Lumbar puncture (adult)

Source: NHS: Lumbar puncture

You have been referred by your doctor for a lumbar puncture. This leaflet explains the following.

• What a lumbar puncture is.

• How to prepare for your procedure.

• What happens during and after the procedure.

• What the risks and possible complications are.

If you have any further questions, please speak to your doctor.

What is a lumbar puncture?

A lumbar puncture involves a needle being inserted into your lower back, between the bones in your spine.

It may be done to find out:

• why you are having certain symptoms

• to treat a condition, or

• to give an anaesthetic.

Why is a lumbar puncture needed?

There are a few different reasons why you might need a lumbar puncture.

A lumbar puncture may be used to:

• find out if symptoms you are having are caused by a brain or spine condition

• treat a condition, such as an infection or some types of cancer

• give you an anaesthetic.

You will usually be referred by a consultant or specialist to have a lumbar puncture. Sometimes it's done if you are very unwell in hospital or need an emergency anaesthetic.

How do I prepare for my lumbar puncture?

The doctor or specialist should tell you if you need to do anything before your lumbar puncture. You can also ask them about any concerns or questions you have.

For example, you may need to stop taking certain medicines for a short time before the lumbar puncture.

You can also ask if you can bring someone to support you during the procedure, but it may not always be possible.

Why do I need to sign a consent form?

All patients must give permission before they receive any type of:

• medical treatment

• test, or

• examination.

Consent is usually given when you sign the consent form before your treatment. We may ask you to give your consent verbally (spoken rather than written consent).

• You must give your consent voluntarily.

• The hospital must give you all the information you need to make a decision about your treatment. This is so you can give us informed consent.  Please speak to staff if:

• staff have not given you this information, or

• they have but you still have questions. 

• You must be capable of giving consent. This means you understand the information given to you, and can make an informed decision.

When we ask you to give consent, please use this time to ask any questions you may still have. For more information, please go to the NHS Consent for Treatment web page. Remember, you can withdraw your consent for treatment at any time.

What happens during a lumbar puncture?

A lumbar puncture is usually done in hospital. It typically takes around 15 to 20 minutes, but can take longer.

Before a lumbar puncture, you will need to get undressed behind a screen and put on a hospital gown.

1. You will be asked to sit down with your head and shoulders bent forwards, or lie down on your side with your knees pulled up to your chest.

2. You will be given a local anaesthetic in your lower back, usually as an injection. This means you will be awake but will not feel any pain. Children are also usually given medicine (a sedative) to help them relax and stay still.

3. A needle is slowly inserted into your lower back, between the bones in your spine (vertebrae). You may feel some pressure and discomfort on your back. You may also have a feeling of pins and needles for a few seconds.

4. If you are having tests or certain treatments, fluid from inside your spine (cerebrospinal fluid) is collected in small tubes. This will be sent to a lab for testing. If you are being given medicines or an anaesthetic, these are injected into your spine.

5. When the lumbar puncture is finished, the needle is removed. A dressing is put on your back to cover the needle wound and to stop any bleeding.

Important

A lumbar puncture may feel uncomfortable, but it should not be painful. Tell the doctor or specialist if you are in pain.

What if I am worried about needles?

Tell the doctor or nurse doing your lumbar puncture if you are worried about needles. They can help you feel more comfortable during the test.

What happens after a lumbar puncture?

You will need to stay at the hospital for around 1 to 2 hours to be monitored. You will need to lie flat on your back and rest.

If you are having a lumbar puncture as an outpatient, you should be able to go home after a few hours.

Recovering from a lumbar puncture

It can take a few days to recover from a lumbar puncture, and for some people it can take longer. There are some things you can do that can help.

Do

• Rest for at least 24 hours after having a lumbar puncture.

• Drink plenty of fluids.

• Try lying flat on your back if you have a headache.

• Take paracetamol to ease a headache or any pain.

Do not

• Do not do physical work, heavy lifting, or play sports until you feel well enough.

What are the side effects of a lumbar puncture?

After having a lumbar puncture you may have some side effects including:

• a headache

• back pain

• bleeding or clear fluid leaking from where the needle went into your back

• swelling where the needle went into your back.

These side effects are common and should go away after a few days.

What are the possible complications of a lumbar puncture?

A lumbar puncture is usually very safe.

Complications are extremely rare, but can include:

• long-term back pain

• infection

• nerve damage, which can cause long-term pain, pins and needles, or loss of feeling in your arms or legs

• hearing loss

• double vision

• blood clots.

Sometimes it is difficult to do a lumbar puncture. If this happens, you may need to go back for a second appointment.

Urgent advice: Ask for an urgent GP appointment or contact NHS 111 if:

You have had a lumbar puncture and:

• you have severe pain

• you have a headache that does not go away

• you have a high temperature

• you are sweating more than usual

• your wound is bleeding or leaking clear fluid for more than 1 week.

You can also call 111 or get help from NHS 111 online.

Immediate action needed: Call 999 if:

• your arms or legs feel weak or numb

• you are having problems peeing or pooing

• you are feeling confused.

When do I get my results?

If you had a lumbar puncture to find out why you are having certain symptoms, you may get your results in a few days. Sometimes it can take a few weeks.

You may need a follow-up appointment to talk about your results.

If you do not hear anything after a few weeks, contact the specialist or GP surgery.

Your specialist, GP or nurse should talk to you about your results and explain what happens next.

Sometimes you may need other tests, depending on why you had the lumbar puncture.

Ask to talk to a healthcare professional if you have questions about your results, or do not understand them.

Ask 3 Questions

There may be choices to make about your healthcare. Before making any decisions, make sure you get the answers to these three questions:

• What are my choices?

• What is good and bad about each choice?

• How do I get support to help me make a decision that is right for me?

Your healthcare team needs you to tell them what is important to you. It’s all about shared decision making.

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