Our Nerve Specialist Explains the Types of Compartment Syndrome

are you at risk for compartment syndrome yes or noCompartment syndrome is a painful, serious condition that occurs when there is a large amount of muscle pressure. It can be caused by an injury—which requires immediate medical attention—or as a result of excessive physical activity. Compartment syndrome can cause injury to the nerves, blood vessels, and muscles inside the muscle compartment. There are two types of compartment syndrome—acute and exertional—that Dr. Williams can treat with various options to reduce pressure, such as nerve release surgery.

Signs and Causes of Compartment Syndrome

Recognizing the signs of compartment syndrome is important for preventing possible complications that can be permanent or fatal. Compartment syndrome can affect various parts of the body, such as the feet, arms, and abdomen, but is most common in the lower legs.

The signs or 5 P’s of compartment syndrome are:

  1. Pain
  2. Pallor/pale skin tone
  3. Paresthesia/numbness
  4. Pulselessness/faint or weak pulse
  5. Paralysis/weakness with moving

In addition to the 5 P’s, other symptoms of compartment syndrome may include:

  • Muscle swelling
  • Tingling or burning sensation
  • Tight feeling in the muscle
  • Visible bulge in the muscle

Depending on the type of compartment syndrome, it can be caused by either a serious injury or excessive physical activity. If the pressure in the muscle compartment reaches a dangerous level and reduces blood flow to the tissues, this can lead to permanent damage or can be fatal. Some causes of compartment syndrome include:

  • Car accident
  • Crush injury
  • Broken bone or fracture
  • Surgery
  • Bruised muscle
  • Anabolic steroids
  • Cast that is worn for a long amount of time
  • Intense or repetitive physical activity

Types of Compartment Syndrome

There are two types of compartment syndrome:

  • Acute compartment syndrome. This type is usually caused by trauma or a sudden injury such as a crushing injury. Acute compartment syndrome can cause permanent damage to the muscles, disability, paralysis, or death if not treated immediately.
  • Chronic (exertional) compartment syndrome. This typically occurs due to physical exertion, such as excessive exercise or sports. It does not require immediate attention and may go away on its own.

Diagnosis and Treatment Options

While exertional compartment syndrome is not considered a medical emergency, acute compartment syndrome is and requires immediate attention to avoid serious complications. To diagnose compartment syndrome, a physical exam will be done, and imaging tests such as an X-ray may be ordered to rule out other possible causes. In addition, a compartment pressure measurement test can be done to measure the pressure in the muscle. In cases of exertional compartment syndrome, a repeat pressure test can be done to compare pressure readings before and after exercising.

To treat acute compartment syndrome, a procedure called a fasciotomy can be done to relieve the pressure in the muscle compartment by cutting tightened tissue surrounding the muscle. If the incision cannot be closed over the tissue, a skin graft may be needed. Acute compartment syndrome is dangerous, and if left untreated, serious complications can happen, such as:

  • Permanent muscle and nerve damage
  • Permanent disability
  • Muscle deformity and rigidness
  • Amputation
  • Death

To treat chronic or exertional compartment syndrome, stopping the activity that caused it to occur can stop symptoms, but they may return once you resume the activity. For chronic cases, treatment may consist of:

  • Rest
  • Taking anti-inflammatory medication
  • Wearing orthotics inside of your shoes
  • Changing your exercise routine to include lower-impact activities and cross-training
  • Working out on softer surfaces
  • Physical therapy

If exertional compartment syndrome is severe and conservative treatments do not provide relief, surgery may be needed. Dr. Williams can perform a fasciotomy for exertional compartment syndrome as well as nerve release to free up nerves that are compressed by the affected muscles. Releasing the nerves can provide symptoms relief.

Contact Dr. Eric H. Williams for Help

If you have signs of compartment syndrome, contact a nerve specialist as soon as possible. Dr. Williams can help ease your symptoms and get you back to enjoying your favorite activities as soon as possible. To schedule an appointment in the Baltimore office, contact us at (410) 709-3868 or fill out our contact form online.