Originally written by: Aaron Cain OMSII. Updated: June 29, 2022

Compartment syndrome is a rare condition that occurs due to the pressure build-up in a muscle.

It’s characterized by internal bleeding or swelling within a bundle of muscles within the body. It is a medical condition that needs immediate attention.

Schedule your appointment with our board-certified physicians at OrthoNeuro. We offer tailored treatment according to your symptoms.

What is Compartment Syndrome?

Our muscle groups are held in place by a complex network of strong connective tissue called fascia. This network creates separations between bundles of muscle fibers and allows us flexibility and mobility.

These walls are strong, with little elasticity. They cannot expand to accommodate pressure build-up within a compartment.

This high pressure leads to muscle and nerve damage, burst blood vessels, and severe pain over time.

Symptoms of Compartment Syndrome

The swelling or bleeding occurs within the muscle compartment created by the fascia. The lack of expansion impedes the blood flow to that compartment.

This circulation interruption can lead to symptoms such as:

  • Severe pain
  • Tingling or burning sensation in the affected area
  • A feeling of fullness or tightness in a muscle
  • Distinct pallor or paleness
  • Increased pressure from the inside out

How Is Compartment Syndrome Diagnosed?

Swelling and other symptoms are not always noticeable from the outside.

Compartment syndrome is diagnosed through a series of compartment pressure measurement and imaging tests—more specifically, MRIs.

Where Does Compartment Syndrome Typically Occur?

While rare, even less severe injuries such as ankle sprains can lead to the development of compartment syndrome. However, compartment syndrome often occurs in the arms and legs, which aren’t the most frequently injured parts of the body.

When Do the Symptoms of Compartment Syndrome Develop?

Symptoms usually develop within hours after the initial trauma, though not always. Compartment syndrome can also have late-onset signs like numbness or paralysis that are indicative of permanent damage to the tissue of the area affected.

There are also different types of this condition to be aware of: acute and chronic compartment syndrome.

Acute Compartment Syndrome

This is the version of this condition that comes after a traumatic injury, usually a broken bone, though not always.

Acute compartment syndrome is a medical emergency. In the most severe cases, acute compartment syndrome can lead to death. Get to a hospital immediately if you suspect you may have it.

Acute Compartment Syndrome Causes

Any of the following can cause the onset of acute compartment syndrome:

  • Crush injuries
  • Prolonged compression of the limb or site of injury
  • Blood clot
  • Bandages bound too tight
  • Severe burns
  • Blood vessel surgeries
  • Use of anabolic steroids

Chronic Compartment Syndrome 

Chronic compartment syndrome is also called exertional compartment syndrome or chronic exertional compartment syndrome.

The symptoms are numbness, difficulty using the affected muscles, and visible muscle bulging. The good news is that it can resolve if you discontinue the offending activity.

Chronic Compartment Syndrome Causes

Chronic compartment syndrome is typically caused by regularly engaging in vigorous exercises, like hurdle jumping or tennis. It is more common in young athletes.

It will take time to develop, over the course of weeks or even months. It is not a severe injury in the same way that the acute version of compartment syndrome is.

Do You Need Surgery to Treat Compartment Syndrome?

Either variation of the syndrome is significant and can permanently damage the muscle or tissue affected.

To treat acute compartment syndrome, a procedure known as a fasciotomy is often required. During a fasciotomy, the fascia is opened to release compartment pressure in the affected limb.

Chronic compartment syndrome can require surgery if left untreated for too long.

Treatments for Compartment Syndrome

Treatments will start non-surgical for chronic compartment syndrome and include:

  • Occupational or physical therapy
  • Non-steroidal anti-inflammatory drugs or NSAIDs
  • IV Fluids
  • Oxygen, given by the nose or mouth

Acute compartment syndrome is a severe injury that can only be treated through a fasciotomy.

Do not attempt to give yourself physical therapy as you risk exacerbating the injury.

After Surgery

After a fasciotomy, you will need physical therapy. The Foot Ankle Journal has published information about negative-pressure wound therapy after ankle surgeries and its success. Your physician will explain the most effective recovery method for you if you undergo surgery.

Conclusions About Compartment Syndrome

Compartment syndrome is a serious injury. If not treated, it can cause permanent damage and even lead to death.

If you believe you have compartment syndrome, call OrthoNeuro immediately, before pressure builds too much in the involved compartment and requires more invasive procedures to correct the issue.

We have providers on call when our office is closed. If you need to speak with a provider after hours please call 614-890-6555 and the on-call physician will be contacted, otherwise, you can contact us to make an appointment.

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