Compartment Syndrome: A Condition to Look Out For
by Aaron Cain, OMSII
One medical emergency that can occur from a broken bone in the leg or the arm is known as compartment syndrome. There are two types of compartment syndrome: acute and chronic. Acute compartment syndrome is a medical emergency and can be caused by a severe injury, such as a broken bone. Chronic compartment syndrome is usually not a medical emergency and can occur from exertion, most often from athletics. A compartment is a group of muscles, blood vessels, and nerves that are encased by a membrane called fascia. Fascia’s role in the body is to keep your tissues in place so it doesn’t allow for much stretching of the compartment it creates.
Acute Compartment Syndrome
Acute compartment syndrome occurs when the pressure inside of a compartment increases. This can occur from bleeding or even the swelling of muscles. Since the fascia doesn’t stretch, the pressure can build rapidly and will compress on the muscles, nerves, and blood vessels in the compartment. There are many ways that compartment syndrome can begin:
- Broken bone
- Badly bruised muscle
- Blood flow returning after being blocked
- Crushing injuries
- Anabolic steroids
- Constricting bandages
- Blood clot
Each of these injuries to the body can increase the pressure in a compartment. The most common areas for compartment syndrome to present are in the arm, the leg, and the abdomen.
Symptoms usually develop over the course of a couple hours after a serious injury. Symptoms can include:
- New and more intense pain than you would expect from the injury
- Tingling or burning in the skin
- Muscles in the area feeling tight or full
- Numbness or paralysis are late signs and usually indicate permanent tissue injury
Often the symptoms of compartment syndrome can be summed up the 5 P’s:
- Pallor (pale appearance)
- Paresthesia (tingling or burning in the skin)
- Pressure (increased)
Acute compartment syndrome is a medical emergency and you should go to the emergency room immediately if you think you might have it. Once you get to the emergency room your doctor will measure your compartment pressure and determine whether you have compartment syndrome or not. If it is determined you have compartment syndrome your doctor will perform a surgical procedure known as a fasciotomy, where an incision is made to cut open the skin and the fascia. This allow the pressure in the compartment to be released. Once the pressure is decreased the skin will be closed.
Chronic Compartment Syndrome
This form of compartment syndrome is often called “exertional” compartment syndrome because it is caused by exercise. Most often it affects athletes with repetitive motions like biking or running. This form of compartment syndrome is not a medical emergency and will relieve itself after the exercise is discontinued.
- Difficulty moving the overused muscles
- Bulging of the muscle
To diagnose chronic compartment syndrome your doctor will measure the pressures in your compartment, after ruling out other conditions like tendinitis or a stress fracture. This condition can resolve itself after discontinuing activity. Other treatment options are nonsurgical:
- Physical therapy
- NSAIDs (e.g. Ibuprofen)
If nonsurgical treatments do not work, a doctor may suggest an elective surgical treatment similar to that in acute compartment syndrome. For chronic compartment syndrome the incision is often shorter.
If you think you may have acute compartment syndrome – SEEK EMERGENCY MEDICAL ATTENTION IMMEDIATELY!