Post Spinal Anesthesia Side Effects

Spinal Anesthesia

Spinal anesthesia has been used since the late 19th century to numb the lower half of the body for surgery. Cocaine was the first local anesthetic used in spinal anesthesia, but cocaine toxicity caused a lot of unwanted side effects and complications. Today, lidocaine, bupivicaine and ropivicaine are among the most common agents used. The technique, medications and needles have evolved over time, but there are still some post spinal anesthesia side effects that can occur. Knowing that most of these are minor and temporary can provide peace of mind before and after your surgery with spinal anesthesia.

The spinal cord ends near the bottom of the spinal canal. Medication for spinal anesthesia is injected into the collection of spinal fluid in this region.
The spinal cord ends near the bottom of the spinal canal. Medication for spinal anesthesia is injected into the collection of spinal fluid in this region. | Source


Understanding how and why side effects of spinals occur is facilitated by understanding a little about the anatomy of the spinal area and how the technique is performed.

The spinal cord runs from the base of the brain down the middle of the back and ends in the area of the lower back, near the level of the hips. Cerebrospinal fluid (CSF) bathes the spinal cord.

A thick, fibrous membrane called the dura (yellow) covers the spinal cord and CSF- also called spinal fluid, for short. Spinal fluid may pool by gravity in the lower back inside this dura creating a sac of spinal fluid. This is sometimes called the 'thecal sac' and thus, you may hear a spinal anesthetic referred to as an intrathecal anesthetic (anesthetic inside the thecal sac).

The space outside of the dura is called the epidural space. This is where epidural anesthetics are administered. The epidural space contains fat and blood vessels as well as the nerves passing through the space.

Outside of the epidural space are ligaments and other connective tissue.

The entire spinal canal is surrounded by the vertebrae that make up the backbone.

Spinal Anesthesia

A spinal anesthetic is achieved using a thin, specialized needle to place numbing and other medications into the CSF, inside the dura. The needle is guided by 'feel' between bones of the back and through the various layers of ligaments and spaces until the subdural (beneath the dura) space is reached. Drops of CSF in the hub of the needle confirm to the anesthesiologist that the needle is indeed, in the right space. The medicine is then carefully injected, and the needle removed. This medicine then numbs the nerves of the spinal cord, making it impossible to feel or move the lower half of your body.

Some post spinal anesthesia side effects result from the technique and needle used, and some side effects of spinals are related to the medication injected.

The technique is shown in the video.

A Note about Side Effects and Complications

Side Effect vs. Complication

A side effect is an unwanted, but not unusual, effect of an intervention that accompanies the desired effect. These are usually mild and self-limited and have no long-lasting sequelae.

A complication is an event that unexpectedly occurs, as a result of an intervention. Complications cause harm, either temporarily or permanently. Most of the time, complications can be avoided, but sometimes they are unavoidable to achieve the desired effect.

Notes from the Operating Room

Spinal anesthetics are used very often for Cesarean sections. The side effect I hear about most in these cases is shortness of breath.

During Cesarean delivery, the mom is laid flat on the bed, tilted to the left side a bit. The arms are extended out perpendicular to the body. Often the neck feels 'crowded' by large breasts and a fully pregnant belly in this position. In other words, everything is pushed upwards.

It would be difficult under the best of circumstances for a full-term pregnant woman to feel like she can breathe well in this position. With the addition of a numb chest wall, it's easy to see why this feeling is so common and often can induce panic if the woman isn't reassured that the monitors show she is actually breathing well. If they still aren't convinced, I show them the fog in the oxygen mask as they breathe. This usually works well until the OB begins to push on the upper abdomen to deliver the baby. Luckily, this actual obstruction to deep breathing ends quickly and when mom hears the beautiful sound of her baby crying for the first time, she forgets all those unpleasant sensations!

