Caffeine Can Ease Postdural Puncture Headaches

A new study found that caffeine tablets may ease the painful throbbing in those who suffer headaches following a spinal tap.

Postdural puncture headaches are the most common complication of lower back punctures, lasting from a few hours to a few days. The puncture can occur intentionally—when drawing a sample of cerebrospinal fluid for a diagnosis, for example—or unintentionally with anesthesia or a medication injection at the lower back.

A team of researchers led by Xavier Basurto Ona of the Hospital de Figueres in Catalonia, Spain, found that caffeine treatment can decrease the number of patients with persistent puncture headaches, when compared to a placebo. Both oral and intravenous caffeine are effective, with the IV form especially helpful in lessening the duration of the headaches, according to a report from the Health Behavioral News Service, Part of the Center for Advancing Health.

Other medicines, including gabapentin, hydrocortisone and the asthma drug theophylline, can also lessen the pain of the headaches when compared to placebo.

“Numerous medications are used in clinical practice to treat postdural puncture headache, so the aim of this review was to assess the effectiveness of these drugs,” said Basurto Ona.

For the study, which is published in The Cochrane Library, a publication of the Cochrane Collaboration, researchers analyzed 7 studies including 200 patients, which compared treatments for the headaches. The patients underwent treatment in the United States, Germany, the United Kingdom, Turkey and Iran, and were mostly women who received regional anesthesia during labor.

Ashina said patients seeking relief have also used alternative therapies such as rest, hydration and abdominal compression binders. “Conservative nondrug therapies for lumbar puncture headaches always need to be considered prior to starting aggressive therapies with drugs,” he noted.

Since most of the patients in the Cochrane studies were women in labor, the results might not have wide applicability, Basurto Ona said. Larger and more diverse studies could help confirm whether caffeine is a good choice for treating most postdural puncture headaches.