How bad does the lumbar puncture hurt?
 

I've had numbness, tingling, swelling and pain in my lower extremities for the past month. For the past couple of years, I have felt pulse in my neck when I look down causing me to be dizzy (didn't really think anything of that). My neurologist ordered an MRI and 4 spinal cord lesions were identified and one possible (but not likely) brain lesion. Due to this as well as my mother having MS, my doctor feels that it is likely that I have MS. He has now ordered a lumbar punture.

I remember having to take my mom to hers 10 years ago. She said it was completely excrutiating. Have there been any medical advances to make this more bearable? What should I expect during and after?

Thanks for everything.

~M~

When I had my LP done in March 08, I didn't find the procedure painful at all.

My neurologist had me covered up, a nurse sat in front of me, neuro behind me, and the neuro did a freezing needle first (that barely hurt), then the LP needle was not bad at all. I didn't feel it, the most I felt was a weird tickle sensation down to my tail bone (I actually laughed at the sensation!).

The important things to remember in having the LP completed are, drink lots of caffeine the day before, day of, and wouldn't be a bad idea the day after. The day of the LP, you will need to remain horizontal for hours after the procedure. Your doctor/neuro will be able to best explain this to you. If you are not working that day, strong suggestion to stay in bed for the entire day of the procedure. Getting up to use the washroom and getting right back in bed. If you are up and get a headache feeling, lie down asap. You should be fine!

Welcome to Neurotalk!

When I had mine...I really didn't feel anything but a mild pressure...but then it could have been the drugs they gave while I was in the hospital. I didn't feel the needle, I felt the fluid being drawn out which was strange. Then pain was very minimal.

Just drink plenty of caffiene, take a couple ot Tylenol extra strength, advil, etc and you will be fine. Just imagine us all there telling the doctor exactly where to stick the needle.:wink:

Bet you won't be worried at all...lol

I know it sounds scary, and I was really scared!

But it was a piece of cake. No pain. No caffeine for me. I did stay in a motel room with my hubby that day so I could lay on my back (we live 2 hours away from clinic).

The idea is to keep your puncture "wound" from leaking spinal fluid afterward. When it leaks, that's when the headache happens. Takes about a day to heal, then you're fine.

I wish you good luck!!!

I wasn't worried, didnt know what could happen, DH drove me home, didn't go to bed, cooked dinner, didn't leak drank water like I always do, no caffeine like usual then. I'm glad I didn't know some had problems. Didn't.

Unfortunately I drink a lot of caffeine anyway. But I didn't find the procedure bad at all. My radiologist did it with fluoroscope, so he knew just where to go.

He was unable to get enough fluid out of the lumbar area without grabbing a ton of nerves, so he asked if he could go ahead and move up to my cervical area (needle goes into spinal area just behind my ear!) Sounds awful, but it was not painful either.

He said docs should order cervical pokes over lumbar for these kinds of tests because it is easier to get the needed fluid. But I think it just would make too many people queasy!

I knew this radiologist, a religious acquaintance that has an outstanding reputation that I requested. I trusted him totally, and he did a super job. I didn't even stay down all day after, went to work the next day with an ibuprofen, and was super!

Not a horrible experience at all!

No pain, no caffeine, no extra fluids, just laid flat for two hours after. It was not a bad experience.

I have had 4 of them, you lay flat afterward and your done. it sounds scarier than it is just breath relax and dont move about, these docs know what they are doing and you might feel a little discomfort, thats about it, you will see after you are done it is scarier sounding then it is, like twink said I was a big chicken about it, and it turned out fine
good luck on the LP

Thank you all for your support. I feel much better. Has anyone ever heard of having the lumbar puncture come back negative for MS even with lesions on the spine? As you can tell, my neurologist isn't really explaining things to me as we go along so I may start shopping around after I get a better idea of the diagnosis.

Misti, I can't comment on that -- I'm still pretty new at this disease.

I just wanted to wish you the best of luck. Being diagnosed with MS can be devastating; however, there are certainly far worse diseases to be diagnosed with.

On the upside, I have really enjoyed the MS community here at NeuroTalk and have met many of my "cyber-friends" face-to-face at various get-togethers.