Common Side Effects of Spinal Anesthesia

  • Itching - Itching most often results from narcotic pain medication that is added to the numbing medicine in the spinal. The narcotic provides long-lasting (12-24 hours or more) pain relief after the numbing medicine wears off in the post-op period.
  • Back Pain - Although the needle used to place the spinal is not very big, it still can make your back feel bruised at the injection site. In addition, ligament strain is not unusual. The muscles in the low-back region are completely relaxed, making stretching or straining of other structures such as ligaments more likely.
  • Prolonged Numbness or Weakness - The duration of numbness with spinal anesthesia varies depending on which numbing medication is used, but should be gone within 6-8 hours in almost all cases. Occasionally, numbness can last longer. This can be a side effect or complication depending on how long it lasts and how much it impairs function.
  • Urinary Retention – Some of the last nerve fibers to recover from spinal anesthesia are the ones that coordinate emptying your bladder. Urinary retention can be quite uncomfortable and can even lead to changes in heart rate and blood pressure. It may be necessary to have a catheter inserted to drain the urine if retention lasts a long time. Urinary retention is one of the more common complaints after spinal anesthesia. It is also one of the reasons we don't often do spinals on patients who are going home after their surgery.
  • Nausea and Vomiting – In the first minutes after receiving a spinal anesthetic, the effects on your body occur rapidly. With the onset of the spinal, you will notice a warmness, numbness or even tingling spreading up your body. As the numbness rises, your blood vessels dilate and also, nerves of the autonomic (involuntary) nervous system are affected. These changes (and some others) cause your blood pressure to decrease. Nausea can be the first sign of this side effect. Usually, this is easily treated with IV fluids and medication; so let your anesthesiologist know if you feel queasy shortly after being given a spinal. Nausea can persist after the spinal, as well. This can be from lingering changes in blood pressure or can be related to any narcotic pain medicine that was injected.
  • Headache – Some might place this into the category of complication since it has become a more rare occurrence and can be quite debilitating in the short term. It is mentioned here as a side effect, as it seems to be a fairly well known possibility and seems worth discussing. A spinal headache occurs less than 1% of the time after a spinal anesthetic and is a result of CSF leaking out of the subdural space. When the level of CSF around the brain gets low, a headache results. During a spinal anesthetic, as the dura is entered with the needle, some CSF can leak out. Our modern smaller, needles spread apart the fibers of the dura more than cut them, so the CSF leak is minimized, and so is the incidence of headache.
  • Shortness of Breath – First, this is really a subjective feeling, not usually backed up by objective monitoring. When the spinal is placed for abdominal surgery, the level of numbness often needs to be quite high up into the mid-chest region to block all the involved nerves. As a necessary side effect, the spinal numbs the sensory nerves of the chest wall. We aren’t aware of it, but the feedback from these nerves let our brains know we are breathing deeply and adequately. When they are numb, especially in combination with the other factors, such as flat positioning on the operating bed, the patient may feel as if she isn’t breathing well, even when she is.

More by this Author

Comments- Have You Had Post Spinal Anesthesia Side Effects? 47 comments

jhunpaler profile image

jhunpaler 4 years ago from Philippines

Informative :) saw a couple of patients with headache after a spinal anesthesia :) voted up

TahoeDoc profile image

TahoeDoc 4 years ago from Lake Tahoe, California Author

Thank you. It can be a confusing topic, even for health-care providers. Thanks for reading!

habee profile image

habee 4 years ago from Georgia

Wow - amazing information! I love how you explain this to laymen. Even I can understand it!

Voted up.

poowool5 profile image

poowool5 4 years ago from here in my house

I had to steel my nerves a little here, TahoeDoc, as I have a horror of needles!

So, while I think it is a very informative and well-written hub, I had to skitter quickly over some of the pictures (but that's just me!). And this after 3 kids and 3 epidurals...what a wimp!

Nice hub, and very useful if this procedure is upcoming for a reader, they would then clearly understand all the implications and side-effets of what they were about to undergo.

Voted up and useful!

Horatio Plot profile image

Horatio Plot 4 years ago from Bedfordshire, England.

Interesting and informative. Medical stuff can often seem so dull. Great stuff


donepudi jagadeesh 4 years ago

can any one of explan me clearly about the Post Spinal Anesthesia Side Effects .......... in few lines which in i can understand language......

please to

Bharat 4 years ago

I got headach and nack pain after spinal anesthesia.

What to do to avoid it

Funom Makama 3 profile image

Funom Makama 3 3 years ago from Europe

As usual.... A wonderful hub.

