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Compartment Syndrome

Acute or Chronic?

By

Updated May 06, 2008

Pain after an injury is not uncommon, but if the pain seems out of proportion to the injury and there is a significant amount of swelling (edema), you may have a condition called compartment syndrome. Compartment syndromes can be acute (sudden onset) or chronic (long-term problem). Learn more about compartment syndromes.

What is Compartment Syndrome?

Compartment syndrome is a condition that can affect various areas of the body. For the purposes of this article, focus will be on the lower legs and feet. Four compartments are in the lower leg and nine compartments in the foot. Some of the tissues found in the compartments are muscles, nerves and blood vessels. The compartments in the lower leg and foot are divided by a fibrous band called the fascia. The fascia covers and separates the muscles and it is not very flexible.

In compartment syndrome, there is a significant increase in pressure (due to trauma, or exercise) in the compartments. This can lead to damage to the muscles, blood vessels and nerves because the fascia does not allow for expansion of the compartments. There are two types of compartment syndromes, acute and chronic. Acute compartment syndrome is usually caused by trauma. Chronic compartment syndrome is also known as exercise induced compartment syndrome. More than 200,000 people in the United States are diagnosed annually with compartment syndrome.


Causes

Acute Compartment Syndrome

Acute compartment syndrome is usually caused by trauma. Examples of trauma include crush injury, muscle tear, burn injury, bite injury (dog, insect, snake) or car accident. Acute compartment syndrome can also be caused by a cast that is too tight, drug overdose or electrocution.

Chronic Compartment Syndrome

Chronic compartment syndrome is also known as exercise induced compartment syndrome or exertional compartment syndrome. It is most often seen in the lower legs and is more common than acute compartment syndrome. When exercising, blood flow to the muscles increases and the muscles expand within the compartments. The expansion increases the pressure in the compartments and the fascia does not allow enough room for the expansion, which leads to the pain.

Signs and Symptoms

Acute Compartment Syndrome
    • Decreased or abnormal sensations (numbness, tingling) in the area
    • Severe swelling (edema)
    • Excruciating pain
    • Pain gets worse with stretching the affected muscles
    • Muscle weakness
    • Paleness (pallor)
    • Absent pulses (no blood flow)
Chronic Compartment Syndrome
    • Pain starts as dull ache
    • Pain occurs within 30 minutes of starting to exercise
    • Burning, cramping, aching, tightness develop if continue exercising
    • Pain goes away after stopping exercise

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