Depending on where you live, your local MS society may have various activities for free or cheap: my husband and I been river rafting, watched a minor league baseball game/picnic, attended various lectures and spent a couple of free nights at motels. I mean, you don't get all that with a gout diagnosis (which my husband has)! Lol!

Please let us know how it goes for you and what you find out. :hug:

hi misti and welcome,

when i had my LP i went to a center attached to my local hospital.
the MD radiologist did mine. i laid on my stomach and he numbed the skin.
that's the most pain i felt.

he did mine also under floroscopy. that means they use a machine so they can see where the needle actually is. much more accurate and causes the pt less pain. i don't suggest you go to a teaching hospital. they tend to let the underlings do tests on pts and it doesn't go as smoothly.

they tell you to drink a lot of fluids to stay hydrated. i'm going blank on the reason for the caffeine but that's good too. if you're dehydrated it's harder for the dr to get enuf spinal fluid.

best of luck. bring someone to drive you home. then lay flat for 24 hrs except when you have to get up. will help tame any spinal headache you might get.

IF you get a headache afterwards make sure you call the asap. that way they can handle the problem. my final suggestion is to not have this test done on a fri. if you have any problems and need your dr they may not be available.

please keep us posted.

Ha ha Ha! Thanks I needed the giggle. Gotta love the free stuff!!!

~M~:D

I've had 3 over my lifetime. None of them bothered me and there was 'little' discomfort.

I was told to drink plenty of water the day of and to lay flat. I never had any problems afterwards either.

Take care.

Hi MistiC

As most people said the lumbar puncture was not bad--more nervewracking waiting for it then going through it. I didnt' feel any pain (just the first needle putting in the pain killer). Afterwards I had a lower back ache but nothing a few ibuprofen couldn't fix. As far as the results coming back...I did not have the O-bands which apparently 90% of people with MS do. But I had one other abnormality (high IgG index) that pointed to MS. I only have brain lesions.

Good luck!
Natalie

I have a severe bad back that they did not take into consideration....So mine was bearable at first...Then unbearable....They gave me a Vike......Then I'm like Hello'oooo......May I have another one so I can get out of here.....

So I had an abnormal time.....Maybe 3-5 days of hellish pain....But it really was not from the LP...It was the LP making my back flare up badly.....


If you have the ability to just do and not think your far ahead of this process and this disease...

good luck with prayers added for more luck...


pete

Giving birth 7 times was way easier and a LOT less painful. :rolleyes: Mine was awful, the Dr did any awful job and stuck me over and over again with no numbing meds. I got that awful headache the next day and went to the ER, they gave me a caffeine IV and than sent me home still in a little pain. The next day I was back in the ER with the worst stomach bug I have ever had, they gave me meds and sent me home. Well over the next week and a half I got 2 more stomach bugs and was in a awful amount of pain (my back and my head). So my LP was the worst 2 weeks of my life.

I don't understand why he needs a LP to confirm MS anyway? My first question to him would be "do the results of this test have the potential to change the dx, and if so, to what other disease?"

Unless we have an acute Transverse Myelitis attack (which you didn't) there are only a very few non-MS related diseases that can cause "lesions" in the spine, including; ADEM (Acute disseminated encephalomyelitis), Sarcoidosis, Lyme (Borrelia burgdorferi) and SLE (Lupus). See link:

ALL of those diseases also have O-bands:

http://www.diseasesdatabase.com/resu...ClassSort=True

There are "other" tests that can be done to rule out those disease, like chest x-rays (for Sarcoidosis), Western Blot (for Lyme), blood tests positive serology with ANA and double-stranded DNA (for Lupus). Sarcoid, Lyme, and ADEM also do not have dissemination in time, which MS has. See link:

The LP itself did not hurt me, at least no moreso then an epidural did with the delivery of both my kids (and there's NO WAY they could have talked me out of that procedure at the time! :D). However, my LP was botched, and I was left in the Brain Trauma Unit for a week after having it, so I flat out refused to have another when they desired to "see" the O-band details years later.

I just don't see how having this test is going to prove anything to him? :confused:

Cherie

Good links Cherie, thanks! :)

Cherie provided some good information!

I have had 4 LPs. I have one lesion on my spine. 2 LPs were negative, 2 were positive for MS.

None of them were painful. I will add, tho, that following the 2 positive LPs I did have the dreaded LP headache. My neuro, who performed all 4 of them, says it's just coincidental!

