What Are Compartments?
Compartments are groups of muscles, blood vessels, and nerves in your arms and legs. There is a tough membrane, known as a fascia, that covers these tissues – the fascia doesn’t stretch or expand easily as its main purpose is to hold the tissues in place. For instance, the area between the knee and ankle has four major muscle compartments. Compartment syndrome is most often seen in the calf. However, it can also occur in the other compartments of the lower extremity, as well as in the feet, buttocks, arms, and hands.
Compartment syndrome occurs when there’s swelling or bleeding within a particular compartment. Since the fascia doesn’t stretch, the additional pressure caused by the swelling and bleeding places a great amount of stress on the muscles, nerves, and blood vessels within the compartment. This, in turn, disrupts the blood flow to the area and, without a steady flow of oxygen and nutrients; the tissues can suffer extensive damage.
Types of Compartment Syndrome
There are two types of compartment syndrome – acute and chronic. Acute compartment syndrome is a serious medical emergency and is typically caused by a severe injury such as a crush injury, fracture, or a muscle that has suffered extreme bruising. If acute compartment syndrome isn’t treated (meaning that the pressure is relieved quickly), permanent muscle damage – or tissue death – can result. Acute compartment syndrome can also be a result of anabolic steroid use, blocked blood flow to a limb, or constricting bandages.
Chronic compartment syndrome – which is also known as exertional compartment syndrome – is often caused by athletic exertion and isn’t typically regarded as a medical emergency. The pain and swelling exhibited by chronic compartment syndrome is typically caused by activities that involve repetitive motions, like biking, running, and swimming. This type of compartment syndrome can usually be relieved by simply discontinuing the activity that was causing it, although occasionally surgery is necessary.
Signs and Symptoms of Compartment Syndrome
Acute compartment syndrome brings with it extreme pain (more so than what would be expected from the injury itself), especially with the affected muscle area is stretched. Tingling and burning sensations may be felt on the overlying skin, and the muscle may feel very tight or “full”. Numbness and paralysis are late signs of compartment syndrome and typically indicate that permanent tissue injury has occurred.
Chronic compartment syndrome most often occurs in the leg and tends to cause pain or cramping during exercise. Numbness, visible muscle bulging, and difficulty moving the foot are also signs of this ailment.
Treatment of Compartment Syndrome
If acute compartment syndrome is suspected, you must go to an Emergency Room immediately as this is a medical emergency. Once there, the ER physician can measure the compartment pressure to determine if acute compartment syndrome is present. There is no non-surgical treatment for acute compartment syndrome and, as such, it is considered a surgical emergency. The pressure within the compartment is relieved via an incision to cut open the skin and fascia that covers the affected compartment.
If you are diagnosed with chronic compartment syndrome (which would occur as your doctor works to determine the cause of your pain by ruling out other conditions that could be causing your pain) there are both non-surgical and surgical treatment options. However, surgery for chronic compartment syndrome isn’t typically an emergency – instead, it’s an elective procedure.
The physicians here at Prairie Orthopaedic & Plastic Surgery, PC – Dr. Hurlbut, Dr. Machado, and Dr. Krejci – are extremely skilled in their areas of expertise, and have extensive knowledge and experience in the diagnosis and treatment of compartment syndrome, be it acute or chronic. Regardless of the situation, always know that we’re here to help!