What is compartment syndrome?
Compartment syndrome is an increase in pressure inside a muscle compartment, which can limit blood flow and lead to permanent damage of your muscles and nerves. The muscles, together with nerves and blood vessels, are contained in spaces known as compartments that are separated by thick tissues known as fascia. The fascia surrounding the compartments cannot expand, so if there is swelling in one of the structures within a compartment, increased pressure and potential damage to the structures within the compartment occurs.
Compartment syndrome usually occurs as a result of a crush injury or other trauma like a long bone fracture (such as a car accident or if your arm or leg is run over by a car). Compartment syndrome can also be caused by surgery, a severe bone fracture, overuse of a muscle group in extreme endurance athletics, or by a venomous snake or insect bite.
Compartment syndrome may occur in the arms, hands, feet, and legs. Compartment syndrome is a serious condition and usually requires surgery. Though treatable, compartment syndrome may sometimes result in permanent damage to your muscles and nerves or may even result in amputation.
Seek immediate medical care (call 911) if you have sustained an injury to an extremity that is extremely painful and does not improve with pain-relieving medications, and if the skin over and around the injury looks very tight.
What are the symptoms of compartment syndrome?
Symptoms of compartment syndrome include severe pain in the affected region (especially with movement) that does not get any better with pain-relieving medications or with icing. When this symptom follows an injury, extensive use of a muscle, or a venomous bite, compartment syndrome is likely.
Common symptoms of compartment syndrome
You may experience symptoms of compartment syndrome very soon after an injury or even as long as a day or two later. These symptoms are usually severe and include:
- No relief from pain after taking pain medications or icing the affected region
- Numbness, tingling, or loss of sensation in the affected region or in your hands or toes beyond the affected region
- Pain in the affected region
- Pale skin in or around the affected region
- Severe pain upon moving the affected limb
- Tight, swollen, and shiny-looking skin over the affected area
Symptoms that might indicate a serious condition
In almost all cases, compartment syndrome is a serious condition that should be immediately evaluated in an emergency setting. Seek immediate medical care (call 911) if you, or someone you are with, have any of these serious symptoms:
- Coldness of the affected limb
- Loss of sensation in the affected limb
- Pale skin in the affected limb
- Severe pain that does not improve with pain-relief medications
- Weakness in the affected limb
What causes compartment syndrome?
When you are injured, you often notice swelling in the skin and tissue near the injury. Similarly, your muscles and tissues deep inside your arms and legs can also swell after an injury. Muscle tissue is separated by a tough and relatively inflexible material called fascia, so when your muscles swell, there is little room for them to expand. The result of this constricted swelling is an increase in pressure inside the muscle compartments that can stop blood flow to the area and lead to serious damage to the nerves and muscles. The swelling associated with compartment syndrome can be brought on by any serious injury, especially crushing injuries, by venomous bites, or by extreme endurance athletic events.
A number of factors increase the risk of developing compartment syndrome. Not all people with risk factors will get compartment syndrome. Risk factors for compartment syndrome include:
- Involvement in a car accident or other serious trauma
- Participation in dangerous activities that may result in traumatic injuries to the legs or arms
- Participation in extreme endurance athletic events
How is compartment syndrome treated?
If compartment syndrome is suspected, your health care provider will assess the pressure inside the affected region using a special probe. If compartment syndrome is diagnosed, surgery is generally required. Surgeons will open the affected region and make incisions in the fascia surrounding the swollen muscles. The wounds will be left open and covered with sterile bandages for several days until the swelling diminishes, at which time your health care provider can close the surgical wounds.
Identification of compartment syndrome and prompt treatment usually result in a good outcome. Failure to treat compartment syndrome promptly may result in extreme pain, as well as permanent damage to muscles and nerves, which may even require amputation of the affected limb.
Compartment syndrome is a serious condition and can directly result in several complications. You can help minimize your risk of serious complications by following the treatment plan you and your health care professional design specifically for you. Complications of compartment syndrome include:
- Amputation of the affected limb
- Muscle weakness
- Permanent muscle damage
- Permanent nerve damage