Sue 3 years ago

I was under anesthetic about 1 1/2 to 2 hours. Having a lot of belching and hic-ups. Is this related to anesthetic?

TahoeDoc profile image

TahoeDoc 3 years ago from Lake Tahoe, California Author

There are a few things that can contribute to these types of issues. Air can enter your stomach when you are breathing or being helped to breathe with a mask. Nitrous oxide can expand an air bubble in the stomach. This can lead to hiccups or belching.

It is also possibly related to the surgical procedure, if that was in the abdomen.

jklahlou profile image

jklahlou 3 years ago

Great article!

TahoeDoc profile image

TahoeDoc 3 years ago from Lake Tahoe, California Author

Thank you!

Gita 3 years ago

I just had a myomectomy using a spinal instead of undergoing general anesthesia. I have been having the feeling that my back is out of alignment and a headache. It's article gives me some reassurance that all is ok and normal.

TahoeDoc profile image

TahoeDoc 3 years ago from Lake Tahoe, California Author

Gita- Thanks for letting me know the article helped. Rest and fluids and hopefully you will be back to feeling good soon!

mariasial profile image

mariasial 3 years ago from united kingdom

Oh TahoeDoc you make me recall all this; each and every part of your hub. I have taken it once and i went through to all this, except doctor has not given me anything nausea expect keep on holding my head so i can bear it. rated up and sharing

Majidsiko profile image

Majidsiko 3 years ago from Kenya

Total spine is a rare and terrifying ordeal that can end up with a lot of anxiety

Clare 3 years ago

TahoeDoc, thanks for that great and informative piece. I was hoping it would give me an answer as to why i have had back pain 4years after the spinal anesthesia i had while having my 1st child. i went on to have my 2nd child 2 years later and still, the same back pain is there. What can i do to heal it

TahoeDoc profile image

TahoeDoc 3 years ago from Lake Tahoe, California Author

While there are some reports of chronic back pain after spinal anesthesia, there are even more reports of back pain after labor and delivery (with or without spinal). Unfortunately, the only way to know the source, and therefore the best course of treatment of the pain is to see your doctor for a full evaluation. Sorry I can't help more with that Clare. Good luck to you.

zahid 2 years ago

Great information,,,

Rose Kebuka Otieno.From Nairobi Kenya. 2 years ago


I had a spinal 5 wks ago.After 2 days of surgery i had severe headache for 3 days.sometimes i felt stiffness on my neck.

After five weeks,the headache is back.I also suffer from carpel tunnel syndrome.Now the numbness has increased.

How do i treat the severe headache?

TahoeDoc profile image

TahoeDoc 2 years ago from Lake Tahoe, California Author

Hi Rose- if you still have the headache, you can try to drink extra fluids and take pain medicine. Caffeine sometimes helps. Usually, you will have to contact the doctor who placed the spinal and as for their evaluation and recommendation.

Hope you feel better.

Mary 2 years ago

Hi! I had a spinal 6 weeks ago, I did had the itching side effect and headache. I have been feeling light-headed and it seems it's getting worst. Do you think it's related to the spinal?

TahoeDoc profile image

TahoeDoc 2 years ago from Lake Tahoe, California Author

Hi Mary,

If you still have a headache, call the doctor (anesthesiologist, surgeon or clinic where you were seen).

If you don't have a spinal headache, the lightheadedness shouldn't be related to the spinal so far out BUT without A LOT of other info, this is not certain. Other factors that would need to be known include your past medical history, the reason you had surgery and spinal, your medications, your other symptoms, your current hydration status, whether you lost blood during surgery and your current blood count and so on…

So, I cannot say for sure what is causing your lightheadedness. Under usual circumstances, for a healthy person with an uncomplicated medical history, routine, uncomplicated spinal who is not on any medications, surgery without significant bloodless (or fluid loss as is common in labor and delivery) and is well-hydrated, the spinal would not likely be a factor at this point.

Please call the doctor if it really is getting worse. Best wishes to you.

sharon 2 years ago

Hi I had spinal about 3 months ago.I still have continuous itching in a small area of my back . Is it normal nd due to this treatment ? Thanks

Hi I just done my rfa last thursday. My eyesight is not cleared and i feel the sensation sharp feeling in my thigh 2 years ago

Should I seek my doc advise

TahoeDoc profile image

TahoeDoc 2 years ago from Lake Tahoe, California Author

Yes, please do.

