Lumbar puncture
A test in which a thin needle is used to take a small sample of the fluid around the spinal cord, usually to help diagnose conditions affecting the brain, nerves or their coverings.
✓ Medically reviewed by a GMC-registered consultant · last reviewed September 2026 · next review September 2027 · how we review
In short
- A lumbar puncture uses a thin needle to take fluid from around the spinal cord, mainly to help make a diagnosis.
- The needle goes in below the spinal cord, so it does not damage the cord; local anaesthetic numbs the skin first.
- A headache afterwards is common and usually settles within days, but occasionally needs treatment with a 'blood patch'.
- Some results come back within hours, while others, such as cultures, take several days.
A plain-English summary. The detail — including risks and recovery — is below.
At a glance
A general guide. Your specialist will give you advice for your situation.
Can confirm or rule out serious conditions such as meningitis quickly.
When there is raised pressure in the brain from a mass, where removing fluid could be dangerous (a scan may be needed first).
You usually rest or lie flat for a short period. Some people are advised to lie flat for an hour or two; advice varies between hospitals.
Clear written advice on managing a headache, including when to seek help.
You usually rest or lie flat for a short period. Some people are advised to lie flat for an hour or two; advice...
Take it easy, drink plenty of fluids, and avoid driving and strenuous activity. A headache may come on during this...
Any headache is usually at its most noticeable now and tends to ease. Lying flat, fluids, simple painkillers and...
Avoid heavy lifting and vigorous exercise. Most soreness and headache have settled. Contact the clinic if a...
What is a lumbar puncture?
A lumbar puncture, sometimes called a spinal tap, takes a small sample of the fluid that surrounds your brain and spinal cord. This is called cerebrospinal fluid, or CSF. A thin needle is passed between the bones of your lower back, below where the spinal cord ends, so the needle does not touch the cord itself.
It is done to help diagnose conditions, not to treat them. Doctors test the fluid for signs of infection (such as meningitis), inflammation, bleeding around the brain, or unusual cells. The pressure of the fluid can also be measured, which matters in conditions such as raised pressure around the brain.
Sometimes a lumbar puncture is used to give medicines or, occasionally, to remove fluid to relieve pressure. But most lumbar punctures are diagnostic tests.
A lumbar puncture is generally considered a low-risk procedure, but a headache afterwards is common and is the part most people notice. It is described honestly below so you know what to expect.
Types, options & approaches
There may be different ways to do this. The right approach depends on the clinical question and your circumstances.
Options at a glance
These are the main approaches described in this guide. The right option depends on the diagnosis, your goals and what your clinician thinks is safe.
Diagnostic lumbar puncture
The most common type: fluid is taken to test for infection, inflammation, bleeding or unusual cells, and the pressure may be measured.
Opening pressure measurement
The pressure of the fluid is measured with a thin tube, important in conditions such as raised pressure around the brain (idiopathic intracranial hypertension).
Therapeutic lumbar puncture
Occasionally fluid is drained to relieve pressure, or medicine is given into the fluid (for example certain chemotherapy or anaesthetic medicines).
Atraumatic ('pencil-point') needle technique
Using a special non-cutting needle, which evidence shows reduces the chance of a headache afterwards. It is worth asking whether this is used.
Preparing for your procedure
- Tell the team about any blood-thinning medicines (such as warfarin, clopidogrel or apixaban), as these may need to be paused or checked first.
- Mention any bleeding disorders, low platelets or problems with your immune system.
- Say if you have had back surgery, spinal problems, or difficulty lying still or curling up.
- Tell them about allergies, especially to local anaesthetic or skin-cleaning fluids.
- Ask whether you should eat and drink normally beforehand; most people can.
- Plan for someone to be with you afterwards, and ideally to take you home.
- Arrange to take it easy for the rest of the day, and to avoid strenuous activity for about a week.
What happens
You will usually lie on your side and curl up, bringing your knees towards your chest, or sit leaning forward over a table. Curling up opens the spaces between the bones in your back. The skin on your lower back is cleaned and a local anaesthetic is injected, which stings briefly and then numbs the area.
The doctor then passes a thin needle between two of the bones in your lower back into the space holding the fluid. You may feel pressure or pushing, but it should not be sharp pain once the area is numb. A few small samples of fluid are collected, and the pressure may be measured.
