Compartment Syndrome

Overview

Inside the arms in legs, we have ‘compartments,’ which are bundles of nerves, blood vessels and muscle tissues enveloped by a membrane. When the contents of these compartments begin to swell, the membrane that surrounds the compartment is unable to grow, causing pressure to build within the compartment. This buildup of pressure is called decompressive fasciotomy, or compartment syndrome.

In compartment syndrome, the pressure inside the membrane leads to a decreased flow of blood to nerve and muscle tissues. This can lead to symptoms such as numbness, tingling and pain in the muscle.

Compartment syndrome can be acute or chronic. Acute compartment syndrome develops after an injury, while chronic compartment syndrome often worsens with exercise that involves repetitive motions. Symptoms of, and treatments for, compartment syndrome will vary accordingly.

Call your doctor if you have symptoms of chronic compartment syndrome. If you develop symptoms of compartment syndrome following an injury, seek immediate medical attention. 

Compartment syndrome causes

Symptoms of compartment syndrome develop when swelling or bleeding in a muscle compartment cause pressure to build inside. This bleeding or swelling can result from an injury, as is the case in acute compartment syndrome, or from high-impact endurance exercise, as is characteristic of chronic compartment syndrome.

Compartment syndrome risk factors

After a severe injury, you may be at an increased risk of developing compartment syndrome. Injuries that may put you at risk include:

• A bone fracture
• A severe muscle bruise
• Drug or alcohol abuse
• An arm or leg getting crushed

You may be at an increased risk of developing chronic, or exertional, compartment syndrome if you:

• Are under age 30
• Engage in exercise that involves repetitive motions and high impact on the body, such as distance running
• Over-train or overexert yourself in a sport

Compartment syndrome symptoms

The main symptom of acute compartment syndrome is intense pain in the affected limb following in injury. Other symptoms may include:

• Tingling or tightness in the muscle
• Pain that worsens while stretching

Symptoms of chronic compartment syndrome may include:

• Numbness in the muscle
• Cramping or pain in the affected muscle during exercise
• Limited ability to move the affected muscle or limb
• A visible growth of the muscle

Compartment syndrome complications

If left untreated, acute compartment syndrome can cause severe and permanent damage to your nerves and muscles, and in extreme cases, may require amputation.

Compartment syndrome diagnosis

When assessing a possible case of chronic compartment syndrome, your doctor will perform a physical examination of the affected areas. Your doctor may also attach a pressure meter to the affected area and ask you to perform the activity that causes your symptoms.

Compartment syndrome treatment

Treatment for acute compartment syndrome requires emergency surgery to cut open the affected compartment and relieve pressure.

To treat chronic compartment syndrome, your doctor may recommend:

• Wearing sole inserts in your athletic shoes
• Avoiding or limiting exercise and physical activities that cause pain
• Stretching the affected limbs after exercising

When to seek care

Call your doctor if you experience symptoms of chronic compartment syndrome. If you develop symptoms of acute compartment syndrome following an injury, seem emergency medical attention immediately.

Next Steps

Your doctor will assess your symptoms and set up a treatment plan for chronic compartment syndrome that works best for you.