Compartment Syndrome: Symptoms, Causes, Treatment

What are the symptoms of compartment syndrome?

Compartment syndrome occurs when increased pressure within a muscle compartment (a group of muscles, nerves, and blood vessels enclosed by a tough membrane called fascia) restricts blood flow and function. This can lead to serious complications and requires immediate medical attention. Symptoms of compartment syndrome can include:

1. Severe pain: The most common symptom is persistent, severe pain that is out of proportion to any injury or that worsens with movement of the affected limb.
2. Swelling: The affected area may become swollen, tense, and firm to the touch.
3. Numbness or tingling: There may be sensations of pins and needles or numbness in the affected area.
4. Weakness or difficulty moving the limb: Muscle weakness or difficulty moving the affected limb may occur.
5. Pale or shiny skin: The skin over the affected area may appear pale, shiny, or tight.
6. Decreased pulse: In some cases, there may be a decrease or absence of pulse in the affected limb.
7. Cool skin: The skin over the affected area may feel cool to the touch.
8. Delayed capillary refill: When pressure is applied to the skin over the affected area, it may take longer than usual for the color to return after releasing the pressure.

Compartment syndrome most commonly occurs in the lower leg and forearm but can occur in other parts of the body as well. It is considered a medical emergency and requires immediate evaluation and treatment to prevent complications such as tissue death and permanent damage to muscles and nerves.

What are the causes of compartment syndrome?

Compartment syndrome is typically caused by an increase in pressure within a muscle compartment, which can be due to various reasons. The most common causes include:

1. Trauma: Fractures, crush injuries, or severe blows to the muscle can cause swelling and bleeding, leading to increased pressure within the compartment.
2. Repetitive motion: Activities or exercises that involve repetitive motion, such as running or biking, can cause swelling and inflammation within the muscle compartments, leading to increased pressure.
3. Prolonged compression: Prolonged compression of a limb, such as from tight bandages, casts, or constrictive clothing, can restrict blood flow and lead to compartment syndrome.
4. Burns: Severe burns can cause swelling and fluid accumulation within the affected area, leading to increased pressure.
5. Intravenous drug use: Injecting drugs into a muscle can cause inflammation and damage to the muscle, leading to compartment syndrome.
6. Snake bites: Some snake venoms can cause severe swelling and tissue damage, leading to compartment syndrome.
7. Vascular injury: Damage to blood vessels within a muscle compartment can cause bleeding and swelling, leading to increased pressure.

It’s important to note that compartment syndrome can also occur without any external cause, such as in cases of exertional compartment syndrome, where increased pressure is caused by muscle swelling during exercise.

What is the treatment for compartment syndrome?

The treatment for compartment syndrome is aimed at reducing the pressure within the affected muscle compartment to restore blood flow and prevent tissue damage. Treatment options may include:

1. Immediate surgical intervention: This is the primary treatment for compartment syndrome. A procedure called a fasciotomy is performed to relieve the pressure by making a surgical incision through the fascia (the tough membrane surrounding the muscle compartment) to allow the muscles to expand and relieve the pressure.
2. Monitoring and observation: In some cases, especially if the symptoms are mild or if surgery is not immediately available, the affected limb may be closely monitored for any signs of worsening compartment syndrome. This may involve measuring compartment pressures and assessing the limb for signs of decreased blood flow.
3. Pain management: Pain management is an important aspect of treatment for compartment syndrome. Pain medications may be given to help manage pain, but they do not treat the underlying cause of the condition.
4. Fluid management: Intravenous fluids may be given to help maintain blood pressure and improve blood flow to the affected limb.
5. Elevation and immobilization: Elevating the affected limb and keeping it immobilized can help reduce swelling and relieve pressure on the compartment.
6. Physical therapy: After the acute phase of compartment syndrome has resolved, physical therapy may be recommended to help restore strength and function to the affected limb.

Compartment syndrome is a medical emergency that requires prompt treatment to prevent serious complications such as tissue death and permanent damage to muscles and nerves. Prompt recognition and treatment are crucial for a successful outcome.