Caffeine for spinal headaches

All Woman

Dear Dr Mitchell,
I had quite the experience in the hospital the other day after my C-section. I delivered a healthy baby boy and was told by the anaesthesiologist the night before the surgery that I may get spinal headaches post-surgery, and that caffeine may help. I was told to have a bottle of Pepsi on hand so I asked my husband to get one just in case. After my surgery I was loudly scolded by the nurse who came to give my baby his first vaccine, as she said the soda would hurt my baby and basically implied that I was a bad mother. I'm now home and I have had excruciating aches at the base of my neck that have only eased when I drink cola. Can you explain what happened and why the nurse wouldn't have known this?

Spinal headaches are described as severe headaches distributed over the front and back of the head and radiating to the neck and shoulders. Neck stiffness may also be present. The pain is worsened by head movement and an upright posture. An increase in the severity of headaches on standing is the hallmark of spinal headaches. The pain may be quite severe and prolong one's hospital stay.

A spinal headache is a relatively common complication of an epidural or spinal anaesthesia. It tends to be even more common if the anaesthetist has difficulty getting the spinal needle into the space and has to make several attempts during the procedure.

Spinal headaches are caused when spinal fluid leaks from the membrane around the spinal cord; this leakage of fluid reduces the pressure on the brain. The greater the number of attempts at getting the needle in and the bigger the size of the needle, the greater the likelihood of spinal fluid leaking out after the procedure, thus causing severe headaches. Without treatment the spinal headaches will go away on their own within two days to a couple of weeks.

To manage spinal headaches, lying down and drinking lots of fluids — including drinks containing caffeine — helps. These include coffee, tea and soft drinks, including cola. The use of Panadeine, Panadol and ibuprofen will also provide significant relief.

Caffeine is a central nervous system stimulant and helps with spinal headaches by inducing constriction, or narrowing of the blood vessels, in the brain. Caffeine may be given orally or as an injection in the veins or muscles.

In severe cases that do not respond to the increased fluid intake, caffeine, bed rest and painkillers, a blood patch may be done by the anaesthetist. This involves injecting some blood into the space around the spinal cord to seal off the leakage of spinal fluid. In some cases the use of steroids helps to decrease the headaches.

The nurse in attendance should have been knowledgeable about the use of caffeine to treat spinal headaches. If the headaches are not resolving you should go back to the hospital and get a review done by the doctors on the ward.

Caffeine intake, generally speaking, should be limited during breastfeeding and pregnancy. When used to treat spinal headaches for a short period of time it is perfectly safe. The consumption of coffee and cola or caffeine-containing drinks during pregnancy can definitely cause growth restriction of the foetus, and this should be discouraged.

Consult your doctor who will advise you further.

Dr Sharmaine Mitchell is an obstetrician and gynaecologist. Send questions via e-mail to allwoman@jamaicaobserver.com; write to All Woman, 40-42 1/2 Beechwood Ave, Kingston 5; or fax to 876-968-2025. All responses are published. Dr Mitchell cannot provide personal responses.

DISCLAIMER:

The contents of this article are for informational purposes only, and must not be relied upon as an alternative to medical advice or treatment from your own doctor.

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