Compartment Syndrome

Written by Amanda Delgado | Published on June 18, 2012
Medically Reviewed by Brenda B. Spriggs, MD, MPH, FACP on June 18, 2012

What Is Compartment Syndrome?

Compartment syndrome is a serious condition that occurs when there is a large amount of pressure inside a muscle compartment. Compartments are the groups of muscle tissue, blood vessels, and nerves in your arms and legs.

Each compartment is surrounded and held in place by thick tissue called fascia. Because fascia does not expand, swelling in a compartment will result in pressure against the structures inside the compartment.

Compartment syndrome mainly occurs in the forearm or lower leg.

Causes of Damage to Muscle Compartments

Compartment syndrome develops when there is bleeding or swelling within a compartment. This can cause pressure to build up inside the compartment, which can prevent blood flow. It can cause permanent damage if left untreated, as the muscle tissue and nerves won’t get the nutrients and oxygen they need.

Types of Compartment Syndrome

Acute Compartment Syndrome

This type of compartment syndrome typically occurs following a major injury. In rare cases, it also can develop after a minor injury. You can develop acute compartment syndrome:

  • following a fracture
  • after an injury that crushes your arm or leg
  • as a result of a severely bruised muscle
  • from wearing a cast or tight bandage
  • from heavy drinking or drug use (one of your blood vessels may become blocked while you’re sleeping or lying down after passing out)

Chronic (Exertional) Compartment Syndrome

Exercise, especially when it involves repetitive motion, causes this type of compartment syndrome. Although it occurs most frequently in people under 40, you can develop it at any age. You’re more at risk for developing chronic compartment syndrome if you do activities such as swimming, playing tennis, or running. Intense or frequent workouts also increase your risk.

The link between exercise and this condition isn’t fully understood. However, possible causes include:

  • the way you move when doing certain activities
  • having fascia that is thicker than normal
  • having enlarged muscles
  • having a high amount of pressure in your veins

Recognizing the Symptoms of Compartment Syndrome

Acute Compartment Syndrome

Pain that doesn’t improve after taking medication or keeping the injured area elevated is the most common symptom. It can feel worse when you stretch or use the injured muscle. Other symptoms include a feeling of tightness in the muscle or a burning sensation or tingling in the skin around the affected area.

Symptoms of advanced acute compartment syndrome include numbness or paralysis. This is usually a sign of permanent damage.

Chronic Compartment Syndrome

The most common symptom of this type of compartment syndrome is pain or cramping when you exercise. The pain or cramping usually goes away within 30 minutes after you stop exercising. If you continue doing the activity that causes your condition, the pain might gradually begin to last for longer periods after you’ve ceased the activity.

Other symptoms include:

  • having trouble moving your foot, arm, or affected area
  • numbness
  • a noticeable bulge in the affected muscle

Long-Term Complications

Acute Compartment Syndrome

Acute compartment syndrome requires immediate medical attention to relieve pressure. Permanent damage to your muscle and nerves can develop between 12 to 24 hours after the condition starts.

Chronic Compartment Syndrome

Chronic compartment syndrome is not considered an emergency, but you should let your doctor know if you’re experiencing any symptoms. Don’t try to exercise when you’re in pain, as this can cause permanent damage to your muscle, blood vessels, and nerves.

Tests and Diagnosis of Compartment Syndrome

Your doctor will give you a physical exam to check for signs of acute or chronic compartment syndrome. For example, he or she may squeeze the injured area to determine the severity of your pain.

Your doctor will also use a pressure meter with a needle attached to measure how much pressure is in your compartment. Your doctor needs to take the while you’re performing the activity that makes your leg or arm hurt, and again after you have finished.

You might also have X-rays taken to rule out other conditions.

Treatment Options for Compartment Syndrome

Acute Compartment Syndrome

Surgery is the only treatment option for this type of compartment syndrome. It involves cutting open the fascia to reduce the pressure in the compartment. In severe cases, your doctor will have to wait for the swelling to go down before closing the incision. If you developed this condition because of a cast or tight bandage, it will need to be removed or loosened.

Chronic Compartment Syndrome

Your doctor might try nonsurgical treatment methods first. These include:

  • physical therapy to stretch the muscle
  • shoe inserts (orthotics)
  • anti-inflammatory medication
  • changing the type of surface on which exercise is performed
  • performing low-impact activities as part of the exercise routine

If these methods don’t work, you may need surgery. This would involve making a small incision into the fascia or removing part of the fascia to relieve pressure. Surgery is generally more effective than nonsurgical methods for treating chronic compartment syndrome.

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