How painful is a spinal tap?

Question

Question says it all, my sister is going to get one most lickley and we just want to know.

Answer 1

It more uncomfortable than painful.... it's a feeling of pressure, along with some pain, but it's tolerable.

See if they can numb the area before they do the procedure.

Hope this helps?

Answer 2

A lumbar puncture (LP), sometimes called a spinal tap, is a procedure in which a small amount of the fluid that surrounds the brain and spinal cord, called the cerebrospinal fluid (CSF), is removed and examined.

In infants and children, a lumbar puncture is typically done to look for meningitis, an infection of the meninges, which is the membrane covering the brain and spinal cord. There are other reasons to do lumbar punctures, too: They may be performed to remove fluid and relieve pressure with certain types of headaches, to look for other diseases in the central nervous system, or to place chemotherapy medications into the spinal fluid.

What Happens During a Lumbar Puncture?
There are steps to make sure that a child doesn't feel pain during the lumbar puncture. For a nonemergency LP, a nurse will rub a topical anesthesia cream on the skin of the back where the LP will be done about 30 minutes to 1 hour before. When the needle goes into the skin, the child won't feel sharp pain, only perhaps some pressure. After the skin is numbed, some doctors also inject liquid anesthesia such as lidocaine into the tissues right under the skin to prevent any further pain.

After the preparation has been completed, the child is positioned on an exam table so that the spaces between the vertebrae (bones of the spine) are as wide as possible. Infants and small kids lie on their sides curled up with their knees under their chin, like the letter C. (Sometimes nurses or aides have to hold kids in the position in order to get the best test results.) Teens may lie down or sit with their heads resting on a pillow placed on a table at waist level.

Next, the doctor places a small needle through the skin and then forward through the space between the vertebrae in the lower back until it enters the space that contains the spinal fluid. The spinal fluid drips out through the needle into tubes, is collected, and sent to a lab for analysis. The pressure in the brain (intracranial pressure) can also be measured as part of the test, which can provide important information in some situations. After the sample is collected (usually this takes several minutes), the needle is withdrawn and a bandage is placed on the site.

It is important to note that the needle does not enter the spinal cord or nerves because the test is done in the lower back, below the level to which the spinal cord extends.

Understanding the Results
Fluid collected from a lumbar puncture is immediately sent to the laboratory and analyzed for evidence of an infection. Some of the results are available within 30 to 60 minutes. However, bacterial culture is necessary to watch for an organism growing in the sample. Culture results are usually available in 48 hours. If the doctor determines that the child has an infection, he or she will start antibiotic treatment while waiting for the results of the culture and then make any necessary adjustments once the final results come in.

The lab technicians look for a number of things when examining the spinal fluid sample, including:

General appearance: CSF is usually clear and colorless and looks like water. Cloudy spinal fluid may indicate infection because of increased cells and proteins suspended in the fluid.
Cell count: This includes the number and type of white blood cells and the number of red blood cells present. CSF normally does not contain either of these types of cells. The presence of too many white cells indicates an infection.
Protein: Large amounts of protein in the spinal fluid also suggest an infection or other disease.
Glucose: In bacterial infections of the spinal fluid, the glucose level of the fluid is often low.
Gram's stain and culture: CSF is also stained and examined under the microscope to look for bacteria. The staining technique used, called the Gram's stain, detects bacteria in the CSF. To confirm an infection, it is also cultured to see if any organisms grow from the fluid.
CSF may also be processed for other tests for which results are not available immediately.
Complications From Spinal Taps
Most of the time, there are no complications with spinal taps. In the rare instances when they do occur, complications can include:

Headache: This can occur because of continued leaking at the site where the fluid was taken. If this occurs, you may want to give your child acetaminophen or another non-aspirin type of pain reliever. If the headache persists for more than 2 days, call your child's doctor.
Infection: In rare cases, it's possible to cause an infection if bacteria are introduced into the skin when the puncture is done. This is very rare, because doctors always use sterile techniques to perform the test.
Bleeding: If a small blood vessel under the skin is nicked during the spinal tap, there may be some bleeding.
Again, these complications are uncommon. If you have any other questions or concerns about your child following a spinal tap, contact your child's doctor.