The needle is then removed and a small dressing is applied. There is no cut and no stitches. You will usually be asked to lie flat for a short time afterwards. The whole process, including settling and resting, often takes around 30 to 45 minutes.
Is this procedure right for me?
A good consultation should explore whether it's the right choice for you now — including reasons to wait or consider something else.
May not be suitable if…
- When there is raised pressure in the brain from a mass, where removing fluid could be dangerous (a scan may be needed first).
- People with significant bleeding disorders or on blood thinners that cannot be safely managed.
- Infection of the skin or tissues at the puncture site.
- Situations where the answer can be obtained more safely by another test.
Delay or rearrange if…
- Blood-thinning medicines that need to be paused or reversed first.
- Skin infection over the lower back.
- Uncontrolled bleeding tendency or very low platelets, until corrected.
- When brain imaging is needed first to make sure the procedure is safe.
Alternatives to discuss
- Blood tests and imaging when these can answer the question.
- Watchful waiting and review if symptoms are mild and a serious cause is unlikely.
- Different imaging such as CT or MRI for some conditions.
- Specialist neurology assessment to decide whether the test is truly needed.
Before you decide
Use this as a shared-decision checklist. The aim is not just “can this be done?”, but whether it is right for you, now, with the risks and alternatives clearly understood.
What matters most to me?
Think about symptoms, daily life, work, caring responsibilities, sport, fertility, travel, appearance and anxiety — the right choice depends on your priorities, not just the medical facts.
What are all my options?
Ask about waiting, monitoring, medicines, rehabilitation, a smaller or larger procedure, a different test, NHS referral, or a second opinion where that would help.
What would make me pause?
Active infection, pregnancy, unstable medical problems, smoking, medicines that increase bleeding, poor support at home, or feeling pressured are all reasons to slow down and get tailored advice.
What happens if I do nothing today?
For some problems, waiting is safe; for others, delay can make treatment harder. A good consultation should explain the trade-off in plain English.
Comfort, sedation or contrast choices
If local anaesthetic, sedation, contrast or pain relief is used, ask what is planned, why, and what it means afterwards.
Benefits
- Can confirm or rule out serious conditions such as meningitis quickly.
- Tests the fluid directly, which other tests and scans cannot do.
- Can measure the pressure around the brain, which is hard to assess any other way.
- Helps diagnose inflammation, bleeding or unusual cells affecting the nervous system.
- Can guide urgent treatment decisions, sometimes life-saving ones.
Risks & complications
- Headache afterwards, which is the most common side effect and can last a few days.
- Back pain or soreness where the needle went in, usually mild.
- A small amount of bruising or discomfort at the puncture site.
- Feeling faint or anxious during the procedure.
- A headache severe enough to need treatment, including lying flat, fluids and pain relief.
- Temporary nerve irritation causing brief tingling or shooting sensations in a leg.
- Needing a second attempt if the fluid is difficult to reach.
- Minor leakage of fluid at the puncture site.
- Infection introduced by the needle, such as meningitis or an abscess.
- Bleeding into the spinal canal, which is more likely with blood-thinning medicines or clotting problems.
- A severe, persistent headache needing an 'epidural blood patch' to seal the leak.
- Damage to nerves in the lower back; permanent damage is extremely rare.
The biggest practical issue is a post-lumbar puncture headache, caused by a small leak of fluid lowering the pressure around the brain. It is common, typically eases over a few days, and is helped by lying flat and fluids; rarely it needs a blood patch. The more serious risks (bleeding and infection) are uncommon, but blood-thinning medicines and clotting problems raise the bleeding risk, so always tell the team about them.
Published figures to discuss
A lumbar puncture is generally low-risk, but headache afterwards is common. Reported rates of post-lumbar puncture headache vary widely depending on the needle used, the patient's age and other factors, so figures should be treated as approximate. Serious complications such as bleeding or infection are uncommon.