Deb 2 years ago

Dr Tahoe, Question? I have a bladder polyp.. just one- it is 1.7 mm (not sure I got the mm part of measurement right).. Been told by Dr. it is the size of my pinky nail. I have had a cycscopy - with local. I wanted the urologist to do a biopsy then.. or even remove the polyp.. He would not.. said I had to have surgery for that.. My question is Why? When I asked him - his reply was that is how it is done. So I go to the Hosp for outpatient surgery.. I wanted a spinal.. they checked my blood for clotting or whatever.. all was good.. Three hours later - I am still waiting for this surgery.. I have been hooked up to an IV with just fluid and antibiotics for that three hours. I ask the nurse how much longer? she says there is still one ahead of me.. I freak and say dis-connect the IV - I am outta here! Mind you, I had the pre op requirements all done the week before. I was told to not eat or drink after midnight- the surgery time to arrive was 11:30 am.. I have CML - I had to stop the Gleevec 5 days before the surgery per my oncologist instructions.. I was having a spinal... Why it God's name was it necessary for me to stop food and liquids for way more than 6 hrs. PS I did leave - no surgery was done thanks for any input

saddam 2 years ago

very nice thanks

marites jacinto 2 years ago

had appendectomy for more than 1 month now. i jerkd when i felt the needle inserted & it was bent. As a result, i had peripheral neuropathy of right leg. what damage to the nerve could have happened. diagnosis was also delayed 48 hrs aftr operation. How long will i recover thru physical therapy & mecobalamin? what other treatment should i undergo? is it temporary or permanent?

TahoeDoc profile image

TahoeDoc 2 years ago from Lake Tahoe, California Author

Hi Marites-

If I understand, you had a spinal for your appendectomy and had a nerve injury that is believed to have resulted from it, is that correct?

If so, I'm not sure peripheral neuropathy would be the correct diagnosis- that usually means that a nerve in the periphery (not near the spinal cord, but in the leg itself) is damaged.

EMG studies are (as far as I know) the best way to determine where the injury originates - whether it's central (spinal cord) or peripheral (somewhere outside of the central nervous system). If you have a peripheral injury, it isn't from the spinal needle but the surgery itself. If it's from the spinal needle, another name should be used for the diagnosis.

An MRI may also be able to determine injury to the spinal cord or central nerves (I think).

Does that help or make sense?

Until you know the nature and origin of the injury, it is impossible to say what the outcome will be or how long it will take.

Good luck.

mamta 2 years ago

Hi..i have severe backache after 4-5 months of c that a side effect of injection in spine. If yes, please tell me how can it be cured completely.

aman rawat 2 years ago

I had a surgery using spinal anesthesia. I was advised not to put my head up for 24hrs aftr surgery. But I stood up now I am having severe neckache I can't stand up for more then 5 min. What should I do..t

TahoeDoc profile image

TahoeDoc 2 years ago from Lake Tahoe, California Author

I am so sorry it took a while to see these questions.

mamta- your question never appeared until recently- apologies. Usually, when we investigate these things, it is the result of pregnancy or labor that leads to the backache. If you are having continued symptoms OR especially if you have numbness, tingling, weakness or other issues with your legs, please call your doctor for an exam.

aman- Most of the time, spinal anesthesia will not cause headaches since we use smaller needles now. But, in the event this represents spinal headache (and it sounds like it since it comes on with standing), please have your surgeon ask your anesthesiologist to evaluate you.

In the meantime, fluids and caffeine (coffee or tea) may help. This will resolve itself usually within a week, but you should at least let your doctors know this is happening.

Joan 2 years ago

I have had a compression fracture. An MRI 12 weeks after the fall shows a 50% compression of the L-1 (still with edema) and a 25% compression of the T-10 (appears to be healed). Yet my bone density shows normal. I had a spinal with the delivery of my first child (even though I could still move my legs and push, just with decreased effect). I also had a spinal as part of my hystorectomy. When they found more complications they gave a second (higher) spinal. Now my question. Is it possible for spinal medications to weaken the surrounding bones?

bharat 2 years ago

I have been given spinal anestia for acl reconstruction surgery. After that I still feel mild back pain after 1 year.

