What are the side effects of Lumbar Puncture (LP)?

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Last updated: April 13, 2025 • View editorial policy

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From the Guidelines

Lumbar puncture (LP) side effects include headache, which occurs in about 10-30% of patients, and back pain, which occurs in around 16-17% of patients, with the risk of headache being lower in patients over 65 years and those with dementia 1.

Common Side Effects

  • Headache: typically worsens when sitting or standing and improves when lying flat, caused by cerebrospinal fluid leakage through the puncture site
  • Back pain or discomfort at the needle insertion site: usually resolves within a few days

Less Common Complications

  • Bleeding (particularly in patients on blood thinners): can be reduced by normalizing hemostatic factors such as platelet counts and coagulation parameters
  • Infection at the puncture site: rare, but can be serious
  • Nerve damage causing temporary numbness or tingling in the legs: rare

Rare but Serious Complications

  • Brain herniation: can occur if there is increased intracranial pressure, which is why a CT scan is often performed before LP if this condition is suspected
  • Cerebral or spinal hemorrhage, spinal epidural or subdural cerebral hematoma, and cerebral venous thrombosis: very rare, but potentially disabling or fatal

Minimizing Side Effects

  • Patients are advised to lie flat for 1-2 hours after the procedure and increase fluid intake
  • If headache persists, treatment options include caffeine, hydration, analgesics like acetaminophen or ibuprofen (400-600mg every 6 hours as needed), and in severe cases, a blood patch procedure where a small amount of the patient's blood is injected into the epidural space to seal the leak 1.

Important Considerations

  • The use of atraumatic needles is associated with a lower incidence of adverse events, including headache and back pain 1
  • The risk of headache is reduced with age, and patients with dementia have a lower risk of headache and back pain compared to healthy controls 1

From the Research

Lp(a) Side Effects

  • There are no direct studies on the side effects of Lp(a) itself, as it is a lipoprotein and not a medication.
  • However, studies have investigated the effects of elevated Lp(a) levels on cardiovascular health, and the potential side effects of therapies aimed at lowering Lp(a) levels 2, 3, 4.
  • Elevated Lp(a) levels have been linked to an increased risk of atherosclerotic cardiovascular disease and aortic stenosis, but the side effects of Lp(a) itself are not well understood.
  • Therapies aimed at lowering Lp(a) levels, such as antisense oligonucleotides and small interfering RNAs, have shown promise in reducing Lp(a) levels, but their potential side effects are still being investigated in ongoing clinical trials 3, 4.

Statin-Related Side Effects

  • Statins, which are commonly used to lower LDL cholesterol levels, have been shown to cause dose-dependent borderline elevations of liver function tests over time 5.
  • These elevations are typically clinically and statistically insignificant, and should not deter physicians from prescribing or continuing statins.
  • Coenzyme Q10 supplementation has been shown to improve metabolic parameters, liver function, and mitochondrial respiration in rats with high doses of atorvastatin and a cholesterol-rich diet 6.

Emerging Therapies

  • Emerging therapies, such as pelacarsen and olpasiran, have potent Lp(a)-lowering effects and appear safe, but their potential side effects and effectiveness in reducing cardiovascular risk are still being investigated in ongoing clinical trials 2, 3, 4.
  • The potential side effects of these therapies, such as new-onset diabetes, will be important to assess in future trials 2.

References

1
Guideline

Guideline Directed Topic Overview

Dr.Oracle Medical Advisory Board & Editors, 2025

3
Research

Lp(a): A Rapidly Evolving Therapeutic Landscape.

Current atherosclerosis reports, 2024

4
Research

Treatment of Lp(a): Is It the Future or Are We Ready Today?

Current atherosclerosis reports, 2023

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Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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