“The Worst Headache of Her Life”: Headache and Spinal Fluid Leaks After a Spinal Cord Stimulator
Summary
Placing or removing the leads of a spinal cord stimulator involves a needle near the spinal cord. Occasionally the needle punctures the membrane around the spinal fluid, causing a severe headache that is worse when sitting or standing. This guide is for people who were left bedbound, sent home without answers, or not told it could happen. It explains the headache, the warning signs, the treatment, and when it might point to care that fell short.
Quick answer · updated November 2026
A headache that is much worse sitting or standing and eases when you lie flat, starting within days of a stimulator trial, implant or lead removal, may be a spinal fluid leak. Tell your treating team. Most improve, and an epidural blood patch often helps. Drowsiness, confusion, vomiting, fever, or new numbness or weakness need urgent care.
A leak headache at a glance
- 1The procedureA needle places or removes the leads. A puncture should be noted and explained.
- 2One day to a weekHeadache, worse upright and better lying flat. Nausea and light sensitivity.
- 3First stepsRest, fluids and pain relief. Tell your team it is positional.
- 4Blood patchIf it isn’t settling, an epidural blood patch often relieves it.
- 5AfterwardsMost recover. Lasting symptoms need answers.
At any stage: a headache with drowsiness, confusion or vomiting, fever, or new numbness, weakness, or bladder or bowel problems is an emergency. Call 000 or go to an emergency department.
I’m writing this as her husband, because for nine days she couldn’t sit up long enough to write anything.
Karen had the stimulator trial leads put in on a Tuesday. On Wednesday morning she tried to get out of bed and folded back down onto the pillow, hands over her eyes. “It’s like my brain is falling out the back of my head,” she said. Lying flat, she could talk to me. Sitting up for thirty seconds, she was white and retching.
I rang the clinic. The nurse said it sounded like a migraine and to give her Panadol and fluids. On Friday I drove her to emergency with the passenger seat right back. They gave her a drip and an anti-nausea injection and sent us home.
I remember standing in the kitchen at 2 am, watching her through the doorway, lying perfectly still in the dark. I didn’t know what was wrong. I just knew it wasn’t a migraine.
A composite story, drawn from the experiences of many families I have worked with, combined and changed so that no one can be identified. It does not describe any individual client.
If you or someone you love has had this kind of headache after a stimulator procedure, I want you to know that it has a name, it is recognised, and in most cases it can be treated. You are not imagining how bad it is.
This guide is for anyone who has had a spinal cord stimulator trial, implant or lead removal, and for the partners and family caring for them. It covers what a dural puncture is, the typical headache, the warning signs, how it is treated, what your records should show, and how the law looks at it.
Why I can write this
I have been a medical negligence lawyer since 2014 and have worked on many hundreds of claims, including many involving spinal procedures. My doctorate looked at patterns of failure in medical negligence. I am not medically qualified. The clinical facts in this article are checked against named sources, listed in the references, and I explain how I work in our editorial standards.
Start with your question
- Why would a spinal cord stimulator cause a severe headache?
- What does a spinal fluid leak headache feel like?
- How common is this?
- What is an epidural blood patch?
- When is a headache after a stimulator an emergency?
- What should I ask my team?
- Could this be medical negligence?
Why a stimulator can cause a headache
Definition
The dura is the tough membrane that surrounds the spinal cord and the fluid around it. Stimulator leads are placed in the epidural space, just outside the dura. A dural puncture happens when the needle goes through the dura. Spinal fluid can then leak, lowering the pressure around the brain and causing a post-dural puncture headache.
In plain terms: the needle went a little too far, spinal fluid is leaking, and the brain is being pulled down when you sit up. That’s why lying flat helps.
Stimulator leads are usually placed through a large needle into the epidural space. Dural puncture is a known risk of that step. It can also happen, less obviously, when temporary trial leads are removed.1
How common is it?
