Spinal headache symptoms include:

• Dull, throbbing pain that varies in intensity from mild to incapacitating
• Pain that typically gets worse when you sit up or stand and decreases or goes away when you lie down

Spinal headaches are often accompanied by:

• Dizziness
• Ringing in the ears (tinnitus)
• Hearing loss
• Blurred or double vision
• Nausea
• Neck stiffness

Spinal headaches are caused by leakage of spinal fluid through a puncture hole in the tough membrane (dura mater) that surrounds the spinal cord. This leakage decreases the pressure exerted by the spinal fluid on the brain and spinal cord, which leads to a headache.

Spinal headaches typically appear within 48 hours after a spinal tap or spinal anesthesia.

Sometimes epidural anesthesia may lead to a spinal headache as well. Although epidural anesthetic is injected just outside the membrane that surrounds the spinal cord, a spinal headache is possible if the membrane is unintentionally punctured.

Risk factors for spinal headaches include:

• Being between the ages of 18 and 30
• Being female
• Undergoing procedures involving the use of larger needles or multiple punctures in the membrane that surrounds the spinal cord
• Having a small body mass