Originally written by: Aaron Cain OMSII.
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 in Columbus, Ohio, today. We offer tailored treatment according to your symptoms.
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.
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:
Swelling and other symptoms are not always noticeable from the outside. Compartment syndrome is diagnosed through a series of compartment pressure measurements and imaging tests, more specifically, MRIs.
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.
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 affected area.
There are also different types of this condition to be aware of: acute and chronic 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.
Any of the following can cause the onset of acute 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 be resolved if you discontinue the offending activity.
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.
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 may start non-surgically for chronic compartment syndrome and include:
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 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.
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.
Compartment syndrome is a condition in which pressure inside the compartments of the muscles rises to dangerous levels. These compartments contain muscles, nerves, and blood vessels surrounded by fascia that does not easily stretch.
When compartment pressure increases, it can reduce blood flow to the affected muscle compartment, potentially leading to tissue death, muscle nerve damage, and other serious complications.
Acute compartment syndrome most often occurs after a severe injury that causes swelling or bleeding within the muscle compartments.
Common causes include:
These situations can lead to decreased blood flow, increasing the risk of permanent muscle damage if treatment is delayed.
Chronic exertional compartment syndrome, sometimes called exertional compartment syndrome, is a form of chronic compartment syndrome that occurs during physical activity.
It is most common in runners and athletes. The condition typically affects the lower leg and causes:
Symptoms often improve with rest but may return when the activity resumes.
Doctors diagnose compartment syndrome by evaluating symptoms, reviewing injury history, and performing tests.
One key diagnostic method is compartment pressure measurement, which measures the pressure inside the affected muscle compartment. Imaging tests such as MRI scans may also help evaluate the affected muscle and surrounding tissues.
Early diagnosis is important because developing compartment syndrome can quickly become dangerous.
Acute compartment syndrome treatment should begin immediately, as it is a medical emergency.
The most effective treatment is a surgical procedure called a fasciotomy, which releases the fascia and reduces compartment pressure. This procedure restores blood flow and helps prevent permanent muscle damage.
Without prompt treatment, patients may develop acute compartment syndrome complications, including tissue death or loss of limb function.
To treat chronic compartment syndrome, doctors usually begin with non-surgical approaches such as:
If symptoms persist or worsen, surgery may be recommended to relieve pressure and allow athletes to return safely to physical activity.
Several risk factors increase the likelihood of developing exerertional compartment syndrome, including the following:
Athletes who train intensely may develop chronic compartment syndrome over time due to repeated stress on the muscle compartments.
While not all cases can be avoided, certain strategies may help prevent compartment syndrome, particularly in athletes:
Early evaluation by sports medicine specialists can help reduce the risk of serious complications.
