u canever lay in bed for a week hopi.g headache goes away or risk nerve damage….

  39. Maryam says:

    Hello all
    I had my second baby on 11/5 and several failed epidural attempts resulting in a spinal catheter that only numbed half of my body. Immediately after the spinal catheter I had severe head and neck ache that the anesthesiologist stated will go away by day 5 post partum.
    I spent 4 nights in the hospital on hydration, drugs and bed rest…breastfeeding my baby in laying position. I was only able to stand up for 15 mins before reaching my pain threshold for these headaches. The worst was the neck and upper back headaches subside when I lay down ofcourse but neck ache continues.
    Now it’s 11/9 and I still have the headaches. I am on bed rest and drugs and caffiene and hydration at home. It’s so hard caring for my toddler and new baby. My husband is doing everything.
    My question is will this wait it out succeed? I am scared to get a blood patch as it involves epidural and I’m scared about getting another puncture. I am willing to wait it out another week. Should I ask the doc for an MRI? Will that help with identifying anything?
    My family tells me not to go for any invasive procedures and tha I shud just wait…I’m so confused.

    • David Draghinas says:

      I’m sorry to hear about all our troubles dealing with a “spinal headache”. It can be really a terrible experience.

      Post dural puncture headaches (spinal headaches) do eventually resolve on their own. What I can’t tell you is exactly how long that will take to happen.

      Any updates on what happened to you?

      Dr Dave

    • Jacqui says:

      I’ve had 3 back operations and four blood patches. Seems that my spine doesn’t like to be touched. Another one tomorrow as for the last one they only injected 10ml blood. Other times has been 30ml.
      I wouldn’t wait any longer! The procedure done under CT is safe and works quickly!

  40. Kristy Evans says:

    I had a blood patch done yesterday and I felt pressure behind my ears when the blood was injected. I’m still feeling that pressure. I don’t know what to do. I have not been diagnosed with MS yet but I almost feel like it’s a exacerbation

  41. Jessica French says:

    Wanted to share my story. I am 35, live in NYC, and developed a severe headache when standing that gradually got worse during the day until I could no longer be upright. I was traveling and had to wait to return home to see a doctor. I diagnosed myself with a spontaneous csf leak (i am an MD) but couldnt get a timely neurologist appt so I went to the ER 3 times. MRI, MRA, MRV were all negative and I was discharged on numerous pain meds (fioricet, amitriptyline, flexeril). I DID NOT have a previous lumbar puncture or trauma.

    Meanwhile, i couldnt work or leave my bed for 2 weeks. I then finally saw a neurologist who agreed i likely had low csf pressure headache based on clinical symptoms and she sent me to the ER to get an urgent blood patch. Ultimately, anesthesia wouldnt do a blood patch without a confirmatory myelogram (which is more invasive then the blood patch and is likely going to be negative). I suffered a few more days until my neurologist found a pain management clinic that would do the blood patch. My headache went away immediately following the patch, which was done under sedation with 20cc of blood, and i rested in bed for a week.

    I am now 3 weeks post blood patch and am significantly better but i do have some symptoms remaining. I always have a very mild headache which gets worse when i bend over or move too quickly. I have a stuffy feeling in my head and my neck and shoulders will be very sore by the end of the day. I am also constantly fatigued. I have read these symptoms may be due to increased csf pressure following the blood patch, or due to meningeal irritation due to the blood in the csf space (some ppl get treated w IV steroids for this).

    I am glad the terrible headache is gone and am hoping the rest of my issues resolve with time… (ps- i have been traveling via airplane and it doesnt seem to have affected the effectiveness of the blood patch). Msg me if you’d like more information about my story, bc i have done extensive research and know this illness is quite terrible and can leave you feeling hopeless and worried you will be chronically ill forever. Best wishes to all.

    • David Draghinas says:

      Thank you for sharing your story in so much detail with our community.

      Praying you make a full recovery.

      Have you and your physicians figure out why this happened in the first place?

