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Spinal fluid leak headache (low pressure headache)

Also called: Spinal fluid leak, low pressure headache, post-spinal headache

A headache that gets worse when sitting or standing and better lying down, from a leak of spinal fluid, often after a spinal tap or epidural.

Key signBetter lying flat
TreatmentRest, fluids, caffeine, blood patch

Overview

Spontaneous leaks can happen without a procedure.

Spinal fluid leaks, lowering pressure in the head.

Symptoms

Common signs:

  • Headache worse upright

Less common

  • Neck pain
  • Ringing ears

When to get medical care

Call 911Confusion or fever with stiff neck.
Get care todayHeadache after a spinal tap or epidural.
See a doctor soonSymptoms that last or keep coming back.

Causes

Fluid leak.

Does it spread or run in families?

  • It isn't contagious. You can't catch it from someone else.

Who is more likely to get it

  • Recent spinal procedure

Possible complications

Diagnosis

A clinician asks about your symptoms and may order tests.

The exam

A physical exam.

Tests

Tests, if needed:

  • MRI:

Treatment

Treatment depends on the cause and how severe it is.

Self-care

  • Lie flat
  • Drink fluids
  • Caffeine may help

Which doctor treats this

  • Start with your primary care provider (family doctor or internist).
  • They may send you to a neurologist (brain and nerve doctor).

Children, pregnancy, and older adults

  • Women 30 to 50: Most common.

Pregnancy and breastfeeding

  • If you're pregnant or planning to be, tell your prenatal provider about this condition.
  • Don't start or stop any medicine on your own. Some are safe in pregnancy and some need to be changed.
  • Ask before taking any pain reliever. The FDA advises avoiding ibuprofen and naproxen after 20 weeks unless your doctor says to.
  • Breastfeeding: Most medicines are fine, but ask. The NIH LactMed database lists what's known about each one.

Outlook

A blood patch usually fixes it.

Getting ready for your visit

Bring a list of your symptoms and medicines.

What to bring

  • A list of your medicines and supplements
  • Notes on when symptoms started and what makes them better or worse

Questions to ask

  • What's causing this?
  • What treatment do you recommend?

Research studies

Research studies test new ways to find and treat health problems. Some are looking for volunteers. Talk with your doctor before joining one.

Search ClinicalTrials.gov for studies on Spinal fluid leak headache (low pressure headache)

Sources

Last updated 2026-11-12.