Follow the post LP instructions to the "T", if you decide to have one. It is not required for a diagnosis.

The decision is ultimately up to you. Here's a like to the Revised McDonald Criteria for Diagnosing MS http://www.mult-sclerosis.org/DiagnosticCriteria.html

It's been awhile, but I don't remember any pain, just pressure....But, even though I was in the hospital and laid flat for 24 hrs (almost), after, I still had the headache, when I got home. I had a myelogram with the LP, and that was bloody uncomfotable, but not painful.

Good luck...let us know how it goes..:hug:

My Moms Doc jokingly told her if he tested her for Lupus now he would have to tell her she does not show for Lupus at this time.....

We know different...she is 74 and almost lost the battle a few times.......

My Mom In Law figures that we in this boat are held captive to the insurance companies.......Thats why we jump thru hoops while many fall apart waiting for a Dx....

they WANTED TO LP ME AGAIN ....i JUST LAUGHED..Said put me down as saving the INS company money...K!

sorry cap locks....

I"Ve had three experiences with a lumbar puncture. The first as a young boy when They couldn't get the needle in and the operator ended standing on the operating table, to drive the needle home. The second was completely uneventful and painless. The last time the puncture leaked and I had a three day headache. The leak was patched by injecting some of my blood back into the leak so that the blood could scab over and shut the leak..and that provided immediate relief.
On a scale 1 to 10, I'd rate the experience an 8, 10 being the worst. Good luck.

No pain for me either. I was terrified, but it ended up being no big deal. I think the key is to have it under flouroscopy(sp?) from what I understand that's where they can see where they are inserting the needle.

Lumbar puncture
 

It was the most painful experience of my life. I had a two strokes when i was twenty so they wanted to text my spinal fluid.
They couldn't get the needle in right at first so they had to try again 40 mins later, although they gave me local anaesthetic i could feel everything. It took them an hour to get enough fluid.
I never ever want another one in my entire life. Thinking about it i can feel it all over again.

I am personally shocked and surprised how many people posted on here and said that their lumbar puncture was not painful.

For me, personally, it was one of the worst experiences in my entire life.

I haven't felt that much pain, ever, before my lumbar puncture.

I have trigeminal neuralgia, and my doctor has no idea what is causing it. It is being controlled quite well by taking two 300 mg capsules of gabapentin spaced out by taking 1 capsule when I wake up in the morning, and 1 when I go to bed at night.

Anyways, my doctor ordered an M.R.I. with and without contrast, and that was no big deal, other than the fact that the contrast dye had to put injected into an i.v. in my arm, and I hate needles, and also the dye is bad for my kidneys, so I had to drink a lot of water to flush out the contrast dye. The M.R.I. should be sufficient to tell my doctor what is causing the T.N.

But, he also ordered a lumbar puncture, and assured me that it is standard procedure and not a big deal.

It is an enormous deal!

Everyone at the hospital where it was performed assured me it was not painful, just slightly uncomfortable.

Back up a minute. When the hospital called me to schedule both the M.R.I., and the lumbar puncture for the same day, they didn't mention that I would have to stay in the hospital for most of the day to recover from the lumbar puncture and that I wouldn't be able to drive myself back home. I think if they had told me that, I would have chickened out. And that's probably why they kept me in the dark.

Now onto what happened to me. I arrived at the hospital nice and early. They told me not to eat or drink anything that morning, and you'll see why in a moment. I checked in, and they verified who I was and gave me the standard hospital bracelet stuff, and then someone arrived with a wheelchair to get me. I thought that was strange, since I can walk just fine. Little did I know, that I would not be walking when I came out of there. Oops, I shouldn't jump ahead so far. So, they wheeled me into my hospital room and it had one of those hospital beds with wheels, and I thought that was strange. I thought this was just going to be a quick, simple, easy, and painless experience, like everyone was telling me. They had me take off my clothes and put on one of those backless gowns with no metal-- for the M.R.I. Then a nurse came in and put in an I.V. Okay, I hate needles, but so far, no big deal. They then took out 6 tubes of blood from me, labeled them and rushed them off to the lab, who knows what they are checking for with those?