      Dr Dave

    • Amina says:

      Hi Jessica, I’m sorry to hear how you have suffered with this condition, I’m glad you are recovering and hope you you have by now made a full recovery.
      I have for the last 7 weeks suffered from this condition, I have had 3 epidural blood patches, the last one was 9 days ago, I no longer have severe headaches, but have this dull feeling in my head, and no energy, I have only sat out of bed for 15 minutes today, after 7 weeks of lying flat. The MRI spine showed I had a significant csf leak, so I was booked for another patch this week, but I don’t know if I need it because the headaches have gone, just this horrible dull feeling constantly in my head, I used to get a burning sensation in my head ( maybe this was mengieal irritation) . I would really appreciate any advice/ suggestions you can offer.
      Thank you.

      • Jessica says:

        Sorry for my delay and I hope you have recovered since then. I don’t think a repeat blood patch would be necessary if you no longer have the headaches. I still, 5 months out, have a fullness in my head at the end of the day and a stick neck. I have not tried taking a round of steroids, but that may be my next step.

    • Jerome says:

      Hope you’re a hundred percent by now. I guess I’m reaching out to you for my wife who’s having the same symptoms on day 10 post blood patch. My main concern is that she still has soreness in the neck shoulder lower back and light pressure on top of her head.

      Also her fatigue is really bad as I’m driving her and picking her up from work but she is exhausted. Doctors are all pretty useless at this point just get usual response.anyways hope you’re all healed up

      • Jessica says:

        Hi Jerome, sorry for my delay. For the first month following the blood patch, I was extremely fatigued and would sleep for over 15 hours a day. I took it pretty easy and would need to lay down every few hours. I have gotten significantly better since then but I don’t think my energy has gotten back to 100%. I still get a fullness in my head when I move or get up quickly or ride too long in a car being jostled; and if I sit for hours on a train or plain, my neck gets very sore. I really have no idea why these symptoms have persisted for so long but if I choose further treatment, I may request a round of steroids from my anesthesiologist. The problem is, this is so rare that many physicians are unfamiliar with the associated symptoms and even less so on the treatments. I hope your wife is doing better.

  42. Laurie says:

    Hello…I had a blood patch after I had my second child in 2006. Didn’t realize what was going on until I was in tears with pain the second day home with my baby. I get migraines so I couldn’t figure out what was wrong until I went to the closest clinic and the very kind and smart doctor recognized what was going on. God bless him because I guess it’s not very common. Long story short they did the blood patch and all was fine. Except now I get terrible neck pain that reminds me of the same pain I had when before I had the boodpatch. It scares me. Can a blood patch have long term effects? I tried to look it up on several web sites but can’t seem to find anyone else with this problem. It’s not all the time but when it happens it’s quite painful. I can’t sit stand or lye down until it eventually goes away. But it reminds me of the same pain as before the blood patch. Yikes!!

    • David Draghinas says:

      Thanks for sharing your story, Laurie.

      I’m not aware of a blood patch causing such long term effects.

      Praying you feel better soon.

      Dr Dave

  43. Montgomery says:


    I just wanted to leave a positive story. I had a lumbar puncture to test for possible MS and a few other things (I was terrified of the procedure, was given 15mg Valium that helped and the procedure really wasn’t painful – just stinging of the numbing agent). I developed the postural headaches about 6 hours later. Had to wait four days to go in for blood patch. Was again terrified of procedure but told the staff that I had a lot of anxiety and was given IV versed and some propophol – a seemingly low dose as we talked all the way through the procedure about our favorite musicians. It was practically painless and helped very quickly. I am still lying flat and following post procedure protocol but wanted everyone to know that it has been great for me. My headaches had been easing a bit before the blood patch but still tough and this was a great help. PS: I really freak out thinking about needles but I had great experiences both times.

    • David Draghinas says:

      Thanks for sharing your positive story.

      Most times, it’s those that have had a bad experience or are fearful of an upcoming procedure that find our site.

      It’s important for us to share their stories. But your positive experiences are important too to give a more complete picture of people’s experiences.