A 2022 case report summarised the research. One study found post-dural puncture headache in 0.81 per cent of stimulator lead placements, and a larger study of more than 90,000 patients found a dural puncture rate of 0.48 per cent. Younger age, being female, a previous problem with the dura, lower body weight and the type of needle were associated with higher risk.1 For comparison, an Australian hospital information sheet puts the risk after an epidural or spinal injection at between 1 in 100 and 1 in 500.2
Before the procedure
Questions to ask
- What is the chance of a dural puncture, and what would happen if it occurred?
- Will you tell me if you think the dura was punctured during the procedure?
- What kind of headache should I watch for, and who do I call?
- Would a blood patch be available if I needed one?
- Do any of my risk factors make this more likely?
The headache
The headache usually starts between one day and one week after the procedure. It is typically worse when sitting or standing and better when lying flat. It may be felt at the front or back of the head, with neck pain, nausea and sensitivity to light.2 In the case described in the 2022 report, the patient had a frontal headache that worsened on sitting or standing, with nausea, vomiting and sensitivity to light, which left her bedbound.1
The positional pattern is the key. A headache that changes dramatically when you sit up or lie down is different from an ordinary migraine, and you should say so clearly when you call your team or attend an emergency department.
First steps
Most of these headaches improve within about a week. Regular pain relief is usually prescribed, and heavy lifting and straining should be avoided. Lying flat may help.2 But if you can’t function, if the headache isn’t improving, or if it is getting worse, ask for review rather than waiting it out.3
The epidural blood patch
Definition
An epidural blood patch is a procedure in which a small amount of your own blood is injected into the epidural space near the leak. The blood helps seal the hole.
In plain terms: your own blood is used as a plug for the leak.
If the headache persists, an epidural blood patch is frequently used. One Australian hospital information sheet says it relieves the headache in 60 to 70 per cent of people within 24 hours.2 In research on headaches after stimulator procedures, about 64 per cent of patients had a blood patch, with a median time to treatment of four days.1
After a blood patch, trouble passing urine, severe back pain, or numbness in the back or legs is not normal and needs urgent attention.2
Expected, worth a review, or emergency
A general guide only. If you are worried, get help.
Typical leak headache
- Worse sitting or standing
- Better lying flat
- Neck ache, nausea, light sensitivity
- Started within a week of the procedure
In plain terms: tell your team it is positional and ask for a plan.
Ask for review today
- Not improving with pain relief
- Getting worse instead of better
- You can’t care for yourself or others
- Changes to your vision or hearing
In plain terms: don’t wait it out. Ask about a blood patch.
Emergency
- Headache with drowsiness, confusion or vomiting
- Fever or redness at the needle site
- New weakness or numbness in the legs
- Trouble passing urine or controlling your bowels
In plain terms: call 000 or go to an emergency department now.
These warning signs are drawn from Australian and UK patient information about headaches after spinal procedures.23
Afterwards
Most people recover fully. If you were left with lasting symptoms, or with a stimulator that was never used because of what happened, ask for a clear explanation and a plan. Our guides to stimulator lead migration and pain after spinal surgery may also help.
If you were told it was “just a migraine” and sent home, you may find when being dismissed by a doctor becomes a legal issue useful.
On day nine, a different emergency doctor sat on the end of the bed and asked Karen to sit up while he watched. Thirty seconds. Then he asked her to lie down. “Has anyone mentioned a dural puncture?” he asked. Nobody had.
The anaesthetist did a blood patch that afternoon. By evening Karen was sitting up at the table eating toast and crying because she could. I cried too.
Weeks later we got the records. The operation note from the trial said, in one line near the bottom: “? dural tap at second pass, procedure continued.” There was no note that anyone had told her. The discharge sheet said to call if the wound was red.
Karen read it lying on the couch, out of habit more than need. “They wrote it down,” she said. “They just didn’t tell me.”
A composite story, drawn from the experiences of many families I have worked with, combined and changed so that no one can be identified. It does not describe any individual client.
