Lauren Way, MA
Compartment Syndrome is a potentially life threatening condition caused by an excessive pressure build up inside of compartmentalized muscle groups in the body, called compartments. Rising pressure inside the compartments can block blood flow to tissue, which organs need to function. The connective tissue that form the walls of the compartments is called the fascia. The fascia is unable to easily expand, so injury to these compartments can cause blood or edema to accumulate.
There are two types of compartment syndrome, Acute Compartment Syndrome, and Chronic Compartment Syndrome. Physicians can check the pressure inside of a compartment during a physical examination, by inserting a needle into the area of suspected compartment syndrome while an attached pressure monitor records the pressure.
Acute compartment syndrome comes on rapidly over hours or days. Around 75% of Acute Compound Syndrome is caused by a broken arm or leg. The areas that are most commonly affected by Acute Compound Syndrome is legs, arms, and abdomen. Examples of trauma that can lead to Acute Compartment Syndrome are crash injuries, burns, overly tight bandaging, surgery or blood clot to a blood vessel of arm or leg, extremely vigorous exercise, or taking Anabolic Steroids. Pain is reported early and almost universally. The pain is described as a deep, constant, poorly localized pain which is out of proportion to injury. The pain is aggravated by passively stretching the muscle group within the compartment, or actively flex it. Other symptoms reported by patients of Acute Compartment Syndrome include the compartment feeling very tense and firm, swollen or shiny skin, with obvious bruising, and paresthesia, which is the feeling of pins and needles.
The most effective treatment for patients with Acute Compartment Syndrome is surgery. The surgery is called a Fasciotomy, which includes cutting open the fascia to reduce the pressure. This type of procedure is done in the operating room. If presenting to an Urgent Care, the provider might recommend a referral to an emergency room as it is out of the scope of Urgent Care practice to perform this type of procedure.
Chronic Compartment Syndrome progresses over days or weeks. The portions of the body most affected by Chronic Compartment Syndrome are the lower legs, the buttocks, and the thighs. Chronic Compartment Syndrome is brought on by vigorous repetitive use of muscles, such as running or cycling. Patients describe it as a feeling of extreme tightness, which worsens to a painful burning sensation if exercise is continued. These symptoms will usually dissipate with rest and muscle function remains normal. Although treatment for Chronic Compartment Syndrome can sometimes include surgical intervention, it can normally be treated with physical therapy, anti-inflammatory medication, or changing your exercise routine. Other recommended methods of treatment for Chronic Compartment Syndrome include changing the type of surface you exercise on, elevating the extremity, and icing the extremity.
The prognosis between the two varies greatly, which is why it is immensely important to be seen by your physician if you suspect you may have Compartment Syndrome. Acute Compartment Syndrome can be a potentially devastating condition, the longer the delay of surgical intervention, the more potential there is for a permanent loss of nerve function. However, the prognosis for Chronic Compartment Syndrome is excellent if treated properly.
Lauren Way, MA
Surfside Urgent Care of Laguna Beach
32341 Coast Highway
Laguna Beach, CA 92651