Anyways, next they checked all my vital signs and recorded them in their computer and then they had me lie down in the hospital bed and they whisked me away to the M.R.I. area. Weird I thought. I could have walked there. I guess they were getting me ready for what was to come.

The M.R.I. was no big deal. Even the injection of the contrast was no big deal. They secured my head down so I couldn't move, put in ear plugs in my ears, and wedged my ears very tightly, once again to keep me still. I can handle that with no problem. They then slid me into this long tube and then for about 20 minutes all sort of sounds and vibrations were bombarding my head, neck, and my body. I think it was a whole body M.R.I. Then they slid me out and injected the contrast dye into my vein, and then slid me back in and did some more sounds and vibrations, but not quite as long. Then they slid me out and put me back in my bed and rolled my med down the hall, where the real fun began!

They had me get up on a table and lie on my stomach, and my chin was on a pillow. They found the area where they wanted to puncture and then gave me small shots of some local anesthetic. It numbed my lower back and I wrongly assumed that there would be no pain.

Then came the long, big needle and when it went in, I could feel it and I knew I was in for a world of pain. It was the most excruciating pain I have ever felt as it tore into my spine. I felt weird sensations running down my legs, in my butt, and then a wave of nauseating feelings like I needed to vomit. My left shoulder began to twitch and shake involuntarily. My legs were doing the same thing. I had sweat rolling down my face. My eyes were twitching, and I could feel the fainting reflex coming on strong, like I was going to pass out. I tried to vomit, but there was nothing in there but mucous to come out. I cried and moaned, and they told me they were having trouble getting enough spinal fluid out on the first go around, and so guess what? They pulled out that needle, got a new needle, and tried it all over again! Oh God! The waves of pain from that. They even moved the needle around to try to get more fluid out, and they raised the head end of the table to get more fluid to drip out of my spine. I blacked out from the pain briefly, and when I came to, they were asking if I was okay. I was still unresponsive, because I couldn't speak at that point, the pain was so intense. The finally finished getting enough fluid out and then they removed the second needle and rolled me over onto my back and put me back on the hospital bed with wheels and rolled me back to my room.

I stayed there on my back for 2 hours, and then they came in there to see if I could get out of bed and walk down the hall to go to the bathroom. They wanted to discharge me. I tried to get up, but then the worst headache of my life occurred. I have never felt such a horrible headache in my entire life. Suddenly the pain of trigeminal neuralgia seemed like it wasn't such a big deal, and certainly not worth all this pain and suffering, trying to find out what caused it.

2 more hours passed, and I could finally get out of bed, but I couldn't walk without help.

They went ahead and discharged me anyways.

They wheeled me out to front circular drive of the main entrance to the hospital and I sat down on a concrete chair and was supposed to wait for my ride. I then called the relative who was supposed to be picking me up, and since the whole thing took far longer than any of us had expected, he was at work and couldn't come and get me.

I had to call a taxi and wait there for about an hour for the taxi to show up and drive me home. The ride home was quite painful, as we all know how carefully taxi drivers drive. When I finally got home and paid the taxi driver, I hobbled away from the taxi and barely made it into the front door of my home.

My lumbar puncture did not hurt at all. I give credit to this for the highly skilled neurologist who did it. He was good at other things, too, like prescribing magnesium for jerks and spasm when I could not take Baclofen or Zanaflex. I didn't realize at the time how good he was, as that was fairly early in my diagnosis. I don't remember his name but he was James, a doctor at Scripps, now retired so you can't go see him, but I had lots of luck at Scripps in San Diego.
I am not lying. No pain with lumbar puncture. No headache afterwards. It was the doctor's skill.

I felt preasure but no pain. I too had a top notch Neurosurgeon.

No pain at all and no headache afterwards. Like Sal, just a little pressure.

I had no pain with my LP either.

I have had 2. One without flouroscopy and one with it. I had the first one due to a completley different reason than MS. i was having a high B/P crisis and my head was killing me so I don't thik I could have felt the LP if I had tried to. The second was the flouroscpy and it was apiece of cake. I would have it again with no reservations if it was recommended. Oh, the first one, my vacation started the next day and we traveled to Disney World.

I'm sorry that you had such a painful lumbar puncture Nippers2, but as others have posted ..... it is not be a painful procedure.

