During compartment syndrome, the blood flow to the tissues is restricted due to high pressure inside a muscle compartment (a group of muscles, nerves, and blood vessels). It can result in severe pain, nerve damage, muscle damage, and even death. Although compartment syndrome can affect any part of the body, it is most common in the legs and arms. There are two types: acute and chronic compartment syndrome.
Causes of Compartment Syndrome
An acute compartment syndrome is usually caused by a severe injury that causes bleeding or swelling within the muscle compartment.
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Bone fracture
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Crush injury
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Burn
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Surgery
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Blood clot
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Snake bite
It is a medical emergency that requires immediate treatment to prevent permanent damage or limb loss. Acute compartment syndrome can develop within hours or days after an injury.
A chronic compartment syndrome occurs when repetitive or prolonged physical activity increases the pressure in the muscle compartment. Some of the activities that can cause chronic compartment syndrome include:
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Running
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Cycling
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Swimming
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Weight lifting
Compartment syndrome develops over a period of weeks or months. It is not a medical emergency but can affect the affected person's performance and quality of life.
Symptoms of Compartment Syndrome
Compartment syndrome is characterized by intense pain that does not go away with rest or pain medication. Other symptoms of compartment syndrome include:
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Affected area swells and feels tight
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Affected limb is numb and tingly
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Affected limb weakness or paralysis
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Affected limbs have pale or bluish skin colors
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Affected limb has difficulty moving or feeling
Chronic compartment syndrome usually occurs during or after exercise and subsides with rest. Acute compartment syndrome symptoms can occur suddenly or gradually after injury.
Diagnosis of Compartment Syndrome
A doctor will ask about the patient's medical history, symptoms, and activities to diagnose compartment syndrome. A doctor will also perform a physical examination and measure the pressure inside the muscle compartment with a device called a pressure monitor. Pressures greater than 30 millimeters of mercury indicate compartment syndrome.
The following tests may also be used to diagnose compartment syndrome:
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The purpose of blood tests is to check for signs of infection, inflammation, or muscle damage.
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Bone fractures or other injuries can be detected with X-rays.
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An MRI scan is used to check for muscle damage or other abnormalities.
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A blood vessel ultrasound is used to check for blood clots or other blockages.
Treatment of Compartment Syndrome
Treatment for compartment syndrome depends on the type and severity of the condition. The main aim is to reduce the pressure in the muscle compartment and restore blood flow to the tissues.
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It is most common to treat acute compartment syndrome with surgery. It involves making an incision in the skin and fascia (the tough membrane that covers the muscle) to release the pressure and allow blood flow. Sometimes a second surgery is required to close the wound after the swelling has gone down. This is called a fasciotomy.
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For chronic compartment syndrome or acute compartment syndrome, medication can be used as an adjunct to surgery. To reduce swelling and pain, anti-inflammatory drugs (such as ibuprofen) are used, antibiotics (such as metronidazole) are used to prevent infection, and anticoagulants (such as heparin) are used to prevent blood clots.
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As part of rehabilitation after surgery for acute compartment syndrome or to treat chronic compartment syndrome, physical therapy may be used. It involves doing exercises to stretch and strengthen the affected muscles, improve blood circulation, and prevent scarring.
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A lifestyle change can help prevent or manage chronic compartment syndrome. This involves modifying or avoiding activities that trigger or worsen symptoms, such as running on hard surfaces, wearing tight shoes or clothing, or increasing exercise intensity or duration too quickly.
Prevention of Compartment Syndrome
It may not be possible to prevent compartment syndrome in some cases, especially if the injury is unpredictable. However, there are some measures that can help lower the risk or severity of compartment syndrome, including:
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When playing sports or exercising, wear protective gear and follow safety rules.
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It is important to seek medical attention as soon as possible after an injury that causes severe pain, swelling, or bleeding in a limb.
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Drinking excessive alcohol, smoking, or using drugs that can affect blood flow or clotting should be avoided.
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Maintaining hydration and nutrition by drinking plenty of fluids and eating a balanced diet.
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Preventing muscle strain and injury by stretching and warming up before and after exercise.
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In the event of pain or swelling during or after exercise, rest and ice the affected area.
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Taking any medications or supplements that may affect blood flow or clotting should be discussed with a doctor.
