Compartment Syndrome: Recognizing Signs and Understanding Treatment

Compartment syndrome is a potentially life-threatening condition that occurs when pressure within the muscles builds to dangerous levels. This pressure can decrease blood flow, which prevents nourishment and oxygen from reaching nerve and muscle cells.

The body is divided into various "compartments" composed of muscles, nerves, and blood vessels. These compartments are wrapped under a tough membrane called the fascia, which does not easily expand. Any swelling in a compartment, therefore, leads to increased pressure in that area.

Compartment syndrome can be either acute or chronic:

• Acute compartment syndrome: This is a medical emergency. Most often the result of a severe injury such as a fracture or crush injury, it can also occur after a relatively minor trauma. Increased pressure impairs the function of blood vessels, nerves, and muscles in the compartment. Without prompt treatment, acute compartment syndrome can lead to permanent muscle damage.

• Chronic compartment syndrome (also known as exertional compartment syndrome): Typically caused by athletic exertion, this form of compartment syndrome is usually not a medical emergency. It is most common in athletes who engage in activities that involve repetitive impact, such as running. The pain or disability is more gradual and typically resolves when the exertion stops.

Symptoms of compartment syndrome can include severe pain that doesn't go away after taking pain medication or elevating the injured area, and sometimes includes symptoms such as numbness, tingling, paleness of skin, and decreased or no pulse in the affected area.

Treatment for compartment syndrome usually involves surgery to cut the fascia and relieve the pressure (fasciotomy). In severe cases, physical therapy may be necessary after the surgery, and in some cases, amputation of the affected limb may be necessary.

Untreated compartment syndrome can lead to severe and irreversible damage. Muscles may die, requiring amputation, and nerves can be permanently damaged, leading to a loss of function and sensation. In rare cases, a dangerous syndrome called rhabdomyolysis can develop, which can lead to kidney failure.

It's critical to seek immediate medical attention if compartment syndrome is suspected.