Overview

Compartment syndrome is a painful and potentially serious medical condition in which increased pressure within a muscle compartment interferes with blood flow to the area, leading to tissue damage and muscle and nerve injury. The most common cause of compartment syndrome is a fracture, but other conditions like crush injuries, bleeding, burns, or extreme exertion can also cause the syndrome. Symptoms of compartment syndrome include pain, swelling, tightness, and numbness in the affected limb. If left untreated, compartment syndrome can lead to long-term muscle and nerve damage. Treatment involves releasing the pressure by making a small incision in the affected area. In some cases, surgery may be necessary to relieve the pressure. Early recognition and treatment of compartment syndrome are important to prevent long-term complications.

 

What is Compartment Syndrome?

Compartment syndrome is a condition in which increased pressure within a muscle compartment leads to decreased blood flow to the muscles and nerves within that compartment. This can cause pain, muscle weakness, and even permanent damage to the affected tissues if not treated promptly. The most common cause of compartment syndrome is a traumatic injury, such as a crush injury, a broken bone, or a deep cut. Other causes include burn injuries, prolonged immobility, and overuse of the affected limb.

 

How Common is Compartment Syndrome?

Compartment syndrome is a relatively uncommon condition, but its incidence may vary depending on the underlying cause and the patient population. The most common form of compartment syndrome occurs after traumatic injuries, such as fractures, and may affect up to 20% of patients with fractures of the lower leg. Acute compartment syndrome, which is the most severe form, is a medical emergency and requires prompt treatment. Chronic compartment syndrome is less common, and it may develop in people who engage in repeated high-impact activities, such as running or cycling.

 

Types of Compartment Syndrome

There are two main types of compartment syndrome: acute and chronic.

Acute compartment syndrome occurs suddenly, usually as a result of injury or overuse, and is considered a medical emergency. Symptoms include intense pain, swelling, and pressure in a confined area, as well as numbness, tingling, and muscle weakness.

Chronic compartment syndrome is a more gradual form of the condition and typically affects athletes or people with repetitive motions. Symptoms include aching pain during or after exercise and muscle weakness. Unlike acute compartment syndrome, chronic compartment syndrome is not typically considered a medical emergency.

 

Compartment Syndrome Causes

Compartment syndrome is caused by increased pressure within a muscle compartment, leading to decreased blood flow and potential damage to the muscles and nerves within the compartment. The following are common causes of compartment syndrome:

1. Trauma: Fractures, blunt force trauma, and other types of injuries can cause increased pressure within the affected compartment.
2. Overuse: Repetitive and intense physical activity, such as running or playing sports, can cause increased pressure within the affected compartment.
3. Prolonged immobilization: Prolonged immobilization, such as being in a cast or other restrictive device, can cause increased pressure within the affected compartment.
4. Burns: Burns can cause swelling, leading to increased pressure within the affected compartment.
5. Intravenous drug use: The use of intravenous drugs can cause increased pressure within the affected compartment due to swelling and other factors.
6. Medical procedures: Certain medical procedures, such as intramuscular injections or the placement of an IV line, can cause increased pressure within the affected compartment.
7. Congenital conditions: Some individuals may be born with a predisposition to the development of compartment syndrome due to the anatomy of their muscles and other tissues.

You should seek prompt medical attention if you experience symptoms of compartment syndrome, as early diagnosis and treatment can help prevent permanent muscle and nerve damage. Your healthcare provider will be able to provide an accurate diagnosis and recommend the best course of treatment for your individual needs.

 

Compartment Syndrome Symptoms

Compartment syndrome is a medical emergency that occurs when increased pressure within a muscle compartment interferes with the circulation of blood to that area. The following are common symptoms of compartment syndrome:

1. Pain: Pain is usually the first symptom of compartment syndrome and may be severe, unrelenting, and out of proportion to the injury.
2. Tingling or numbness: The affected limb may feel tingling or numb, which is a sign of nerve compression.
3. Swelling: The affected limb may be swollen, and the skin may appear tight and shiny.
4. Weakness: Weakness in the affected limb is a common symptom of compartment syndrome, and the affected limb may feel heavy or difficult to move.
5. Pale or mottled skin: The skin in the affected limb may appear pale or mottled, which is a sign of decreased circulation.
6. Elevated pulse: The pulse rate in the affected limb may be elevated, indicating poor circulation.

Compartment syndrome is a serious condition that requires prompt medical attention. If left untreated, it can lead to muscle and nerve damage, as well as other complications. If you suspect that you or someone else has compartment syndrome, seek immediate medical attention.

 

How is Compartment Syndrome Diagnosed?

