Compartment syndrome is a condition where pressure within the muscles builds up, leading to circulation problems within that muscle compartment. It happens for two reasons: increased pressure due to swelling, or reduced blood flow due to internal bleeding. The pressure restricts the blood flow in the compartment and can lead to damaged nerves or muscles.
The condition can be due to several reasons, including trauma, prolonged activity, exercise or compression from tight clothing. Compartment syndrome is also known as “white muscle disease” because it can cause acute pain and swelling in the affected area.
Compartments are small areas within your muscles that contain nerves, blood vessels and other connective tissue. When you exert yourself, your body releases chemicals that dilate the blood vessels and allow more blood to flow into the muscles. This increase in blood flow causes an increase in fluid pressure within these compartments.
When these compartments become too full of fluid, they can become swollen and inflamed – which can cause pain, numbness or tingling sensations. If these symptoms persist for more than 24 hours without treatment, it could lead to permanent nerve damage – which could cause problems with muscle movement and sensation.
The symptoms of compartment syndrome include pain, tingling, numbness and swelling in the affected area. Pain usually increases with activity and decreases with rest. If you have any of these symptoms after an injury, contact your doctor immediately.
The severity of symptoms depends on how much pressure builds in your muscles. This may vary depending on how much blood flows through the affected area and whether there’s any bleeding or swelling in that area.
Compartment syndrome is most commonly caused by trauma or swelling in the muscles after an injury or surgery. Some other causes include:
-Infection in the muscle tissue
-Vascular disorders such as arterial insufficiency or thrombosis
-Immobilization (such as pins or plates) used during surgery
Compartment syndrome can be acute (sudden onset) or chronic (developing over time). Acute compartment syndrome is more serious than chronic compartment syndrome. Both types can occur during physical activity if you overuse your muscles or exert them too much.
Acute compartment syndrome develops suddenly and usually affects a single muscle or muscle group. It often follows an injury, such as a fracture that causes bleeding into the muscle, but it can also occur after lifting heavy objects or doing other strenuous activities.
The pain caused by acute compartment syndrome is severe and typically worsens as time goes on. You may notice swelling in one of your limbs, and there may be numbness or loss of feeling in the affected area. If you experience these symptoms, seek medical attention immediately because compartment syndrome can lead to permanent damage if left untreated.
Chronic exertional compartment syndrome develops slowly over time and results from repetitive muscle use without adequate blood circulation. Because chronic exertional compartment syndrome occurs gradually, there may not be any noticeable symptoms until you perform an activity that aggravates the condition — for example, running uphill or doing squats with heavy weights on your shoulders. After exerting yourself during this type of activity, you might notice swelling and stiffness in your leg muscles that gets worse when they’re used again — say, after jogging home following a workout at the gym.
A doctor can usually diagnose compartment syndrome based on your symptoms and a physical examination. If there are no other injuries, you will likely be given an X-ray to look for fractures in the area. Your doctor may also order an ultrasound or MRI scan of your limb to confirm the diagnosis.
Most cases of compartment syndrome are mild and don’t require treatment. Severe cases usually need surgery to relieve pressure on the nerves and blood vessels inside the compartment.
If compartment syndrome is suspected, your doctor will order an imaging test such as an MRI or CT scan to confirm its presence. Treatment depends on the severity of symptoms and whether there are any underlying causes for the condition.
Your doctor may recommend rest, ice, compression and elevation (RICE) if you have mild pain or swelling in your leg without any muscle loss or permanent nerve damage. You’ll also likely be prescribed medication to treat pain and inflammation while you rest your leg.
Treatment may also include splinting or casting the affected limb if it’s been immobilized for an extended period of time. The goal is to keep it at an angle so it doesn’t become stiff while allowing fluid drainage from the joint spaces and muscles into the circulatory system.
If those measures don’t help ease pain or swelling after several days, surgery may be required. This is done to relieve pressure from blood vessels and nerves inside the compartment by opening up the muscles and removing fluid buildup inside them.
Physical therapy for compartment syndrome is done to improve the range of motion around the affected area and help restore muscle strength.
The goal of physical therapy for compartment syndrome is to restore normal blood flow and relieve pressure on the nerve within the compartment. This type of therapy can also be used to treat nerve pain (neuropathic pain) caused by a damaged nerve in the compartment.
Physical therapists may use the following treatments:
Exercise – Physical therapists will teach you exercises that flex and extend your muscles. These exercises can help improve your range of motion and strengthen your muscles.
Pneumatic compression devices (PCDs) – PCDs are devices that apply pressure through an air-tight bandage that wraps around your leg or arm. The pressure helps reduce swelling and increase circulation in your extremity. PCDs may be used as part of your home exercise program or as part of your hospital stay if you are unable to walk on your own due to swelling in your leg(s).
Compartment syndrome (also known as exertional compartment syndrome) is a serious and painful condition that can cause permanent muscle damage in your arms, legs, hands, or feet. If you experience, or witness, symptoms of Compartment Syndrome, it’s important to get medical attention. Treating Compartment Syndrome can limit the damage that occurs from swelling, but the condition can permanently disable otherwise healthy muscles if not treated.