What to look for in the records
Your records are often where the story becomes clear. You have a right to access your own health information. In NSW the Health Records and Information Privacy Act 2002 covers both public and private providers, and the Information and Privacy Commission explains how to ask.4 Our step-by-step guide to getting your medical records in Australia walks you through it.
| Record | Why it matters |
|---|---|
| Consent form and pre-procedure information | Shows whether dural puncture and headache were explained as risks. |
| Operation or procedure note | May record a suspected dural puncture, the needle used and the number of attempts. |
| Discharge information | Shows what you were told to watch for and who to call. |
| Phone and nursing notes | Show what was said when you or your family called about the headache. |
| Emergency department records | Show how the headache was described, what was considered and why you were sent home. |
| Blood patch records | Show when it was done, by whom, and the result. |
| Your own diary, photos and messages | Notes made at the time are evidence too. Keep them. |
How the law looks at it
A dural puncture is not, on its own, negligence. It is a recognised risk even with careful technique. The legal questions are whether the care before, during and after the procedure met the standard expected, and whether any shortfall caused harm.
A claim usually turns on three questions: whether the care fell below what peers would widely accept as competent practice (section 5O of the Civil Liability Act 2002 (NSW))5, whether that shortfall probably caused harm you wouldn't otherwise have had (Tabet v Gett)6, and, where it matters, whether you were told the material risks first (Rogers v Whitaker)78. Our guide to how a medical negligence claim works explains each one in plain terms.
In a case like this, the questions might be: was a suspected puncture recognised and recorded? Were you told about it, and about what to watch for? When you reported a positional headache, was a spinal fluid leak considered? Was a blood patch offered when the headache didn’t settle? Were more serious causes excluded?
In plain terms, the question is whether better care would probably have shortened or avoided the days or weeks you were unwell, or other harm you suffered.
For a stimulator trial or implant, that would usually include the risk of dural puncture and headache, alongside infection, bleeding and lead problems.
Who can claim, and when
The person who had the procedure can claim. Family members who cared for them may be able to recover some costs as part of that claim. In NSW, time usually runs from when you knew, or ought to have known, enough to claim, not from the treatment itself, and courts can sometimes extend it, so an old injury may still count. See time limits in NSW or other states, and ask early.
More: complaint or claim? · how a claim is paid for · what a claim can cover
In my practice
In files about headaches after spinal procedures, what I see most is not the puncture itself. It is the silence afterwards. An operation note may record a “possible dural tap”, and the patient goes home without hearing those words. Then come the phone calls: a nurse suggests migraine, an emergency department treats the nausea and discharges. Each person is responding to a single moment, without the full picture. The family, meanwhile, watches someone they love lie perfectly still in the dark for days. When the right question is finally asked, the answer is often simple. That is what makes the delay so hard to accept.
Both things can be true
The doctor who placed the leads may have been careful and skilled, and a puncture may still have happened. The clinicians who saw you afterwards may have been busy and well-meaning, and you may still have deserved a quicker answer. You can be grateful for the blood patch that helped and still want to know why it took so long.
The bigger picture
Spinal cord stimulators have been under scrutiny in Australia. The Therapeutic Goods Administration began a review of these devices in 2022, and has since cancelled some and put conditions on many others.9 A 2025 commentary in the Medical Journal of Australia questioned the evidence for their benefit in back pain and noted how often patients need further surgery.10
You can check any practitioner’s registration on the Ahpra public register,11 and complaints about care in NSW can go to the Health Care Complaints Commission.12 Our guide to missed and delayed diagnosis explains how the law treats delays in recognising a problem.
Support
You don't have to work through this alone. These services can help:
- Lifeline, 24-hour crisis support: 13 11 14 (listed on healthdirect's helplines page)13
- Beyond Blue, anxiety and depression support: 1300 22 4636
- Medicare Mental Health, help finding mental health support: 1800 595 212
- healthdirect, 24-hour nurse advice: 1800 022 222
- Health Care Complaints Commission (NSW): 1800 043 159
A woman who lay perfectly still in the dark for nine days sat up at the table and ate toast, and finally understood why. You deserve that understanding too.