Compartment syndrome is diagnosed based on a combination of clinical symptoms, physical examination, and diagnostic tests. The following are some common methods used to diagnose compartment syndrome:

1. Physical examination: A healthcare provider will examine the affected limb, looking for signs of pain, swelling, and decreased circulation. The provider may also measure the pressure within the muscle compartment, which is a key diagnostic indicator of compartment syndrome.
2. Nerve function tests: The provider may perform nerve function tests to assess the severity of nerve compression and to determine the extent of muscle damage.
3. Imaging tests: X-rays or MRI scans may be performed to rule out other conditions and to confirm the diagnosis of compartment syndrome.
4. Intracompartmental pressure monitoring: This is a more invasive diagnostic test, which involves inserting a small catheter into the affected muscle compartment to measure the pressure within the compartment. This test is typically only performed in severe cases or when the diagnosis is unclear.

If you suspect that you have compartment syndrome, it is important to seek medical attention as soon as possible. Early diagnosis and treatment are critical to prevent permanent muscle and nerve damage.

 

Treatment of Acute Compartment Syndrome

The treatment of acute compartment syndrome typically involves surgical intervention to relieve the increased pressure within the affected muscle compartment. The following are the most common treatments for acute compartment syndrome:

1. Fasciotomy: This is the most common surgical treatment for acute compartment syndrome. A fasciotomy involves making an incision in the fascia, or the connective tissue surrounding the muscle compartment, to relieve the increased pressure. This procedure is usually performed under general anesthesia.
2. Conservative management: In mild cases of acute compartment syndrome, conservative management may be recommended. This may include rest, immobilization, and pain relief medication.
3. Physical therapy: Physical therapy may be recommended after the surgical intervention to help restore mobility and strength to the affected limb.
4. Pain management: Pain management techniques, such as pain relief medication, nerve blocks, or other methods, may be recommended to help manage the pain associated with acute compartment syndrome.

You Should seek prompt medical attention if you suspect that you have acute compartment syndrome. Early diagnosis and treatment are critical to prevent permanent muscle and nerve damage. If left untreated, acute compartment syndrome can lead to serious complications, including muscle necrosis, nerve damage, and limb loss.

 

How Exertional Compartment Syndrome is Treated?

The treatment for exertional compartment syndrome typically involves a combination of conservative and surgical interventions. The following are the most common treatments for exertional compartment syndrome:

1. Conservative management: In mild cases of exertional compartment syndrome, conservative management may be recommended. This may include rest, immobilization, physical therapy, and pain relief medication.
2. Activity modification: Changing the activity that is causing the exertional compartment syndrome may also be recommended. This may involve reducing the intensity or duration of the activity, or switching to a different activity that does not put as much strain on the affected limb.
3. Physical therapy: Physical therapy may be recommended to help restore mobility and strength to the affected limb.
4. Pain management: Pain management techniques, such as pain relief medication, nerve blocks, or other methods, may be recommended to help manage the pain associated with exertional compartment syndrome.
5. Fasciotomy: In severe cases of exertional compartment syndrome, surgical intervention may be necessary. A fasciotomy involves making an incision in the fascia, or the connective tissue surrounding the muscle compartment, to relieve the increased pressure.

It is important to seek medical attention if you experience symptoms of exertional compartment syndrome, as early diagnosis and treatment can help prevent permanent muscle and nerve damage. Your healthcare provider will recommend the best treatment plan based on the severity of your condition and your individual needs.

 

Can You Prevent Chronic Compartment Syndrome?

Yes, there are steps you can take to prevent the development of chronic compartment syndrome:

1. Proper warm-up and cool-down: Before engaging in physical activity, make sure to warm up properly and stretch. After physical activity, make sure to cool down and stretch. This can help prevent the buildup of pressure within the muscle compartments.
2. Avoid overuse: Avoid repetitive, high-impact activities that can cause chronic compartment syndrome. If you must participate in these activities, make sure to take frequent breaks and use proper technique to reduce your risk of developing this condition.
3. Gradual increase in activity level: If you are starting a new exercise program or increasing the intensity of your current program, make sure to do so gradually. This will help your muscles and tissues adapt to the increased demands placed on them.
4. Wear proper footwear: Make sure to wear proper footwear that provides adequate support and cushioning to help prevent chronic compartment syndrome.
5. Maintain a healthy weight: Maintaining a healthy weight can help reduce the strain on your muscles and tissues, reducing your risk of developing chronic compartment syndrome.

It is also important to seek prompt medical attention if you experience symptoms of chronic compartment syndrome, as early diagnosis and treatment can help prevent permanent muscle and nerve damage. Your healthcare provider can provide additional recommendations for preventing chronic compartment syndrome based on your individual needs.

 

How Can You Manage Chronic Compartment Syndrome?

