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Compartment Syndrome

Compartment Syndrome

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What is Compartment Syndrome?

Compartment syndrome (CS) is a dangerous condition that arises when a muscular compartment is under a lot of pressure.

Compartments are groups of muscle tissue, blood vessels, and nerves in your arms and legs that are surrounded by the fascia, a very strong membrane. Because fascia can not expand, swelling in a compartment might result in an increase in compartment pressure. Inside the compartment, this causes harm to the muscles, blood vessels, and nerves.

The blood supply to the compartment can be isolated as pressure increases. Ischemia (a lack of oxygen reaching the tissues) and cellular death can follow (necrosis).

Types of compartment syndrome

Acute CS

This type of compartment syndrome usually develops after a serious injury. It can also arise after a minor injury in rare situations. You might develop acute compartment syndrome following:

  • A broken bone
  • A crush injury to your arm or leg
  • As a result of a significant muscle bruising
  • Wearing a cast or a restrictive bandage
  • As a result of binge drinking or drug use

Chronic (exertional) compartment syndrome

This type of compartment syndrome can be caused by exercise, especially when it involves repeated movements. It is more common in persons under the age of 40, but it can strike anyone at any age.

If you do activities like swimming, tennis, or running, you’re more likely to develop chronic CS. Workouts that are too intense or too frequent can also raise your risk.

The connection between exercise and chronic compartment syndrome is unclear.

Symptoms of compartment syndrome

Acute compartment syndrome

Severe pain that does not improve after elevating the injured area or taking medicine is the most prevalent sign of acute compartment syndrome. Stretching or using the damaged muscle may make your leg or arm feel worse.

Other signs and symptoms include muscle tightness and tingling or burning sensations in the skin around the affected area.

Numbness or paralysis are common symptoms of severe acute compartment syndrome. This is frequently an indication of long-term harm.

Chronic compartment syndrome

The most typical symptom of chronic compartment syndrome is pain or cramping when you exercise. The soreness or cramping normally goes away within 30 minutes after you stop exercising. If you keep doing the activity that’s causing this problem, the pain may get worse and persist longer.

Other signs and symptoms include:

  • Having difficulty moving your foot, arm, or other afflicted area
  • Numbness
  • A visible bulging in the muscle in question

Diagnosis

A physical examination will be performed by a doctor to look for evidence of acute or chronic compartment syndrome. To determine the severity of your pain, they may squeeze the affected area.

To determine how much pressure is in the compartment, the doctor may use a pressure metre with a needle attached. This measurement must be collected while performing the action that causes your limb pain. After you’ve completed the test, it will be taken again.

X-rays may be ordered by your doctor to rule out any other conditions.

Causes

When there is bleeding or swelling within a compartment, compartment syndrome might develop. This could lead to a build-up of pressure inside the compartment, obstructing blood flow. If left untreated, it can result in lifelong damage because the muscles and nerves are deprived of the nutrition and oxygen they require. Amputation may be required if the problem is not treated.

Complications

Acute compartment syndrome

Acute compartment syndrome necessitates medical intervention right away to relieve pressure. Within hours, permanent damage to your muscles and nerves can occur. If not treated immediately, this is a surgical emergency that could result in an amputation.

Chronic compartment syndrome

Although chronic compartment syndrome isn’t a medical emergency, you should contact your doctor if you notice any symptoms. When you’re in pain, don’t try to exercise because it can permanently harm your muscles, blood vessels, and nerves.

Treatment

Acute compartment syndrome

For this kind of compartment syndrome, surgery is the sole therapy option. Cutting open the fascia to relieve pressure in the compartment is part of the procedure. In extreme cases, your doctor may need to wait for the swelling to subside before closing the wound, and some of these wounds will require skin grafting.

If you obtained this condition as a result of a cast or a tight bandage, you’ll need to get it removed or loosened.

Chronic compartment syndrome

Your doctor may first suggest nonsurgical therapy options, such as:

  • Muscle stretching physical therapy
  • Anti-inflammatories drugs
  • Varying the sort of surface on which you workout
  • Incorporating low-impact activities into your workout regimen
  • Raising the affected limb
  • Taking a break after an activity or altering the activity
  • After an activity, cooling the extremities

If these approaches fail, surgery may be required. In general, surgery is more beneficial than nonsurgical treatments for chronic compartment syndrome.

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