The headache wasn’t immediate. It crept in about an hour after Pilates class—sharp, relentless, and only relieved by lying flat. At first, it just seemed annoying. Then it wouldn’t go away.
A 42-year-old woman felt a strange pop in her neck during one of the exercises. No pain. No dizziness. Just a sound. Her doctor assumed it was a pulled muscle and sent her home with opiates and a muscle relaxant. But over the next four weeks, the headache got worse—and weirder.
It wasn’t until she landed at King’s College Hospital in London that anyone thought to scan her head. A CT revealed signs of bleeding near the brain. An MRI of her spine showed something more unusual: pockets of fluid collecting along her spinal column. Her diagnosis was a cerebrospinal fluid (CSF) leak—likely caused by a tear in the dura mater, the protective membrane that surrounds the brain and spinal cord.
A Woman Heard a ‘Pop’ During Pilates Class. Her Spine Had Sprung a Leak.
This kind of leak is rare, but not unheard of. The dura can tear spontaneously, often due to physical strain or underlying connective tissue conditions like Marfan syndrome. But in this case, doctors believe the Pilates session was the trigger. The case was published in the Journal of Medical Case Reports, with authors noting that this adds to a small but growing body of evidence linking certain forms of exercise to CSF leaks.
Dr. Amber Luong, a specialist at the University of Texas Health Sciences Center, told Live Science that “any blood in your spinal fluid is very irritating to the brain and gives you a headache.” Leaks around the spine are harder to detect than cranial leaks, which often present as clear fluid draining from the nose. Here, the only symptom was a crushing, posture-sensitive headache.
With no precise location of the tear, surgery wasn’t an option. Instead, the woman was prescribed bed rest, anti-inflammatory medication, and high doses of caffeine—used to boost CSF production and blood flow. It worked. After two weeks, the headaches subsided, and she was discharged.
It’s a reminder that even low-impact workouts can carry surprising risks—and that not all headaches are created equal. If lying down is the only thing that helps, your body might be trying to tell you something more serious. Like, your spine has possibly sprung a leak.
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