| Figure | Reported range | How to interpret it | Source / confidence |
|---|---|---|---|
| Post-lumbar puncture (post-dural puncture) headache | Reported in up to around 40% with traditional cutting needles, and substantially lower with atraumatic 'pencil-point' needles | Risk is higher in younger adults, women and those with previous headaches; using an atraumatic needle reduces it. | Impact of post-dural puncture headache after diagnostic lumbar puncture - PMCpmc.ncbi.nlm.nih.govPublished figure |
| Bleeding or infection | Rare | Anticoagulants, low platelets, infection at the site and immunosuppression need review before the procedure. | Impact of post-dural puncture headache after diagnostic lumbar puncture - PMCpmc.ncbi.nlm.nih.govSource-linked context |
| Brain pressure or mass-lesion safety concern | Screening-dependent | Papilloedema, focal neurology, reduced consciousness or seizures may require imaging or specialist review before LP. | Guide sourcesClinical context |
| Traumatic or inconclusive sample | Recognised | Blood contamination, low volume or failed attempts can limit interpretation and occasionally require repeat testing. | Guide sourcesClinical context |
These are literature figures, not a personalised prediction. Your own risks and likely benefits depend on your circumstances, your health, and how your care is carried out and followed up.
What happens afterwards
After a lumbar puncture you are mainly waiting for results and watching for a headache. Most people are back to normal within a day or two, taking it easy at first.
- A headache that is worse when sitting or standing and better lying down.
- Mild back soreness or a small bruise where the needle went in.
- Tiredness for a day or so.
- Waiting several days for some of the laboratory results.
Aftercare
- Rest for the remainder of the day and avoid strenuous activity.
- Drink plenty of fluids; some people find caffeine helps a headache.
- Take simple pain relief such as paracetamol if you get a headache, unless told otherwise.
- Lie flat if a headache is bad, as this often eases it.
- Avoid driving until you feel well and any headache has settled.
- Keep the puncture site clean and dry as advised.
- Know who to contact if a headache is severe, persistent, or comes with fever or neck stiffness.
- Confirm whether any blood-thinning medicine should be paused beforehand.
- Arrange for someone to be with you and ideally to drive you home.
- Clear your schedule to rest for the rest of the day.
- Have simple painkillers and plenty of fluids at home.
- Note the clinic's contact number for problems.
- Plan how and when you will receive your results.
⚠ Get urgent help if…
- A severe headache that does not ease after a couple of days, or is not helped by lying flat.
- Fever, neck stiffness or sensitivity to light, which can suggest infection.
- New weakness, numbness or pins and needles in your legs.
- Loss of control of your bladder or bowels (seek emergency care).
- Increasing redness, swelling, pain or discharge at the puncture site.
- Fainting, confusion or feeling very unwell after the procedure.
Who to contact: your clinician, clinic or test provider first (keep their number to hand). For urgent advice when you can't reach them, call NHS 111. In an emergency, call 999.
General guidance — it doesn't replace the specific advice your specialist gives you.
Results & realistic expectations
A normal result means the fluid showed no signs of the conditions being looked for, which can be reassuring, though no single test rules out everything. An abnormal result may show infection, inflammation, bleeding or unusual cells, and the exact pattern helps point to a diagnosis.
Some results, such as cell counts, protein, glucose and pressure, are available quickly. Others, such as cultures for bacteria or specialist tests, take several days. Your clinician should explain what the results mean for you and what happens next, rather than leaving you to interpret numbers alone.
A lumbar puncture reflects what is happening at the time it is done. If your symptoms change or a diagnosis remains unclear, the test may need repeating, or other tests may be added. A normal result now does not guarantee that nothing will develop later.
Related tests, treatments or support
A lumbar puncture is often done alongside blood tests and brain imaging such as a CT or MRI scan. A scan is sometimes done first to check it is safe to proceed. The fluid results are interpreted together with these other tests.
Follow-up & long-term care
Your clinician arranges to discuss the results with you, usually combining the quick results with the slower laboratory tests as they arrive. Make sure you know how and when you will hear, and what to do if you develop a bad headache or other warning signs in the meantime.
Repeat, follow-on and what comes next
- A second attempt is sometimes needed if the fluid is hard to reach.
- If results are inconclusive, the test may be repeated or other tests added.
- A persistent headache may need an epidural blood patch to seal the leak.
Ask what happens if the result is unclear or needs repeating, and what is included if further tests or follow-up are needed.
What good aftercare looks like
- Clear written advice on managing a headache, including when to seek help.
- A named contact route for problems after the procedure.
- A defined plan for getting and explaining the results, including the slower laboratory tests.
- Ready access to treatment, including a blood patch, if a severe headache develops.
What affects the cost
Costs vary a great deal between people and providers, and we don't publish prices. What matters is understanding what drives the cost and making sure your quote is complete. The main things that affect it:
- Whether it is done at the bedside, in a clinic, or with X-ray or ultrasound guidance.
