Lumbar puncture is a common medical procedure nowadays. However, like all medical procedures and interventions, this too isn’t without its demerits.
Back pain is one of those side effects of performing the lumbar puncture. This pain may occur even months after the procedure.
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So, if there is back pain months after lumbar puncture, then you’re at the right place. That’s what we’ll be talking about today.
In order to understand the back pain months after spinal tap, let’s get to know a bit more about the procedure.
Table of Content
Lumbar Puncture
Lumbar puncture functions both as a therapeutic and a diagnostic tool in medical science. It helps doctors know whether the intense headache you have is due to a simple lack of sleep or a life-threatening bacterium. So, doctors perform this procedure frequently in order to correctly diagnose your condition.
Again, some microorganisms reside in the cerebrospinal fluid. The cerebrospinal fluid is the fluid circulating through your spinal cord and brain. It’s not always possible for drugs given via food or blood to reach this fluid. So, physicians often need to perform this procedure to give a drug to the cerebrospinal fluid and kill the harmful organism therein.
So, what exactly is the mechanism of this procedure? For that, we need to know the location of the cerebrospinal fluid. In the spine, this fluid is present outside the spinal cord enclosed by an external membrane.
Where is Lumbar Puncture Performed?
As contrary to the common belief, the spinal cord doesn’t actually run completely down your spine. In fact, it stops around your lower back. Beneath that region, there’s no spinal cord, rather just nerve roots coming out of the cord and the cerebrospinal fluid outside. So, the ideal location for accessing the cerebrospinal fluid is beneath this region.
How it is performed
For performing a lumbar puncture, the patient has to lie on their sides. The doctor or nurse will clean the area and give local anesthesia. After that, they will insert a thin needle in the lower back between two vertebrae of the spine. The procedure takes around half an hour and patients can return home an hour later if they don’t have any symptoms.
Pain After Lumbar Puncture
This sounds good and all, but some people do experience pain after lumbar puncture. The pain can be of two types depending on when the pain appears:
Acute Pain
This type of pain is more frequent. Acute pain is the pain that occurs during the procedure or within a few days of the procedure. The cause of this pain can be many:
- If the anesthesia doesn’t set in properly, there can be acute pain. You should inform the physician or nurse performing the procedure. They should stop and recheck the local anesthesia.
- Another reason for pain during the procedure is a hypersensitivity reaction. This reaction is generally due to the anesthetic used. The doctor would change the anesthesia used. You should best remember the anesthetic used in case you needed to perform the procedure in the future.
- The spinal cord may be damaged while performing this procedure. However, this only occurs if the doctor made an error in counting the vertebra. But, don’t sue your doctor if that happens! Because some individuals rarely may have variations in the termination of the cord. In that case, an imaging procedure can accurately determine where the puncture can be done.
- Even in normal individuals, the spinal nerve roots are present at the level the spinal tap is performed. These are numerous and protrude from beneath the spinal cord to supply your thigh and legs. These nerve roots are thin and moveable. So, during performing a lumbar puncture, the needle pushes them out of the way. However, in rare instances, the needle may pierce the roots. This causes sharp pain due to nerve damage.
- The most common cause of pain days or even months after lumbar puncture is nerve root irritation. This type of pain begins in the lower back and radiates to the thigh and even to the leg and feet. The reason is inflammation of the nerve roots during the procedure. The inflammation can cause irritation and damage and that may be the reason why you feel back pain days, even two months after lumbar puncture.
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Chronic Pain
Chronic pain months after a lumbar puncture is not very common. It is a rare condition in comparison with acute pain. So, it is unlikely that the pain you have is due to the lumbar puncture. Far more common causes of persistent chronic back pain include:
- Spinal stenosis
- Arthritis
- Herniated intervertebral disc
- Degenerative disc disease
- Sciatica
- Paravertebral muscle spasm
- Strain on the muscles of the back
If you have lower back pain months after lumbar puncture, these are the likely cause. However, a rare complication may arise from the procedure. This is known as post lumbar puncture discitis or spondylodiscitis. So, let’s see how this takes place.
As we’ve already discussed, during the spinal tap, the needle is inserted in between two vertebrae. Sometimes, the physician or nurse performing the procedure may push the needle too far. So, the needle may pierce the intervertebral disc in front. Any organism if contained present in the skin or the cerebrospinal fluid thus gets into the intervertebral disc.
