Summary about Disease
Compartment syndrome is a painful condition that occurs when pressure within the muscles builds to dangerous levels. This pressure can decrease blood flow, preventing nourishment and oxygen from reaching nerve and muscle cells. Acute compartment syndrome is a medical emergency, usually caused by injury. Chronic compartment syndrome, also known as exertional compartment syndrome, is typically brought on by exercise.
Symptoms
Severe pain that is out of proportion to the apparent injury.
Pain that worsens when the muscle within the compartment is stretched.
Tightness or a feeling of fullness in the affected muscle compartment.
Numbness or tingling (paresthesia).
Weakness.
In severe cases, paralysis.
Sometimes, but not always, decreased sensation or pallor (paleness).
Causes
Acute Compartment Syndrome:
Fractures (most common)
Severe contusions (bruises)
Crush injuries
Surgery
Burns
Tight bandages or casts
Anabolic steroid use.
Chronic (Exertional) Compartment Syndrome:
Repetitive exercise, especially in athletes.
Medicine Used
Compartment syndrome requires surgical intervention (fasciotomy) to relieve pressure. Medicines are primarily used for pain management and secondary infection prevention.
Pain relievers: Analgesics (opioid or non-opioid) are used to manage pain before and after surgery.
Antibiotics: May be administered post-surgery to prevent or treat infections.
Is Communicable
Compartment syndrome is not communicable. It is not caused by an infectious agent and cannot be spread from person to person.
Precautions
For acute compartment syndrome: Seek immediate medical attention if experiencing severe pain, especially after an injury. Avoid constricting bandages or casts that are too tight.
For chronic compartment syndrome: Proper stretching and warm-up before exercise. Avoid overtraining. Evaluate and adjust athletic techniques. Consider orthotics if foot mechanics contribute.
How long does an outbreak last?
Acute Compartment Syndrome: Does not have outbreaks. It's an acute condition requiring immediate treatment. If untreated, it can lead to permanent damage within hours.
Chronic (Exertional) Compartment Syndrome: Episodes typically last during the duration of exercise and shortly after. Symptoms subside with rest. The condition can persist chronically if the activity causing it is continued without modification.
How is it diagnosed?
Physical Examination: Assessing pain, swelling, and tenderness in the affected compartment.
Intracompartmental Pressure Measurement: A needle is inserted into the muscle compartment to measure the pressure. A pressure reading of greater than 30 mm Hg is generally considered diagnostic for acute compartment syndrome.
Chronic Compartment Syndrome Diagnosis: Symptoms are reproduced by exercising. Intracompartmental pressures are measured before, during, and after exercise.
Timeline of Symptoms
Acute Compartment Syndrome: Symptoms develop rapidly, usually within hours after an injury. Pain is the first symptom, followed by tightness, numbness, and weakness. If left untreated, paralysis and tissue death can occur.
Chronic (Exertional) Compartment Syndrome: Symptoms develop gradually during exercise, reaching a peak, and then subsiding with rest. The timeline varies depending on the intensity and duration of the activity.
Important Considerations
Acute compartment syndrome is a medical emergency. Prompt diagnosis and treatment (usually fasciotomy) are crucial to prevent permanent muscle damage, nerve damage, amputation, or even death.
Chronic compartment syndrome can often be managed with conservative treatment such as physical therapy, activity modification, and orthotics. However, surgery (fasciotomy) may be necessary if conservative measures fail.
Delayed diagnosis or treatment of acute compartment syndrome can lead to severe and permanent complications.