Will the lumbar puncture hurt?
I have now had four lumbar punctures. A small sample of fluid is taken from the spinal cord to measure the activity of multiple sclerosis. Think lumbar puncture and my hair stands on end. The idea of a syringe going into my spine and thinking ‘will the lumbar puncture hurt?’ are two concepts I don’t like thinking about. I have just had my fourth one.
Why, why, why
I have lumbar punctures because I take part in MS drugs trials and the lumbar puncture is completely voluntary. I hope going through this process will help research. It is definitely an altruistic act and entirely self-imposed. I’m just that kind of guy.
My first experience, 2012
I am sure the doctor was a rookie. After numerous painful attempts to insert the needle a more experienced doctor took over. The procedure finished soon after that. All I really remember was gripping the nurse’s hand really tightly because of the pain and wishing I wasn’t there. When it was finished I had to lie on the bed for a couple of hours and drink lots of water.
The second time, 2014
Now I was mentally scarred. I did not want to go through it again, I was very apprehensive. This time the entire process took only 20 minutes, it was totally painless and afterwards I went down to watch the disabled Olympic Games in Stratford, London. No pain, no headache and a happy man.
Third lumbar puncture, 2015
I was starting another drugs trial and I had agreed to a lumbar puncture but straightaway I had regrets. Just before the procedure I had lunch. This was a displacement activity to stop me thinking about the entire process.
The lumbar puncture process began but straightaway I regretted putting a tick in the yes box. There were a flutter of butterflies in my stomach. The doctor said the process wouldn’t hurt. Nonetheless I was tense. It took ages before the needle was inserted into my spine meanwhile I was getting more and more lightheaded.
Eventually it started but just as the doctor was about to start taking the fluid out I told him to stop.
I blurted out ‘I’ve got the spins’. I added ‘My lunch wants to come up and say “hello”’.
The nurse immediately said ‘You don’t look well. In fact you look positively green’.
‘Great’ I thought and felt very sheepish.
Fourth lumbar puncture, 2018
I had no option over this one. I had no fears or worries about it, I don’t know why. In fact the whole process took just 15 minutes and was totally painless. The only way I could go through the process was to talk. A fifteen minute spew of non-stop chat, apparently all the other people on the floor heard every word as well.
Will the lumbar puncture hurt?
I have had a range of experiences, good, bad and traumatic but it has never caused a headache. When you have a lumbar puncture do remember to ask the doctor to use a smaller atrauamtic or non-cutting needle. This will significantly reduce the chance of a headache after the lumbar puncture.
This is an email I received about the atraumatic needles that should now be used for every lumbar puncture
It is widely known that the use of a specially tipped needle reduces the incidence of headaches and other trauma following a lumbar puncture. I discussed this at a MS Research Day with a neurologist and he said that there were lots of trusts where the cheaper needles were still used. He pulled out some hypodermic needles from his pocket, saying he always carried some to give to patients heading for the procedure at a Hospital Trust who refused to use the proper needles. The cheap needle allows spinal fluid to leak after the Lumbar Puncture.
I see that a new ‘Atraumatic’ needle is now available as well as the pointed (diagonally tipped) needle that he used. But I would urge anyone having a lumbar puncture to discuss the type of needle to be used and to refuse to allow a standard needle to be used (they were around £4 cheaper). A college of Prof Giovanonni wrote a Research paper about the issue, or should I say scandal?
I’m sending you a short note on the special needle that ought to be used for taking lumbar punctures.
I have just published your email
I’ve just had the one lumbar puncture and two MRI’s. The lumbar puncture was carried out by two experienced nurses at Addenbrookes and was painless. I was very nervous beforehand, mainly because a needle was entering the spine and one can imagine that somebody with two left feet could really cause mayhem! Your blog inspired me to ring up the MS nurse to find out whether I could pay for an MRI but I New her answer would be ” a scarse resource,what will it prove,there is no cure at the moment etc.”
My walking has got very poor. In fact I sit down most of the day. The nurse encouraged me to set an exercise plan(again) of walking a little every day so I must stick with it this time! Something good may come of it—- or bust
I’m sure you’ve heard this umpteen times. It really is a case of use it or lose it. Your body is not in the least bit interested but the brain must say ‘do it’. I am sure you will feel better for it afterwards.
I’ve only had one lumbar puncture and that was part of my initial checks for MS. I was worried about it as I dislike injection needles. Despite being done by an inexperienced medic, it didn’t hurt – but the pain-killer injection did.
I also suffer an intense dislike of injections after one painful experience a few years ago, nothing to do with lumbar puncture.
I think it was the pain killer injection that was the problem when my lunch tried to come up and say ‘Hello’
I think there’s a case in here – variability by doctor and instrument – for a degree of standardisation and maybe even a robot or two.
A possible idea but big investment and no two people are quite the same. Who says AI will get it right