Organisms can thus cause infection within the intervertebral disc. This is called discitis. The pain occurs weeks and even months after the lumbar puncture. The reason is that different organisms grow at different rates. Some organisms even remain dormant within the body. And after a period of latency, they cause infection. Hence, according to the organism causing the infection, the pain may appear two to six months after the lumbar puncture.
In some instances, the infection may even spread to the vertebra. This infection of the vertebra is called spondylitis. There may also be a fever along with intense back pain. The muscles of the back also tense up and spasms.
These changes which occur within the spinal cord can be visible in radiological examination. CT scan and MRI can detect the damage done to the vertebrae and the intervertebral disc. However, routine laboratory investigations are within the normal range.
So, if you experience intense back pain months after a lumbar puncture, it’s best to go see a doctor. You should also inform him of the procedure. An appropriate MRI or CT can be enough to diagnose whether you have this disease or not.
Treatment of Back Pain Months After Lumbar Puncture
Doctors generally prescribe symptomatic treatment for this type of disease, because the body heals on its own. If the organism can be identified, specific antimicrobials are prescribed to prevent further damage to the spine. If you’re experiencing back pain, you can follow the steps below to get some relief:
Physical activity
Even though it seems that resting all day and giving your spine to heal is the best option, that’s not always the case. You should rest your spine properly. However, you should keep active as well. Research has shown that an exercise program like this can help you reduce back pain considerably.
Stretching
You should try to stretch your back as much as you can. Because stretching moves the back muscles and aids in healing. Also, this strengthens the muscles and helps support the back. Thus, stretching can help in reducing pain occurring months after lumbar puncture.
Maintain Your Weight
It’s pretty obvious that a bigger body puts more stress on the spine. So, it’s best to reduce weight as much as possible to ease the load on the back. However, don’t start avoiding essential proteins and veggies, because they help in the healing process.
Maintain a Good Posture
Posture is a problem for most of us because being slouched in front of a computer screen all day is the new normal. However, bad posture leads to inappropriate strain on the back, especially the lower back. So, it’s time to chin up, puff your chest out, and say goodbye to the rounded shoulders.
Heat and Cold
They may be the complete opposite, but each has its own merits. Using an ice bag can help ease the pain. So, if you’re feeling intense pain, it’s time to bring out the ice bag. Again, applying heat can accelerate the healing process by increasing blood flow. Thus, you should apply heat whenever you can.
Over the Counter Pain Meds
OTC painkillers can ease the symptoms. You can try taking some tablets to help with the pain. The tablets commonly available for this purpose are non-steroidal anti-inflammatory drugs (NSAIDs) and paracetamol/acetaminophen. Various topical creams and ointments are available which are primarily NSAIDs. Applying these creams can really help ease the pain.
Physical Therapy
Physical therapy can be a good option to treat back pain months after lumbar puncture. Therapists can guide you through the various types of exercise which can strengthen the core and back muscles. Thus, stronger muscles provide more support for the spine.
Getting Enough Sleep
Sleep is the time when your body heals. The brain and muscle functions cease. So, the body can focus more on healing itself. Hence, it is important to get adequate 7-9 hours of sleep every day in whatever posture you’re comfortable in.
Supplements
Various supplements can help in treating lower back pain as well. In many instances, back pain is caused by a lack of essential components like vitamin B complex, vitamin D, essential fatty acids, etc. A deficiency of these components can cause neuropathy leading to nerve pain. So, supplements like these can help you to treat your lower back pain.
Conclusion
To wrap things up, back pain months after lumbar puncture isn’t something anyone would expect. It is a painful and debilitating condition. However, with the appropriate treatment and lifestyle changes, you can make the back pain months after lumbar puncture go away.
FAQs
- Can lumbar puncture cause back pain years later?
Although it is very rare, it is possible that lumbar puncture can cause back pain years later.
- How long does your back hurt after a lumbar puncture?
If the procedure goes well, normally back pain at the site of the puncture takes around one to three days to subside.
- Can a lumbar puncture damage your spine?
Yes, if performed inaccurately, a lumbar puncture can cause damage to the spine. However, the likelihood of that happening is very slim as the health care workers doing the procedure are very skilled.
- Can back pain after lumbar puncture take months to heal?
Normally, back pain after lumbar puncture heals in one to three days, however, in rare cases, pain may persist. In that case, you should see your doctor for possible treatment options.