- Whether imaging guidance is needed because the anatomy is difficult.
- The type of needle used and whether pressure measurement is performed.
- The laboratory tests requested on the fluid, some of which are specialised.
- The seniority of the doctor performing the procedure and any monitoring time.
- Whether a follow-up consultation to explain results is included.
- The cost of the procedure itself and any imaging guidance.
- Which laboratory tests on the fluid are included.
- Whether a consultation to discuss the results is included.
- What happens, and what it costs, if the test needs repeating or is inconclusive.
- What support and cost is involved if a blood patch is needed for headache.
- The cancellation and rebooking policy.
On the NHS? Lumbar puncture is a routine NHS test when clinically indicated, often performed urgently; private testing is used mainly for speed or choice, but the decision to do it should always be clinical.
You're entitled to your total cost in writing — including reports, follow-up and what happens if the result is inconclusive — before you decide.
Consent traps and marketing red flags
These are not small details. They are often where patients lose choice, time to reflect, or realistic expectations.
Consent traps
- Not discussing how common a headache is afterwards.
- Not asking about blood thinners or clotting problems before the test.
- Not explaining that a pencil-point needle reduces headache risk.
- Not making clear what to do, and who to call, if a bad headache develops.
- Not explaining that some results take days and what each result will change.
Marketing red flags
- Describing the test as completely pain-free or without risks.
- Not mentioning post-lumbar puncture headache at all.
- Offering the test without proper clinical assessment of whether it is needed.
- No clear plan for managing complications such as a severe headache.
Choosing a specialist safely
- Check the specialist is on the GMC Specialist Register for this area.
- Make sure they work at a CQC-registered service, and look for membership of the relevant Royal College or professional body.
- You're entitled to time to consider and to have your questions answered before you agree — the specialist who looks after you should explain it, not a salesperson.
- Be wary of pressure: time-limited offers or deposits taken before you've had time to think are red flags, not bargains.
- You're entitled to your total cost in writing — including any follow-up — before you decide.
Questions to ask your medical professional
Take this to your consultation. A good specialist will welcome every one of these.
- Why do I need a lumbar puncture, and what are you looking for?
- Will you use a pencil-point (atraumatic) needle to lower the chance of a headache?
- Do any of my medicines, especially blood thinners, need to be stopped first?
- What should I do if I get a bad headache afterwards, and when would I need a blood patch?
- When and how will I get the results, and what happens if they are normal or inconclusive?
- Are you on the GMC Specialist Register for this area, and which Royal College or professional body are you a member of?
- Will you be the specialist who carries out my procedure, and who looks after me afterwards?
- What are the risks for someone like me, and how often do your own patients have a problem or need it repeated or redone?
- What does a realistic result look like — and what can this procedure not achieve?
- What are my options, including waiting, doing nothing for now, or choosing a different approach?
- Can I have written information, results and aftercare instructions in a format I can use, including any accessibility or communication support I need?
- What is the total cost in writing, including any follow-ups, and how much time do I have to decide?
Frequently asked questions
Is a lumbar puncture available on the NHS?
Does a lumbar puncture hurt?
How common is the headache afterwards?
What is a blood patch?
Can the needle damage my spinal cord?
How long will the results take?
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How we made this page
Medically reviewed by a GMC-registered consultant. Written in plain English, checked against NHS, NICE, GMC and relevant Royal College / specialist-society guidance, and kept under review. No clinic paid to appear on this page, and we publish no pricing. This is general information to help you prepare — it is not a substitute for advice from your own clinician. How we review our guides →
Source hierarchy: UK regulator and NHS/NICE guidance first, then relevant Royal College or specialist-society guidance, then peer-reviewed evidence for procedure-specific figures where available.
Sources & standards: Brain & Spine Foundation - Lumbar puncture NHS (North Tees and Hartlepool) - Lumbar puncture in adults Impact of post-dural puncture headache after diagnostic lumbar puncture - PMC Post-lumbar puncture headache: diagnosis and management - PMC Postdural Puncture Headache - StatPearls (NCBI Bookshelf)
Reviews reflect patients' experience of care, not clinical outcomes. For procedure volumes and outcome data see PHIN.
Last medically reviewed 2026-09-21. Spotted something wrong or out of date? Report an error in this guide.
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