For you to have had such a terrible time, I have to assume that either your medical officer was not experienced in the technique, or else there was a physical barrier in your spine making it difficult for him to insert the needle.

I hope that you never have to go through another in the same circumstances. :hug:

I wish I had the same experience. Fortunately, the pains and weird feelings have all gone away for me at this point in time.

I would like to know more about how magnesium relieved your spasms.

Does it need to be a prescription form of magnesium, or could I simply buy it as a vitamin at the grocery store?

I wonder if it would help with Trigeminal Neuralgia, which like a spasm on the face?

I buy mine from the Health store so I assume your grocery store would have suitable brands but when first suggesting I buy some for my own cramps/spasms, my doctor told me to buy plain Magnesium and not a brand that's mixed with anything else like Calcium, etc. You also have to be careful not to get the type that is used as a laxative, but the right one is very effective. So far they have worked and they also work for my husband, who does not have MS.

You could try the search function at the top of the page for more information, and if you posted on our Vitamins Forum, I'm sure that mrsD, our resident pharmacy expert, can tell you how it works and advise you on safe doses and suitable brands for the condition. Here's the link : http://neurotalk.psychcentral.com/forum49.html

Also, a few years back some of us MSers did a trial on the effects of pure soap on night cramps, where a group of us put a bar of pure soap in the bottom of the bed and then measured the results. Do any of you remember this?

I remember that, Koala, but it had to be Ivory, I think. I never tried it, but lots said it worked.:)

It was Ivory soap. It was for Restless Leg Syndrome.

Sorry to bump this thread everyone, but when I just had my spinal tap I felt obligated to explain my situation since reading all these reviews really relaxed my mind and gave me a whole lot of knowledge and put me at ease.

I just had a lumbar puncture (spinal tap) and just want to corraborate what everyone else here said. The process took about 15 minutes (5 for cleaning my back and sterilization, 7 for the spinal fluid to collect and 3 for the local anesthetic/insertion of needle). Its scary to think of a long needle penetrating your body, but the process was relatively painless, (double the pain for a tetanus shot) so not bad at all. The local anesthetic hurt the most, the initial prick and then the release of the anesthetic. For a guy scared of needles and very pain sensitive it is more than manageable. Just a simple wince and deep breath and it was over. Then after waiting, the doctor inserted the needle, it felt like he was just pushing my back. We waited for the CSF to collect then he immediately pulled it out painlessly. The doc and nurse joked about who hurt me most (taking blood or the spinal tap) so that should give you a relative idea of the pain level.

At the end of the day, it was nowwhere near as scary I as thought (granted I'm 5'10, 150lbs). If you are reading this and can feel your spine when you bend your back in the fetal position, you will be fine!! Even if you cant you still should be, but I have no experience on being heavy. Good luck to whoever reads this!

edit: Its been almost 24 hours and no headache. Just a little discomfort at the area and light dizziness if I get up too quickly.

it is important to hydrate well before the test so that hopefully there's good fluid which is easily extracted.

when i had mine the dr moved the needle to get more fluid which caused pressure on the nerve and a lot of pain. he backed off and stopped the test so in the end it wasn't bad.

i would urge anyone having a bad experience (which isn't easy when you're face down on the table) to tell the dr to STOP. it doesn't sound like this dr was experienced enuf. or, maybe they weren't doing it under floroscopy to see where the needle was. that dr should have stopped and ended the test.

always keep in mind that you are your own best advocate when anything is done to you.

It wasn't bad at all. Thinking about it sucked the most, but the actual thing is not real bad.
Sort of like people getting all scared going to the Dentist then seeing that it wasn't bad at all....You'll do fine.

I have a high tolerance fo rpain thoguh hahah J/K....well.....

I had one done in '11. The doctor numbed the area first. I recall it felt weird, feeling him drain the fluid that they tested for lesions with. And after, once home, I took a long nap. Felt a little nauseous.
After realizing this doctor was the same doctor who administered the epidural for my first born and spinal for my third born,(care of his remembering my tattoo :cool::D), I felt comfortable and confident that he knew what he was doing sticking a needle in my back. Trusting the doctor, helps.

Good Luck, hope it's not too bad for you.

My one and only lumbar puncture was pure torture. The guy kept hitting nerves causing shooting pain in my legs. I will never consent to another