Compartment syndrome is a condition resulting from a buildup of pressure inside a muscle compartment: the tissue, blood vessels, and nerves enclosed in the fascia. Since fascia—sheets of connective tissue around muscles that stabilize, surround, and separate the muscle— is not flexible and does not expand, pressure from bleeding or swelling inside the compartment can cause injury to any of the components. The pressure can cut off the blood supply to the muscles, endangering the affected limb.

Acute Compartment Syndrome

Aside from fractures, other injuries that can lead to acute compartment syndrome include:

  • A blood clot in a blood vessel in the arm or leg
  • A burn
  • Compression of a limb during a period of unconsciousness
  • Crush injury
  • Overly tight bandaging
  • Surgery to blood vessels

The nature of this condition is sudden and intense, as are the symptoms. This condition is considered a medical emergency and must be treated immediately with surgery. Left untreated, it can result in nerve damage or amputation.

man in overalls with his broken arm in a cast and sling


Symptoms of Acute Compartment Syndrome

Acute compartment syndrome is a sudden onset of the condition and is typically experienced after a trauma, such as a fracture or a gunshot wound. Symptoms include:

  • Sudden and intense pain out of proportion to the apparent injury. The pain is especially intense when the muscle in stretched. Due to the pressure in the affected compartment, the muscle has no room to stretch, causing pain.
  • Tightness in the affected limb. This happens because of the swelling that is putting pressure on the fascia and affecting the muscles in the compartment.
  • Paresthesia. People with this condition will most likely experience a burning or tingling sensation on the skin of the affected limb.
  • Numbness or paralysis. This is a later stage of compartment syndrome and usually indicates permanent damage.

man experiencing extreme pain in his elbow and arm


Chronic Compartment Syndrome

This version of the syndrome develops over a long period due to repetitive motion, such as exercise in the form of swimming, tennis, or running. Chronic (exertional) compartment syndrome is more difficult to diagnose because it happens over a long period of time. It is marked by pain or cramping during physical exertion, which usually subsides when the exercise stops.

young woman with arm or elbow pain from playing tennis


Symptoms of Chronic Compartment Syndrome

Look out for these six symptoms if you experience pain during physical activity:

  • Aching, burning, or cramping pain in the affected limb
  • Tightness of the affected limb
  • Numbness or tingling of the affected limb
  • Weakness of the affected limb
  • Swelling or bulging of the muscle
  • Pain occurs in the same area each time

When experiencing these symptoms, "walking it off" is never a good idea. Exercising through the pain may lead to permanent nerve and muscle damage. In order to diagnose chronic compartment syndrome, a doctor will measure the pressure in the affected area before and after exercise. If the pressure remains high after exercising, the doctor will diagnose the patient with compartment syndrome.

acute compartment syndrome


For acute compartment syndrome, the only treatment is surgery. The surgeon will make an incision and open up the affected compartment and release pressure. Since the surgeon is opening the fascia, this procedure is called a fasciotomy. Nonsurgical treatment for chronic compartment syndrome includes rest - mainly refraining from repeating the activity which caused pain in the affected limb, anti-inflammatory medication, manual decompression, and sometimes physical therapy. If symptoms do not subside, a fasciotomy will be performed to open the fascia and release pressure, making room for the muscles. Surgery is the most effective treatment. However, those with chronic compartment syndrome may choose to treat it manually before turning to surgery.

compartment syndrome


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