I am repeatedly gaining weight.

Does it due to spinal anastasia???

renj00 profile image

renj00 22 months ago

Hi, Ive had a hysterectomy over three weeks ago, in nov, and had the spinal combined with general anesthesia, it went well, however a few hours after the surgery relaxing, I started having severe pain ( 1- 10 definitely a 10 rate being worse), unbearable pain, numbness and tingling and swollen pain on one of my buttock and couldn't sit properly, had to have a warm blanket folded under.

I have had general anesthesia before for my lipoma surgery, and wisdom teeth removal, and had spinal for my c section, but nothing like this ever happened at the end, I am very worried that the combined anesthesia left me with this pain/complication.

Any ideas what it could be? My doctor said if the pain reached my leg to go to hospital and/or it should go away withing a few weeks, but it is very painful to the touch or to sit and is swollen and feels warm. Should I continue to wait to see if it goes away? Could a clot have formed? Or something else? Any thoughts please, very concerned

dr.manal.obstetrician 20 months ago

Thank you very much for your help

christine lu 19 months ago

hi i am a mother of 3 girls, and w/ this 3 girls aged 7, 2 & 1, they all undergone through C-Section, and since after i last gave birth, i frequently get a memory loss w/ headache, even just for a short period..,,what shall i do?

Jo A Wadley 17 months ago

I had Tlift surgery on 5-15-15. Upon waking I felt tingling in my right foot and toes and it's non stop. The tingling is still there 6 days later. I'm so scared I'm going to lose my leg and/or foot. Is this normal or should I be worried. As I notified my surgeon of my discomfort! Please help me I'm scared.....

Sue 15 months ago

I had a knee replacement that was done using a spinal block. After I got home from surgery (and after the more severe pain subsided), I realized that my toes on both feet now feel similar to when your foot begins to fall asleep-- a slight pins and needles/burning sensation. Is this a common side effect from a spinal block? If so, how long will it most likely last? 15 months ago

2 mnths back I got appendice operation that time giving spinal anesthesia now my right leg knee not working then my right leg was smaller then left leg. please give me the solution please

PHANI 3 months ago

very good article on spinal anesthesia i have ever find,Big thanks to you for that Doctor

i got appendicitis operation 10 years back at the age of 19 years by giving spinal anesthesia ,from that on wards ,my back area which is just above my waist became hard surface area i.e that area is quiet different from any other normal person, now also i have the same hard surface area -very stiff one, some times i feel back pain also,how can i over come these side effects

Thanks in advance

gift 2 months ago

I gave birth through ceasesren section one month ago after one week and I started having headache

nd was not able to sleep so I started Foaming and was rushed back to the hospital.

rajiv lootooa 2 months ago

hello doc,its has been three weeks since i have undergo a right inguinal hernia repair under spinal anesthesia since then i often have low back ache n even legs pain,especially during cold season and while driving car,can you please suggest me how to cure the pain especially on the lower back at the site where the spinal needle was penetrated,and will be the pain permanent???? as some patients whom had undergone spinal anesthesia still feel the backache even after several years,thanking you in advance Sir.

srilatha kulkarni 2 months ago

i have had two c-sections about 20 & 18 years ago under spinal. now very often (as often as once in a month) i suffer stiff neck, breathlessness, giddiness, numbness in my limbs which will last for few hours to few days. i have been suffering this right after couple of years of my 2nd c-section. though so far no serious problems i have experienced, it is very disturbing. is this inetrrelated?

Ali 5 weeks ago

Have been having the severe headache now for three days. Now my neck has become really stiff. Feels unstable and I feel dizzy sometimes.

Ashok 4 weeks ago

Even after 24 hrs of spinal anaesthesia for knee surgery (fibula tony)no sensation on fording of my feet. Why?

    Sign in or sign up and post using a HubPages Network account.

    0 of 8192 characters used
    Post Comment

    No HTML is allowed in comments, but URLs will be hyperlinked. Comments are not for promoting your articles or other sites.

    Click to Rate This Article