Small or blunt tipped needles used for lumbar punctures are less likely to cause headaches afterwards yet few hospitals seem to use them, a study has found.

Most hospitals still recommend bed rest to prevent headache, even though this has been proven to be of no benefit.

Researchers say that in a study of 71 hospitals, most preferred to give the lumbar puncture while the patient was lying down, although it is quicker and easier with the patient sitting upright.

Only about one third of the departments inserted the needle correctly. The needle itself also had a bearing on whether the patient suffers a headache afterwards; a 20 and 22 gauge Quincke needle caused a headache in 36 per cent of patients, and although the departments studied felt that half this was an acceptable rate, most used a similar needle (BMJ 1998; 316: 1709-10).

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Written by What Doctors Don't Tell You

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