With care,
Rosemary
Frequently asked questions
Can a spinal cord stimulator cause a headache?
Yes. If the needle punctures the membrane around the spinal fluid during placement or removal of leads, a leak can cause a severe headache.
What does a spinal fluid leak headache feel like?
It is usually much worse when sitting or standing and better when lying flat, often with neck pain, nausea and light sensitivity.
How long does a post-dural puncture headache last?
Most improve within about a week. If it doesn’t, an epidural blood patch often helps.
What is an epidural blood patch?
A small amount of your own blood is injected near the leak to seal it. One Australian hospital says it relieves the headache in 60 to 70 per cent of people within a day.
When is a headache after a stimulator an emergency?
If it comes with drowsiness, confusion, vomiting, fever, new numbness or weakness, or bladder or bowel problems.
Can I claim for a headache after a spinal cord stimulator?
Possibly. It depends on whether your care fell below the accepted standard and caused harm you wouldn’t otherwise have had.
Questions about a headache after a spinal procedure?
When you're ready, and not before, I can look at what happened and help you understand your options.
Spinal surgery and stimulator guides
- “The tingling moved and the pain came back”: Spinal cord stimulator lead migration
- “The worst headache of my life”: Headache and spinal fluid leaks after a stimulator (you are here)
- “I heard something click”: When spinal fusion hardware fails
- What to do if you still have pain after spinal surgery
- Cauda equina misdiagnosis: when back pain red flags are missed
Part of our guide to spinal and neurosurgical negligence. Not sure where you stand? Try the free claim checker.
References
- Bajaj G, Southerland WA, Badiola I, Bell R. Post-dural puncture headache after removal of trial spinal cord stimulator leads: a case report. Cureus. 2022.
- Mercy Hospitals Victoria. Headache after a spinal or epidural injection (patient information).
- Royal College of Anaesthetists (UK). Headache after a spinal or epidural anaesthetic (patient information).
- Information and Privacy Commission NSW. Fact sheet: Accessing your health information in NSW.
- Civil Liability Act 2002 (NSW) s 5O, Standard of care for professionals.
- Tabet v Gett [2010] HCA 12.
- Rogers v Whitaker [1992] HCA 58; (1992) 175 CLR 479.
- Australian Commission on Safety and Quality in Health Care. Informed consent.
- Therapeutic Goods Administration. Post-market review of spinal cord stimulation (SCS) devices.
- Liew S. A stimulating tale about spinal cord implants for managing chronic pain. Med J Aust. 2025;223(5):241–242.
- Australian Health Practitioner Regulation Agency. Register of practitioners.
- Health Care Complaints Commission NSW. Home page.
- healthdirect Australia. Mental health helplines.
Stories in this article are composites, drawn from the experiences of many families I have worked with, combined and changed so that no one can be identified. They do not describe any individual client.
Dr Rosemary Listing, PhD (Law), Medical negligence lawyer since 2014 · Of Counsel, Peter Evans & Associates. Rosemary's doctorate examined patterns of failure in medical negligence, and she teaches health law at the University of Newcastle. She is not medically qualified. About Rosemary.
Last updated: 10 November 2026 · First published: 10 November 2026 · Next review: May 2027
Cite this article: Listing R. “The worst headache of her life”: Headache and spinal fluid leaks after a spinal cord stimulator. Reframe Legal. Published 10 November 2026. https://reframelegal.com/spinal-cord-stimulator-headache/
This article is general information, not legal or medical advice. It does not create a lawyer–client relationship. Speak to your treating clinicians about your health, and get legal advice about your own situation.
If you are in danger or need urgent medical help, call 000. For crisis support, call Lifeline on 13 11 14.
Legal services are provided by Peter Evans & Associates.