      Thanks again,

      Dr Dave

  44. Tracy says:

    I had a blood patch done a month ago and now I’m starting to have blurred vision, ringing and pain behind ears, dull, pressure, headaches, and now I am currently experiencing cognitive issues. Could this mean I need another blood patch? Is there any insight on recovery from these cognitive issues after succesful patching? I’m worried. 😣

    • David Draghinas says:

      I’m sorry to hear this, Tracy.

      This doesn’t sound like a typical course after a blood patch. It would be wise to be evaluated by a physician.

      All the best and let us know how you are doing. Praying for a full recovery.

      Dr Dave

  45. Barbara Viehman says:

    Dr. Dave, I had a lumber puncture 10 days ago for diagnostic purposes to rule out MS. The next morning I got the spinal fluid leak headache. I had a blood patch done 3 days ago. (2/6/17) My headache was gone before I left the hospital but for the next 2 days my back felt like it was hit by a baseball bat. They said that was inflammation from the 20 cc’s of blood that they injected. My back was better yesterday afternoon. Last night (2/8/17) I woke up with throbbing pain at the top of my neck and the base of my skull. I called my neuro dr this morning and they are called in a prescription for steroids. Does this sound like the right treatment. I also want to add that I had Chiari decompression surgery in 2004. I read this morning that people with Chiari should not have spinal taps/lumbar punctures! Is this true? Do you think I should be seeing a specialist in Chiari for what I am currently experiencing or see if the steroids work? Thank you, Barbara

    • David Draghinas says:

      First off, I’m sorry to hear you’ve been suffering through these head aches and neck pain.

      Unfortunately, I can not give any medical advice through this website. I think the questions you asked here are excellent questions for your neurologist.

      They have expertise in this area and could certainly guide you if even more specialized help is needed.

      You are in my thoughts and prayers. Please come back and let us know how you’re doing.

      Dr Dave

  46. Barbara Viehman says:

    Thank you…

  47. Barbara says:

    Good Morning, I am 11 days out. 2 days after the blood patch I researched and found out that some people have to go on prednisone to reduce the inflammation so I called my doctor and he ordered the script for me. What a difference. It helped by day 3. My back was sore but it went away. What still bothers me is bright light. I get an instant headache. I had it slightly before the blood patch but it is worse now. I think this all takes time. The doctor that did the patch said that injecting 20 cc’s of blood into the epidural causes pressure up your spine and head. It something that your body isn’t used to. I hope she feels better. Let me know. Barbara

  48. Traci says:

    I’m at Day 6 of a postdural puncture headache, after a lumbar puncture in er. Days 1&2 I was mainly in bed with limited trips to restroom, severe pain. Days 3&4 were spent at the er getting fluids and caffeine, severe pain. Days 5&6 have been spent at home drinking A LOT of water. Day 5 was complicated with the onset of my menstrual cycle and the headache and backache that come with that. I’m treating the menstrual symptoms now but still have a pdph. The intensity is less, a moderate level of pain. I’d like to avoid the blood patch if possible, but I’m wondering if I’ll have to get it eventually. I guess my questions are: Do people with the severe headaches often need the blood patch? If it heals on its on is it a gradual change or will I wake up one day and feel like a million bucks? Should I go ahead with the blood patch to avoid any long term effects/ am I more likely to have long term effects if I allow myself to heal naturally without the blood patch?

  49. Barbara says:

    I’ve had to have 2 blood patches after an epidural injection. You KNOW when you need a blood patch. If you have it and then have a pressure feeling in the back of your head then you may need to go on a steroid Medrol pack to reduce the inflammation that the blood patch caused. (20cc’s of blood that was injected is something that is not normally there) My headache was instantly gone but the steroid got rid of the pressure feeling. Back to normal less than 3 weeks out from the lumbar puncture. Good luck!

    • David Draghinas says:

      Thank you for sharing your difficult post operative journey with us. I’m sorry to hear it took so long for you to recover.

