Anesthesiology/LP and blood patch


My sister, who is 30, recently had a lumbar puncture done  and was found to have viral meningitis. She developed an excruciating spinal headache after the procedure and had a blood patch done 2 days ago on 8/6. The headache went away and she was discharged yesterday 8/7. Today she has a bad backache exactly where the blood patch was done.She says that she feels like her back muscles are in spasm. The doctor told her to take tylenol, use mild heat and ordered a muscle relaxer. My questions are, 1) Is back pain normal after a blood patch and how long does it take to completely resolve? 2) What should she do is help herself heal? and 3) What sort of things should she be aware of in case things are going wrong, I guess I mean to say, what are some of the bad things that could happen after a blood patch procedure? She is supposed to fly crosscountry in a few days and she is fearful of doing this when she is in pain. Thank you for any advice you might have.

Hi there

Sorry that your sister is having this pain!

To answer your questions:

1) Back pain at the site of insertion is not uncommon. Also, if there was any degree of air injected that can cause some lumbar pain until it absorbs. Additionally, your sisters provider injected somewhere around 20 cc of blood back there and that fullness can cause some back pain as well.  However well over 90% of back pain after epidural blood patch resolves within 7 days. If not, or if it gets worse you should go back to your provider or the ER and see what they think.

2) Best thing to do is warm compresses, relax and continue the tylenol and muscle relaxer. It shouldnt take much more than a week to resolve.

3) The red flag things to look for are:

- weakness in legs
- changes in sensation at or above the level of the injection
- infection signs (redness etc) at the site of the injection
- An unexplained fever
- Mental status changes

Any of these and she should immediately call 911 or goto the ER. Most of which would have likely been evident within a day or 2 of the patch.

As for flying I would suggest she consult with her provider before she does. If she is still having pain that may not be a good idea as sitting in that position could be difficult for her.

I hope she gets better soon!


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Mike MacKinnon MSN FNP-C CRNA


I am a former Trauma Flight RN now a Family Nurse Practitioner and a Nurse Anesthetist (CRNAs). I can help answer questions on the CRNA profession and clinical anesthesia. I work full time as an independent practice CRNA and have a special interest in regional anesthesia, particularly peripheral nerve blocks. I also teach ultrasound regional anesthesia and lecture all over the country. If I do not know the answer, I will find it for you.


I am a Family Nurse Practitioner and a Nurse Anesthetist who works as an independent/autonomous practitioner. There are often questions about my profession and I would like to offer the service of an actual CRNA. If you did not know, there are about 40000 of us which equates to 50% of the anesthesia providers in the USA today. I also lecture and teach ultrasound regional anesthesia all over the country.

AANA (American Association of Nurse Anesthetists)
IARS (International Anesthesia Research Society) AANP (American Association of Nurse Practitioners)

Air Medical Transport Journal
OutPatient Surgery Magazine

Bachelors of Science in Nursing
Masters in Nursing
Family Nurse Practitioner
Certified Registered Nurse Anesthetist (CRNA)

Awards and Honors
Excellence in anesthesia education award

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