Answer 3

If it's like an epidural, it's pretty painful, but it was worth it to get our baby born. Think they usually give you something for the pain in a spinal tap and she could try having something playing in her ear to concentrate on. Depends what her pain threshold is as to what level of pain she perceives.

Answer 4

The most common indication for a lumbar puncture is to collect cerebrospinal fluid in a case of suspected meningitis, since there is no other reliable tool with which meningitis can be excluded and it is often a life-threatening but highly treatable condition. Young infants commonly require lumbar puncture as a part of the routine workup for fever without a source, as they have a much higher risk of meningitis than older persons and do not reliably show signs of meningeal irritation (meningismus). For instance, most experts agree that any infant less than 2 months of age with fever of 38 degrees Celsius or greater and no identifiable source requires a lumbar puncture. In any age group, Subarachnoid hemorrhage, hydrocephalus, benign intracranial hypertension and many other diagnoses may be supported or excluded with this test.

Lumbar punctures may also be done to inject medications into the cerebrospinal fluid, particularly for spinal anesthesia or chemotherapy.


[edit] Procedure
A lumbar puncture requires aseptic technique (sterile) and performance by qualified and skilled medical practitioners.

In performing a lumbar puncture, first the patient is usually placed in a left (or right) lateral position with his/her neck bent in full flexion and knees bent in full flexion up to his/her chest, approximating a fetal position as much as possible. It is also possible to have the patient sit on a stool and bend his/her head and shoulders forward. The area around the lower back is prepared using aseptic technique. Once the appropriate location is palpated, local anaesthetic is infiltrated under the skin and then injected along the intended path of the spinal needle. A spinal needle is inserted, usually between the lumbar vertebrae L3/L4 or L4/L5 and pushed in until there is a "give" that indicates the needle is past the dura mater. The stylet from the spinal needle is then withdrawn and drops of cerebrospinal fluid are collected. The opening pressure of the cerebrospinal fluid may be taken during this collection by using a simple column manometer. The procedure is ended by withdrawing the needle while placing pressure on the puncture site. The patient should then lie on his/her back for at least six hours and be monitored for any signs of neurological problems. The technique described is almost identical to that used in spinal anesthesia, except that spinal anesthesia is more often done with the patient in a sitting position.

The seated position is advantageous in that there is less distortion of spinal anatomy which allows for easier withdrawl of fluid. It is preferred by some practitioners when a lumbar puncture is performed on an obese patient where having them lay on their side would cause a scoliosis and unreliable anatomical landmarks. On the other hand, opening pressures are notoriously unreliable when measured on a seated patient and therefore the left or right lateral (laying down) position is preferred if an opening pressure needs to be measured.

Patient anxiety during the procedure can lead to increased CSF pressure, especially if the person holds their breath, tenses their muscles or flexes their knees too tightly against their chest. Diagnostic analysis of changes in fluid pressure during lumbar puncture procedures requires attention both to the patient's condition during the procedure and to their medical history.

I have heard people say that it can be painful, but i am sure it is worth the pain to get better

Answer 5

I'll be honest with you--I found mine to be very painful. First, they inject anaesthetic--and they missed the right place for me, so they had to inject it twice. That injection hurt. But the actual tap is this pain that's kind of hard to describe--but it's so internal . I hated it--but I've heard if you have a good doctor performing it it can be not so terrible.

Answer 6

It is quite painful to most people but the doctor and nurse will numb the area before starting no doubt. There is really no way to make it painless but comfort will be the top priority for most doctors.

Answer 7

The numb you so you don't feel much but you have to lie flat on your back after you have it for a few hours.

Answer 8

Very unpleasent, expect tears,sorry.

Answer 9

It hurts like hell.Good luck.........