Gravity & Its Bizarre Effect on Spinal Fluid

Did you know that two-thirds of astronauts who are in space for a lengthy amount of time come home only to report vision problems such as papilledema?

Why? Because spinal fluid is very positional. And gravity – or lack thereof – plays a crucial role in keeping levels balanced.

“On Earth, this spinal fluid system is designed to accommodate changes whether a person is sitting, standing or lying down. But in space, ‘the system is confused by the lack of the posture-related pressure changes,’” ¹

My Experience

When I first developed a spinal fluid leak, the tell-tale sign for my doctor was the fact that my pain was relieved when lying flat. Standing up would make it feel like a bowling ball had been dropped in my skull.

When symptoms unknowingly rebounded, I felt foolish telling my neurologist that symptoms were now worse lying down yet relieved when up and about.

At the time, it didn’t make sense. Who wants to get up and move around while dealing with a headache from hell?

But spinal fluid is highly positional, and we can thank gravity for determining what it does.

“Gravity has a profound effect on fluid distribution and pressure within the human circulation.”

– National Center for Biotechnology Information ²

How Does It Work?

Everyone experiences spinal fluid fluctuations all throughout the day and night. Most notice no changes. It is simply your body doing what it needs to do.

But when you have a spinal fluid imbalance, whether high or low pressure, you become extra sensitive to these changes. The simplest of fluctuations can determine how the rest of your day will go.

When you stand up, the fluid in the cranial region “falls down” or reduces/ reabsorbs. If you have a CSF leak or are in low pressure, this can be painful, as you can’t afford to lose any more fluid (cushion) around your brain. But if you are in high pressure, this can be relieving as some of the pressure gets released.

In similar manner, when you lie down flat, the fluid tends to pool around your brain. This can be a nice feeling when you’re low. But when you’re high, the last thing you want is for more fluid to be around your brain.

Since spinal fluid is not only present around the brain but flows through the whole spinal cord, it is also not uncommon to experience high pressure in the lumbar area while in an upright position.

In my personal experience, the longer I stand while in high pressure, the more my lower back becomes full and inflamed.

If we think back on the astronauts, their spine actually lengthens while in space. This lengthening of the vertebrae allows more spinal fluid to fill in the discs. Gravity once again plays a role. ³

Considering our own spine lengthens at night, we may also consider this to be part of the reason high pressure symptoms are worse at night or in early morning hours. Of course, there are several reasons why this happens. (read more here)

What Can Be Done?

Most people in low pressure can simply lie flat to find relief. Ultimately, the leak will need to be sealed, if not naturally than through a blood patch or surgical intervention. Consuming high amounts of fluids and caffeine have also been shown to help.

High pressure tends to be a bit more tricky, as it seems to be even more positional than low pressure. Even sitting for too long could pose a problem. It may take trial and error to discover what position your body prefers.

Many find that lying on a particular side is more likely to cause symptoms as opposed to lying on another. It is often advised to sleep at an incline, such as on a wedge pillow.

Lying on your stomach or arching your back may compress your spine and push more spinal fluid around your brain. Whereas hunching your back may allow more room for the fluid to reside.

Overall, long periods of lying down cause spinal fluid production to increase while re-absorption decreases. The pressure of carbon dioxide in the blood also increases. As painful and contrary as it may seem, sometimes the best thing to do while in high pressure is to get up and get moving. (read about sleep and spinal fluid here)

Personally, I have discovered that it isn’t so much the position of my head, but the position of my neck. Veins in the neck responsible for draining blood from the head become impaired while lying down. This disrupts spinal fluid absorption even more. Again, this means finding that “sweet spot” in what position helps bring you relief.

Keep in mind that position is also important even when it comes to spinal taps, whether diagnostic in determining opening pressure or therapeutic in how that pressure is relieved. You may be asked to rest on your side or stomach, and the table could even be tilted to allow gravity to assist production.

While not everyone will fit into this criteria positional fluctuations, it is still a highly common factor in balancing spinal fluid levels. Each patient must work to find what brings them relief until more answers and treatments are available.