      Having three little kids myself, I know how much more challenging your recovery process must have been.

      Dr Dave

  50. Cipuh says:

    Post-surgical CSF leak with delayed diagnosis is my story.

    10 days a microdiskectomy at a private surgeon I started mobilizing. Still spent most of the day lying flat though. I felt a feeling a needle-prick-like pain in my spine and in a few hours a low degree headache started. It suddenly became much worse when I stood up in the afternoon to look after my daughter and became excruciating by the evening. I presented at E.R. From this on I had regular pin-prick-like pains at the operation site and typical CSF-leak-like headache and neurological symptoms. Over the next weeks several MRI’s were performed, two with contrast on the spine and two cranial ones, none of them showing CSF leak. From this on my case was discussed by four different teams: the private surgeon, the public orthopaedic team, the anesthesiology team and the neurology team. All of the orthopedic team including the private surgeon and the public hospital team agreed that it can not be a CSF leak if it doesn’t show up on the MRI scans. This was contrary to what I found in the medical literature and what the anesthesiology team thought. The orthopedics team maintained their view even when I offered recent printed reviews showing the statistics regarding the accuracy of MRI showing CSF leaks. The neurology team was clueless.

    At my first hospital visit I was transferred to Orthopedics (5 days) I took morphine for the headache. When the pain team attempted to switch me to NSAID’s I received IV metoclopramide to prevent side effects. This was done however without checking my history and also without informing the nurse of correct administration over minutes instead of as a flush. I ended up with a wide range of side effects including acute depression and transient tardive dyskinesia. However, the headache was relieved for a day and in the meanwhile I left the hospital. Over the next week I tried to manage the leak by strict bedrest with no improvement. I was silly enough to overdose caffeine in my desperate attempt to get better and suffered a mild psychotic episode while battling the side effects of metoclopramide. My attempts didn’t work though, I returned to ER and from there to Orthopedics a week later.

    I was offered the following diagnoses: 1. abnormal pain syndrome (by ex surgeon) treatment plan: mobilisation and long term analgesics 2. migrain (by neurology) treatment: mobilization and amitriptyline and/or pizotifen. At this stage I felt very frustrated since the treatment options offered would have had a negative impact on my quality of life due to worsening CSF-leak symptoms and medication side-effects. I felt these options were highly inappropriate. Anaesthetics were unwilling to perform a blood patch as they had no experience in a post-op site. Neurosurgery was unwilling to open up the wound with negative MRI. I left the hospital after a week with some improvement after 9 days of bedrest 4 days in a tilted back position. I felt if I stayed I would be.under pressure to receive inappropriate treatment.
    Let me mention in detail of the original surgeon’s opinion. He is a well known and respected back surgeon. He stated that with negative MRI it can’t be a CSF leak (despite of evidence presented). He said in these cases his diagnosis is always abnormal pain syndrome and a referral to the pain team for long term analgesics (this means opiates). He also stated it happens regularly and at that very moment there was another one of his patients with the same problem next door.

    I again tried to manage my symptoms at home but after a week I needed to present at ER. This time I was transferred to Neurology where the diagnosis of a CSF leak wasn’t questioned. I was referred to anesthesiology for a blood patch. The anesthesiologist consultant said they haven’t done post-surgical blood patch before and he needed to discuss it with the neurosurgeon. After 6 days of discussions the blood patch of 30 cc was performed at the operation site by the consultant. As of today (day1) it feels like it worked which I feel works as a diagnosis retrospectively. The previously inflamed and operated site is painful because of the extra pressure so it takes me longer than usual (4 hours) to mobilise (24 hours).

    I was battling CSF leak for 7 weeks post surgery with three little children. With microdiscectomy the first 6 weeks is essential to mobilise to prevent scarring around the nerve and prevent a failed back surgery. I feel this delay in treating the CSF leak was due to the reluctance of diagnose post-surgical CSF leak. The fact that it is unfamiliar in this large hospital and that there are people with mysterious pain syndromes discharged regularly seems the more likely.

