Compartment syndrome is a condition caused by increased pressure within the muscle compartment. Compartment syndrome could characterized by severe muscle pain after injury or during exercising.
Compartments are parts that consist of muscle tissue, blood vessels, and nerves. This compartment is covered by a membrane (fascia) which cannot expand.
Compartment syndrome results from swelling of a compartment, for example, caused by an injury. Because fascia cannot expand, the swelling will cause the pressure inside the compartment to increase.
If not treated immediately, blood flow and oxygen supply to the compartment will be reduced. As a result, muscle and nerve damage can occur, and it can lead to permanent tissue death (necrosis).
Causes of Compartment Syndrome
Compartment syndrome is caused by an injury that causes bleeding or swelling within the compartment. Because fascia that surrounds the compartment cannot expand, bleeding or swelling increases the pressure within the compartment, so that blood flow to the compartment becomes blocked.
Some conditions that can cause compartment syndrome are:
- crush injury
- Severe sprain
- Severe bruises in the muscles
- Complications of vascular surgery
- Using a bandage that is too tight
- Strenuous exercise with repetitive motion, such as running, tennis, swimming and cycling
In addition, the use of anabolic steroids can also increase the risk of compartment syndrome.
Compartment Syndrome Symptoms
Compartment syndrome can affect the hands, arms, buttocks, legs, and feet. However, in the majority of cases, compartment syndrome is most common in the lower knee. Symptoms can appear suddenly (acute) or gradually (chronic).
In acute compartment syndrome, symptoms may appear several hours after the injury and worsen rapidly. Symptoms include:
- Severe pain, especially when the muscles are moved
- Muscles feel tight
- Tingling, burning, or numbness in the injured area
- The injured part cannot be moved
- Swelling in the injured area
Severe pain in acute compartment syndrome generally does not improve after the patient takes painkillers or after the injured area is positioned higher than the chest.
In chronic compartment syndrome, symptoms appear gradually during exercise. Usually, the symptoms will go away after resting. However, if the exercise is continued, the symptoms can last for a long time.
Symptoms of chronic compartment syndrome include:
- Muscle cramps during exercise, especially in the legs
- Swollen muscles
- The skin in the affected muscle area looks pale and feels cold
- In severe cases, it is difficult to move the affected limb
When to go to the doctor
Immediately see a doctor if you experience symptoms of compartment syndrome, especially if you have previously suffered a serious injury. Prompt treatment can reduce the risk of permanent damage to muscles and nerves.
Compartment Syndrome Diagnosis
The doctor will ask about the patient's symptoms and history of injury. After that, the doctor will perform a physical examination. One of them by pressing the injured area to determine the severity of pain.
To confirm the diagnosis, the doctor will perform special tests to measure the pressure in the compartment. This test is done by inserting a needle equipped with a measuring device into the injured area.
If needed, the doctor can also carry out supporting examinations with X-rays and MRI scans.
Compartment Syndrome Treatment
Treatment of compartment syndrome depends on the type. In patients with chronic compartment syndrome, symptoms usually subside after stopping the activity that triggered the symptoms. Patients will also be advised to do the following self-therapy:
- Changing the mat used for sports
- Changing the type of exercise to a lighter one
- Position the injured body part higher than the chest
If symptoms persist or worsen, the doctor will prescribe non-steroidal anti-inflammatory drugs or perform physiotherapy to stretch the patient's muscles.
In acute compartment syndrome patients and chronic compartment syndrome patients who do not recover after undergoing the above treatment, the doctor will perform surgery fasciotomy. This operation must be performed as soon as possible to prevent tissue death (necrosis).
Fasciotomy done by opening fascia, to relieve pressure on the compartment and remove dead muscle cells if found. After operation, fascia will be left open for several days so that compartment syndrome does not recur.
Compartment Syndrome Complications
Compartment syndrome that is not treated immediately can lead to serious complications, especially in cases of acute compartment syndrome. Some of the complications that can occur are:
- Decreased muscle function
- The appearance of scar tissue in the muscles
- Permanent muscle and nerve damage
- Kidney failure due to muscle tissue deathrhabdomyolysis)
- Tissue death resulting in amputation
Although rare, compartment syndrome that is treated too late can lead to death.
Compartment Syndrome Prevention
Compartment syndrome can't be prevented, but you can reduce your risk of complications by seeing your doctor right away if you have a minor or major injury.
If an injury occurs during exercise, some of the initial treatments you can do are:
- Use the base to position the injured body part higher than the chest.
- If you use a bandage, make sure the bandage is not too tight.
- Apply ice to the injured area to reduce swelling.
- Reduce the intensity of exercise and stop when the body feels tired.