What is Compartment Syndrome?

Compartment syndrome is when excess pressure inside of muscles cause nerve damage. Pressure inside a muscle builds to higher than usual levels. The pressure prevents nerve and muscles cells from receiving adequate amounts of blood flow, oxygen, and other nutrients.

Usually caused by an injury, compartment syndrome comes in two main varieties:

• Acute—This type of compartment syndrome is typically the result of serious injury. Immediate medical care is strongly recommended. Untreated, you can experience permanent harm to your muscles.
• Chronic—This type of compartment syndrome is usually caused by athletic activity. Doctors do not generally consider chronic compartment syndrome an emergency.

Compartment syndrome can impact muscles in your legs, arms, hands, feet, and butt.

Signs & Symptoms

Both acute and chronic compartment syndrome share similar symptoms. In chronic compartment syndrome, the symptoms tend to affect the same muscle compartments of the limbs on both sides of your body.

Common compartment syndrome symptoms:

• Tightness
• Pain
• Burning
• Aching
• Tingling
• Cramping
• Numbness
• Weakening

If the muscles in your legs become severely impacted, you may find it difficult to lift your foot, a condition sometimes called “drop foot” or “foot drop.” Less often, you may experience a hernia-related bulge or swelling in the affected muscle.

The symptoms follow a predictable pattern. You experience the symptom after a certain amount of physical activity—time, distance, or effort. The symptom worsens as you continue to exert yourself. However, the symptoms subside after you stop exerting yourself, typically within 15 minutes. Over time, it may take longer for the symptoms to fade.

Causes

The most common cause of compartment syndrome is a broken leg or arm. This type of injury is an acute compartment syndrome that evolves quickly, usually within a few hours or days. Chronic compartment syndrome generally develops over days or weeks.

Additional compartment syndrome causes:

• Surgery, particularly involving blood vessels in arms and legs.
• Blood clots in arms and legs.
• Extremely compressed bandaging.
• Injury that compresses or crushes the body, known as “crush injuries.”
• Extreme levels of exercise.
• Extended period of limb compression while unconscious.
• Burns to the body.

Compartment syndrome risk factors include taking anabolic steroids, any form of intense exercise, trauma to the body, bone fractures, and treatment for injuries. Sometimes the condition develops after surgery, bandaging, or casting.

Diagnosis

Your doctor will begin a compartment syndrome diagnosis by reviewing your medical history and symptoms, and by performing a routine physical exam. Next, your doctor may perform additional tests such as measuring the pressure inside your affected muscle.

To measure pressure, your doctor will either insert a needle or catheter attached to a pressure monitor. Imaging tests such as X-rays can help confirm suspected compartment syndrome.

When to See a Doctor

Acute compartment syndrome is considered a medical emergency.

If you or a loved one experience any of the signs or symptoms of compartment syndrome, please contact your primary care physician. An orthopedic doctor at Baptist Health may be able to help.

Treatment & Recovery

Ultimately, prevention of injury is the best way to approach compartment syndrome. However, compartment syndrome treatment falls into two major categories: nonsurgical and surgical.

Surgical treatment is required for acute compartment syndrome. Sometimes this surgery is referred to as compartment syndrome surgery. Chronic compartment syndrome usually does not require surgery.

Doctors recommend implementing appropriate treatments as soon as possible after you notice symptoms.

Nonsurgical treatment might include:

• Icing muscles
• Elevating limbs above the heart
• Bandaging
• Casting
• Splinting

Surgical treatment can involve:

• Fasciotomy—A surgeon will make strategic incisions in the affected muscle to relieve pressure and swelling.
• Hyperbaric oxygen—breathing in pure, pressurized oxygen to accelerate healing.

Living with compartment syndrome

Compartment syndrome may limit physical activity. Doctors often recommend avoiding strenuous activity such as running, volleyball, or tennis. Pain and swelling after physical exertion are common for individuals with this condition.

Other possible complications

Prognosis for compartment syndrome depends on factors such as your general health, and the type and severity of the condition. Complications can include permanent damage to your health.

Complications

Individuals with compartment syndrome may experience complications. These can range from minor to serious issues. Some complications are temporary while others might be permanent.

Complications can include:

• Scarring
• Infection
• Loss of limb function
• Amputation
• Nerve damage
• Muscle failure
• Muscle breakdown
• Kidney failure