    • Cipuh says:

      As I received the discharge papers this afternoon I realised that despite “no evidence of active CSF leak” the initial radiology report included fluid pockets around the site and also there was “small dural tear noted”. Despite this the diagnosis wasn’t made and acted upon for six weeks.

  51. Kyle says:

    I just had a LP done two days ago. Sitting in my car made my head feel like it was about to explode. I went back to the hospital today, and I received a blood patch. Immediate relief! I have been lying in bed the rest of the day. I noticed when I get up to use the restroom, sometimes, I have a very quick fleeting headache. Is that normal? I can live with it if it is, as it is only a small fraction of what I was going through. Thank you for this website, and providing your expertise, Dr. Dave.

    • David Draghinas says:

      While I can’t comment on any specific case, it generally seems reasonable that if the dural leak is not yet completely healed, there may be a slight headache upon standing.

      Wishing you a full recovery.

      Dr Dave

  52. Donna Patrick says:

    Just a quick question why when blood is put back in the site can it cause direct leg pain above the knee right side causing blood patch to fail causing permanent lower back pain bowel disfunction?

  53. Amy says:

    Hi. I told a quick story today to an anestesiologist at the gym I work at today and he was clearly upset what are your thoughts. I had an epidural with both my first and my second pregnancies. With the second epidural I developed what I was told was a spinal headache. It lasted 10 days before I finally went in for the bloodpatch. During the procedure the nurses took my blood and the stomach injected it. He told me I would feel a lot of pressure and that it was going to hurt and that he was going to keep going ( injecting) more and more blood until I was in so much pain I was saying “f*uk” 3x. This is how he would know it was enough. I just assumed he has an off sense of humor. I wasn’t offended. Surly enough after a bit of him injecting more and more I was in the worst pain I’ve ever felt that I did say it. And begged him to stop. I payed down for awhile and eventually my headache was gone … I never thought much of it and assumed a blood patch was suppose to VERY painful. Am I wrong? I feel like I may have offended the dr at my club by telling him this story.

    • David Draghinas says:

      Hi Amy,

      I’m not sure why anyone would be upset by you simply telling a story of your experience.

      In my experience, epidural blood patches are not painful. The placement is similar to any other epidural. Once it’s in the right space, we start injecting your sterile blood

      I ask patients to tell me when they start feeling pressure in their back. That let’s me know we are almost finished. This is typically about 15-20 ml of blood.

      I’ve never had anyone in pain due to the blood patch. Quite the contrary; it’s intended to relieve the pain of the spinal headache.

      Dr Dave

  54. Christy says:

    I am just wondering if it is possible to still have a leak 4 years after having a c section. I have had very bad headaches, horrible pressure, ringing ears, light sensitivity and partial hearing loss upon standing since immediately after I had my baby 9/27/2013. Some days are terrible but others I feel almost normal. Could this be what is wrong?

    • David Draghinas says:

      I would find that highly unusual, Christy.

      But if you are having all those symptoms, it’s a good idea to have your physician check you out.

      Dr Dave

  55. Shirelle Zehnder says:

    Christy, I’m wondering the same thing about my c-section 3 years ago and constant daily headaches since. Have you made any new discoveries or has any new procedures that helped? I’m at my wits end. I get that doctors think it’s “unusual” for long term csf leak after spinal but I have no other explanation for constant headache since then

  56. JEnnifer says:

    Dear doctor. I am 3 weeks post my second epidural blood patch. I am now experiencing “flare ups” of what feels like high pressure or too much pressure. It’s a totally different feeling than the low pressure headache. I have pressure in head, blurred vision, ringing in ear, and tingling in sides of neck and shoulders. Is my body just adjusting or absorbing the blood from the patch? Thank you.

    • David Draghinas says:

      Jennifer, thanks for your question and I’m sorry you’re continuing to experience these symptoms.

      What you are now describing does not sound like a “spinal headache”, but you should definitely discuss any concerns with your own physician.

      I hope you feel better soon.

      Dr Dave

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