From the Guidelines
After a lumbar puncture, it is recommended to lie flat in bed for at least 1-3 days to reduce the risk of headache 1. You should also drink plenty of fluids, such as water or non-caffeinated beverages, to help replenish spinal fluid. Over-the-counter pain medications like acetaminophen (650-1000mg every 4-6 hours) or ibuprofen (200-400mg every 4-6 hours) can be taken to manage headache or back pain 1.
Key Aftercare Instructions
- Avoid heavy lifting, bending, or strenuous activities for 24 hours
- Avoid driving or operating heavy machinery for at least 24 hours after the procedure
- Rest and avoid strenuous activities for 2-3 days to allow your body to recover
- Minimise bending, straining, stretching, twisting, closed-mouth coughing, sneezing, heavy lifting, strenuous exercise and constipation for 4-6 weeks 1
Monitoring and Follow-up
- Seek medical attention immediately if you experience severe headache, fever, or numbness/tingling in your legs
- Monitor for concerning features such as new-onset severe back or leg pain, lower limb motor weakness or sensory disturbance, urinary or faecal incontinence, urinary retention, perineal sensory disturbance, nausea and vomiting or fever 1
From the Research
Aftercare Instructions Following a Lumbar Puncture (LP) Procedure
The following are the aftercare instructions following a lumbar puncture (LP) procedure:
- There is no evidence to suggest that routine bed rest after dural puncture is beneficial for the prevention of post-dural puncture headache (PDPH) onset 2, 3, 4, 5.
- Bed rest may not alter the incidence of post lumbar puncture headaches, but may reduce the severity in those who get headaches 6.
- Immediate mobilization may be as effective as bed rest in preventing PDPH 2, 3, 4, 5.
- The role of fluid supplementation in the prevention of PDPH remains unclear 2, 3.
- Patients who received lumbar puncture may be allowed to ambulate instead of resting supine, as this may not increase the risk of PDPH 4.
Key Findings
- A study published in 2013 found that there was no beneficial effect associated with bed rest compared with immediate mobilization on the incidence of PDPH 2.
- A study published in 2016 found that bed rest probably increased PDPH compared with immediate mobilization 3.
- A study published in 1998 found that bed rest does not appear to alter the incidence of post lumbar puncture headaches, but reduces the severity in those who get headaches 6.
- A study published in 2021 found that bed rest following lumbar puncture does not prevent PDPH, and even leads to a marginally increased risk of PDPH 4.
- A study published in 1992 found that there was no difference between the mobile and bed rest groups in the incidence of post lumbar puncture headache 5.