Nerve Decompression Surgery May Provide Relief From Exertional Compartment Syndrome

A doctor can diagnose exertional compartment syndrome.As a rule, most of us don’t think of our bodies as being divided into compartments. After all, we don’t tend to think of our bodies as, say, a large cabinet with different compartments for storing different items.

But each of our limbs has specific areas of muscle, and physicians call those specific areas “compartments.” And so, for example, doctors think of your lower leg as having four compartments. Those compartments are subject to something known as exertional compartment syndrome—a musculoskeletal problem that affects both muscle and nerves that is brought on by exercise or heavy labor.

Let’s take a look at the causes and symptoms of exertional compartment syndrome as well as at what can be done to correct the problem.

The Impact of Repetitive Impact on Your Nerves

While the underlying cause of chronic exertional compartment syndrome is still not completely understood, exertional compartment syndrome is seen most frequently in runners and other athletes whose activities involve frequent and repetitive impact, and prolonged muscular effort. It is generally understood that this syndrome occurs because the compartments that hold the muscles in the legs get filled with blood and the pressure increases above a normal level, perhaps because the blood cannot get out of the compartment, but it is not well understood exactly why this occurs. When the pressure rises above a critical level - pain occurs.

Because any repetitive activities involving impact generally occur on both sides of the body, a person who develops the syndrome in their lower left leg, for example, will often also experience the problem in the right lower leg.

It probably will come as no surprise that exertional compartment syndrome hurts and that pain tends to follow a recognizable pattern. There will be a moment in your workout when you can consistently expect the pain to start, and that pain will get worse as you continue your exercise routine. Early on, once you have stopped exercising, the pain will subside, generally within about 15 minutes. But as the condition worsens, that recovery time may get longer and longer. The pain may take the form of a burning or aching sensation or may feel like a cramp in the affected compartment.

But pain is not the only symptom of exertional compartment syndrome. Other symptoms include:

  • Feelings of tightness or pressure that builds in the leg, tingling, or numbness in the affected limb(s)
  • Weakness of the affected limb(s)
  • In some cases, bulging or swelling that indicates a hernia in the muscle
  • In severe cases in the legs, the condition known as drop foot in which a person has difficulty lifting the front part of the foot

Getting Relief From Exertional Compartment Syndrome

A period of rest or focus on low-impact activities can provide relief from the symptoms of exertional compartment syndrome. Unfortunately, however, the syndrome is likely to flare up again once a person returns to their usual athletic endeavors. 

As a result, your doctor may recommend surgery to correct the issue. One option might be what’s known as a fasciotomy, a procedure that cuts the tightened tissue around the muscle. For some patients this may be treatment enough, however, other patients may also have a component of nerve compression which may require additional nerve releases in addition to the compartment releases.

Another option may be nerve release surgery, which frees nerves that are being compressed by the affected muscles. This surgical solution is not dissimilar from the treatment, for example, of carpal tunnel syndrome, another condition that involves the ongoing compression of a nerve that leads to significant discomfort, pain, and function issues. Releasing the nerve leads to relief of the symptoms.

It is, of course, vitally important to get a correct diagnosis (exertional compartment syndrome is, for example, sometimes mistaken for shin splints) and to consider what treatment options might be most effective for you. Your doctor can identify the problem and walk you through your options so that together you can make an informed choice about how best to move forward with the goal of getting you back to your regular activities without ongoing pain.

Dr. Eric H. Williams Can Help With Exertional Compartment Syndrome

If you are experiencing any or all of the symptoms listed above, the time to see a doctor is now. Dr. Williams has the expertise and experience required to make the correct diagnosis and to recommend the best course of treatment—up to and including nerve release surgery.

Our goal is to get you back to your favorite activities as quickly as possible. Don’t suffer with the symptoms of exertional compartment syndrome any longer. Contact us today to make an appointment.

Eric H. Williams MD
Specializing in reconstructive surgery and pain relief in the Greater Baltimore area.