Post-dural puncture arm and upper back pain--a report of two cases

The typical postdural puncture headache manifests as postural frontal, frontotemporal, or occipital headache, which is worsened by ambulation, and improved by decubitus. Accompanying symptoms are nausea, vomiting, and neck stiffness. Various rare presentations after dural puncture, such as upper back pain, arm pain, thoracic pain, bowel and bladder dysfunction have been sparsely reported. We report two cases who sustained arm and upper back pain after spinal anesthesia, and epidural blood patch gave them a complete relief of the symptoms.