Chronic compartment syndrome can be managed through a combination of conservative and surgical treatments, depending on the severity and persistence of the condition. Some strategies for managing chronic compartment syndrome include:

1. Physical therapy: Physical therapy can help improve the strength, flexibility, and range of motion in the affected limb, as well as reduce pain and swelling.
2. Activity modification: Modifying activities that trigger or exacerbate symptoms can help reduce the development of chronic compartment syndrome.
3. Orthotics: Wearing supportive braces or orthotics can help distribute pressure and reduce symptoms of chronic compartment syndrome.
4. Pain management: Pain management strategies such as nonsteroidal anti-inflammatory drugs (NSAIDs), corticosteroid injections, or nerve blocks can help reduce pain and swelling.
5. Surgical intervention: In some cases, surgery may be necessary to relieve the symptoms of chronic compartment syndrome. This may involve creating a window in the fascia to relieve pressure within the compartment or releasing the fascia entirely.

You should work closely with your healthcare provider to develop an individualized plan for managing your chronic compartment syndrome, taking into account your specific symptoms, medical history, and overall health. By working together, you can develop strategies to reduce symptoms, improve quality of life, and prevent the development of further complications.

 

What Happens If You Don’t Treat Acute Compartment Syndrome?

If acute compartment syndrome is not treated promptly, it can result in serious and potentially permanent consequences, including:

1. Muscle and nerve damage: The increased pressure within the muscle compartment can cause damage to the muscles and nerves. This can lead to muscle weakness, numbness, and tingling.
2. Decreased blood flow: The increased pressure can also cause decreased blood flow to the affected limb, leading to a lack of oxygen and nutrients reaching the muscles and tissues. This can cause further damage and increase the risk of infection.
3. Necrosis: In severe cases, the increased pressure can cause the tissue within the compartment to die (necrosis). This can lead to the development of gangrene, which can be life-threatening if left untreated.
4. Long-term consequences: If acute compartment syndrome is not treated promptly, the long-term consequences can be serious and potentially permanent. This can include chronic pain, muscle weakness, and decreased function of the affected limb.

Therefore, it is important to seek prompt medical attention if you experience symptoms of acute compartment syndrome, as early diagnosis and treatment can help prevent permanent muscle and nerve damage. Your healthcare provider will be able to provide an accurate diagnosis and recommend the best course of treatment for your individual needs.

 

Does Compartment Syndrome Come Back?

Yes, in some cases, compartment syndrome can recur. This can occur if the underlying cause of the condition is not properly addressed or treated. For example, if an individual continues to participate in activities that put excessive pressure on the affected compartment, or if they have a congenital condition that predisposes them to the development of compartment syndrome, they may experience recurrent episodes of the condition.

In other cases, individuals may experience a recurrence of compartment syndrome after undergoing surgery to relieve the pressure within the affected compartment. This can occur if the surgical incision does not heal properly, or if scar tissue forms in the affected area, leading to decreased space within the compartment and increased pressure.

It is important to discuss any concerns about the potential for recurrence of compartment syndrome with your healthcare provider. They will be able to provide guidance on the best course of action to help prevent recurrence and manage any symptoms that may occur.

 

When You Should Go to Emergency?

You should go to the emergency room immediately if you experience symptoms of compartment syndrome, as prompt treatment is crucial to prevent permanent muscle and nerve damage. The following are signs and symptoms that suggest the presence of compartment syndrome and warrant a trip to the emergency room:

1. Pain: Severe pain in the affected area that is out of proportion to the injury or is not relieved by rest or pain medication.
2. Tingling or numbness: A feeling of tingling, pins and needles, or numbness in the affected area.
3. Muscle weakness: Difficulty moving the affected limb or muscle weakness in the affected area.
4. Swelling: Visible swelling in the affected area.
5. Tightness: A tight, constricting feeling in the affected area.
6. Pulses: A decrease or absence of pulses in the affected area.
7. Discoloration: The affected area may appear pale, blue, or mottled.

If you experience any of these symptoms, seek medical attention immediately. Your healthcare provider will be able to perform a physical examination and diagnostic tests to determine the presence and severity of compartment syndrome, and recommend the appropriate treatment to help prevent permanent muscle and nerve damage.

 

Conclusion

Compartment syndrome is a condition that occurs when pressure within a muscle compartment increases, leading to decreased blood flow and potential damage to the muscles and nerves within the compartment. 

Common causes of compartment syndrome include trauma, overuse, prolonged immobilization, burns, intravenous drug use, medical procedures, and congenital conditions. Symptoms of compartment syndrome include severe pain, tingling or numbness, muscle weakness, swelling, tightness, decreased or absent pulses, and discoloration. 

If you experience symptoms of compartment syndrome, it is important to seek prompt medical attention, as early diagnosis and treatment can help prevent permanent muscle and nerve damage. Your healthcare provider will be able to diagnose and treat compartment syndrome, and recommend strategies for preventing the development of this condition in the future.