Compartment Syndrome

By Joan McLoud, Physical Therapist

Compartment Syndrome Overview

Lower Leg Pain can be a symptom of compartment syndrome.

Image of a man with lower leg pain.

Compartment syndrome is a condition in which increased pressure within one of the body’s anatomical compartments result in insufficient blood supply to tissue within that space. There are two main types: acute and chronic. Compartments of the arm and leg are the most common.

The components of this condition are symptoms, diagnosis, treatment, and rehab or aftercare.

Acute Compartment Syndrome

Symptoms of acute compartment syndrome(ACS) can include severe pain, poor pulses, decreased ability to move, numbness or a pale color of the affected limb. It is most commonly due to physical trauma such as bone fracture, or crush injury. Diagnosis is generally based upon a person’s symptoms. Treatment is by surgery to open the compartment in a timely manner. If not treated with about 6 hours, permanent muscle or nerve damage can result.

Chronic Compartment Syndrome

In chronic compartment symptoms, there is generally pain with exercise. Other symptoms may include numbness. Symptoms typically resolve with rest. Common activities that trigger chronic compartment syndrome include running and biking. Generally this condition does not result in permanent damage. Treatment may include physical therapy or if that is not effective, surgery. The surgery for this condition is called a Fasciotomy.

How the body handles this condition

Groups of organs or muscles are organized into areas called compartments. Strong webs of connective tissue called fascia form walls of these compartments. After an injury, blood or edema (fluid resulting from inflammation or injury) may accumulate in the compartment. Severe tissue damage can result when pressure builds in these areas.

Causes of Compartment Syndrome

About three quarters of the time, acute compartment syndrome is caused by a broken  leg or arm and develops rapidly. This condition can develop from the fracture itself or treatment after casting or surgery.

Compartment Syndrome Symptoms  

There are five characteristic signs and symptoms related to this condition:
Pain, paraesthesia (reduced sensation), paralysis, pallor, and the lack of a pulse. Pain and paraesthesia are early symptoms of this condition.

Diagnosis

Intracompartmental pressure can also be important for diagnosis.  An instrument is inserted 5cm into the zone of injury.  Higher  than 30 mmHg of the diastolic pressure is associated with compartment syndrome.

Treatment

Fasciotomy is indicated in the above conditions. Surgery to release the pressure in the area.  The area needs to be left open as the condition heals.  Chronic compartment syndrome can be treated conservatively or surgically. Conservative treatment consists of rest, anti-inflammatory medications, and manual decompression.  The key to successful treatment of compartment syndrome is early diagnosis and effective treatment. Although this condition does not happen all the time the more we are aware of signs and symptoms the faster we can seek treatment or be treated shortly  after surgery.

If you would link to learn more about lower leg and foot ankle issues, please visit our Trending Section.

JOI Fracture and Injury Care

JOI Physicians are currently offering ASAP Fracture care. Make an appointment by calling (904)JOI-2000. This is a new option for patients who would like to avoid the emergency room if they have suffered a fracture or soft tissue injury. To learn more about this service, read this article about fracture and injury care.

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If you would like to make an appointment with a lower leg Orthopedic Specialist, please call JOI-2000 or click the link below.

By:  Joan McLoud, PT

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