What is compartment syndrome?

Compartment syndrome is increased pressure within an enclosed space of the body as a result of trauma or swelling.

As a result of the increased pressure, the blood supply to nerves and muscles may be restricted.

Types of compartment syndrome

Acute compartment syndrome occurs after a traumatic accident, such as a fracture, when pressure builds in the lower leg and leads to insufficient blood supply to the nerves and muscles.

Chronic compartment syndrome can occur during exercise when the muscles swell and the fascia surrounding the compartment is so tight that it restricts blood flow. The restricted blood flow puts pressure on the nerve and causes pain and numbness in the lower leg.

Causes of compartment syndrome

Compartment syndrome typically develops after car collisions or broken bones.

Conditions that may cause acute compartment syndrome include:

  • Fractures
  • Crush injuries
  • Steroid use
  • Constricting bandages
  • Severely bruised muscles (potentially after a motorcycle accident)

Causes of chronic compartment syndrome include:

  • Too much activity, too quickly — exercising too hard, too quickly or too often can cause chronic compartment syndrome because the blood pressure increases and the muscles expand; the pressure cuts off the blood supply to the muscle.
  • Enlarged muscles — enlarged muscles can cause the blood supply to be cut off to the tissues.

Risk factors for compartment syndrome

  • Age — male and female athletes under the age of 30 are higher risk for chronic compartment syndrome.
  • Overtraining — people who work out too much or too often put themselves at risk for compartment syndrome.
  • Repetitive exercises — activities, such as running or long-distance walking, can increase your risk of compartment syndrome.

Symptoms of compartment syndrome

Symptoms of acute compartment syndrome include:

  • Pain that is more intense than the injury would suggest
  • Burning or tingling sensations
  • Tight muscles
  • Paralysis or numbness

Symptoms of chronic compartment syndrome include:

  • Pain or cramping while exercising that subsides when activity stops
  • Inability or difficulty moving the foot
  • Muscle bulging
  • The foot slapping the ground as it strikes

Diagnosis of compartment syndrome

Acute compartment syndrome
Acute compartment syndrome needs immediate treatment. Go to your nearest ER if you think you have acute compartment syndrome.

Chronic compartment syndrome
Compartment syndrome is diagnosed by a physician in a physical exam. The physician will measure the pressure in the compartments of the legs before and after exercise.

It is necessary to rule out other, potentially more serious, conditions during the exam so your physician may order an x-ray or MRI.

Treatments for compartment syndrome

Acute compartment syndrome requires immediate fascia release surgery, where the skin and fascia is cut open to relieve the swelling and pressure.

Chronic compartment syndrome can be treated with:

  • Physical therapy — exercises to help relieve the pressure caused by compartment syndrome, including range of motion and muscle strengthening exercises.
  • Anti-inflammatory medications
  • Orthotics — your doctor may recommend using custom orthotics to relieve stress during physical activity and encourage you to avoid high-impact exercise during the recovery process.
  • Fascia release surgery — more severe cases of chronic compartment syndrome will require fascia release surgery, fascia release surgery opens the fascia so there is room for muscles to swell.

Recovery from compartment syndrome

If surgery is required to treat compartment syndrome, physical therapy is essential for recovery. The physical therapist will work closely with your orthopedic surgeon to ensure your recovery plan is appropriate for your case.

To prevent future incidences of chronic compartment syndrome, follow your doctor’s instructions closely.

Lifestyle modifications, such as using orthotics, reducing the activities that are causing the condition and applying ice when you feel symptoms, can help you avoid future occurrences.

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