Are you having back pain with any of the following?

  • Severe pain, weakness or tingling in your leg(s).
  • Difficulty stopping urination or loss of control of bladder or bowels.
  • Unexplained fever, nausea or vomiting.
  • A history of cancer or unexplained weight loss.

We understand that you are experiencing one or more of the health issues that might be impacting your back pain.

We recommend that you discuss these health issues with your doctor before proceeding with this program.

Once you are cleared by your doctor to do this program, we hope it helps you find relief from your back pain.

Lumbar Puncture

Overview

A lumbar puncture, also known as a spinal tap, is a test that examines the cerebral spinal fluid (CSF). CSF is the fluid that surrounds and cushions the brain and spinal cord. We perform a lumbar puncture to measure the pressure in the CSF and to collect a sample of the fluid for further testing. Abnormal fluid results can help us diagnose certain neurologic disorders, such as multiple sclerosis (MS), or certain infections or inflammatory conditions, such as meningitis.

 

How It Is Performed

Lumbar punctures are performed in our clinic, in the hospital in your room at the bedside, or in the radiology suite. Usually, we will ask you to lie on your side in the fetal position, with your chin down and knees tucked up to your chest. In some cases, we perform the test while you are sitting up and leaning on a bedside table.

We will make sure you are comfortable before we begin. It is very important that you stay in the same position during the procedure in order to avoid moving the needle which could injure the spinal nerves. If you do need to move during the procedure, please tell us before doing so.

We clean your lower back with antiseptic solution before injecting a local anesthetic to numb the area. You may feel a mild burning sensation before the anesthetic takes full effect. 

Once the area is numb, a spinal needle is inserted into your lower back. You will feel a sensation of firm pressure as the needle goes in.  Some people feel pain briefly as the needle goes through the sac surrounding the spinal fluid.

Once the needle reaches the spinal fluid we measure the pressure and collect a small sample. We then remove the needle and bandage the puncture site.

Afterwards, we will ask you to lie flat for up to 60 minutes. The entire procedure usually takes about 30 minutes.

Risks

Common risks of a lumbar puncture procedure include:

  • Allergic reactions to the anesthetic or antiseptic cleaning solution.
  • Back pain due to the insertion of the needle. This is temporary and may last a few days at most.
  • Headache caused by the removal, or leakage of spinal fluid. These headaches usually improve quickly, but may last for 24 to 48 hours, or sometimes longer.

Rare risks of the procedure include:

  • Infection in the spinal canal. This is very rare. We use an antiseptic solution to clean your back and sterile needles to prevent this from happening.
  • Bleeding into the spinal canal. Bleeding can cause compression of the nerves to the legs, which could result in numbness or weakness. However, this usually only occurs if you have a history of bleeding problems, or are on blood thinners. 

If you are on blood thinners, we may give you specific drugs or blood products to prevent bleeding. We will discuss the benefits and risks of the procedure with you, and may decide that a lumbar puncture is not a safe test for you.

After Your Procedure

After the test we recommend that you rest and avoid heavy lifting or strenuous exertion, to allow the back area to heal. Lying flat in bed for several hours can prevent headaches that sometimes develop after a lumbar puncture. If you do develop a headache then it's a good idea to lie flat and drink plenty of fluids. Sometimes a small amount of coffee or caffeinated soda can help with this type of headache. You can take over-the-counter medications, such as acetaminophen or ibuprofen, if pain develops. Applying an ice pack on and off for a few hours can also help with any back pain after the procedure. 

You should be able to return to your normal daily activities the next day.   

If you experience any of the following symptoms, please contact our 24-hour Appointment and Advice line for advice, or your hospital-based physician if you are in the hospital:

  • Fever with a stiff neck or a severe headache.
  • Drainage or bleeding from the puncture site.
  • Numbness or loss of strength below the puncture site.

Results

Depending on the type of testing, the results are often available within 24 hours. However, some tests take longer. Results for multiple sclerosis, for example, take up to a week to come back.

Additional References:

If you have an emergency medical condition, call 911 or go to the nearest hospital. An emergency medical condition is any of the following: (1) a medical condition that manifests itself by acute symptoms of sufficient severity (including severe pain) such that you could reasonably expect the absence of immediate medical attention to result in serious jeopardy to your health or body functions or organs; (2) active labor when there isn't enough time for safe transfer to a Plan hospital (or designated hospital) before delivery, or if transfer poses a threat to your (or your unborn child's) health and safety, or (3) a mental disorder that manifests itself by acute symptoms of sufficient severity such that either you are an immediate danger to yourself or others, or you are not immediately able to provide for, or use, food, shelter, or clothing, due to the mental disorder.

This information is not intended to diagnose health problems or to take the place of specific medical advice or care you receive from your physician or other health care professional. If you have persistent health problems, or if you have additional questions, please consult with your doctor. If you have questions or need more information about your medication, please speak to your pharmacist. Kaiser Permanente does not endorse the medications or products mentioned. Any trade names listed are for easy identification only.