Compartment syndrome – what can help

Compartment syndrome can be very painful and stop you going about life as normal. Here’s what to do about it.

What are the symptoms?

What’s the cause? 

When to see a doctor

Diagnosing compartment syndrome

What’s the treatment?

Self-care tips for compartment syndrome

From broken bones and tight bandages to running too hard or too often, compartment syndrome has many causes. Learn what the symptoms are, when to manage the condition at home, and when to see a doctor.


A burning pain or a deep ache in your muscle (usually in the lower legs or forearms), combined with numbness, swelling and not being able to move the affected body part normally, can be tell-tale signs of compartment syndrome.

The condition is often triggered by a severe injury or repetitive movements when exercising, which causes pressure to build up inside a muscle. This pressure limits blood flow and causes  varying levels of pain.

There are 2 types of the condition – acute compartment syndrome, where pressure inside the muscle comes on suddenly, and chronic compartment syndrome, where it increases more gradually, and comes and goes.

## What are the symptoms?

The symptoms of compartment syndrome can include:

- a burning pain or a deep ache in your muscle – this feels worse when the muscle is stretched
- tightness and difficulty moving the affected body part
- weakness, numbness, or [pins and needles](https://www.livehealthily.com/health-library/symptoms/pins-and-needles)
- swelling of the muscle – it can feel fuller or firmer than usual
- a tingling or burning feeling under your skin (paresthesia).

__Get emergency medical care if you have sudden, severe pain in any part of your body. If acute compartment syndrome is the cause, you’ll need surgery as soon as possible.__

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## What’s the cause? 

Compartment syndrome happens when a muscle swells and bleeds internally. When the pressure becomes too much, blood flow is restricted, as well as oxygen and nutrients.

The cause of compartment syndrome depends on which type you have, but the most common triggers are:

- __sudden and severe injuries__ – this means trauma or crush injuries, like car accidents, and injuries that happen in contact sports, such as fractures or a severe [sprain](https://www.livehealthily.com/health-library/conditions/sprains). It might also be caused by a bandage or plaster cast being too tight. These types of injuries are more likely to lead to acute compartment syndrome
- __repeated stress (over-exercising)__ – in activities that require lots of repetitive motions, such as running. This often leads to chronic compartment syndrome.


## When to see a doctor

Book an appointment with a doctor if you:

- keep getting pain, numbness, or swelling in a muscle
- have difficulty moving this part of your body when you exercise.

Sudden, severe pain in any part of your body is a medical emergency. If acute compartment syndrome is the cause, you’ll need surgery as soon as possible.

## Diagnosing compartment syndrome

At your appointment your doctor will ask you questions about your symptoms, while taking a look at your muscles and the affected area.

If they suspect compartment syndrome, or they want to rule out other conditions like [tendonitis](https://www.livehealthily.com/health-library/conditions/tendonitis), they might refer you for tests, such as:

- __an X-ray__ – to check if you’ve broken a bone
- __an MRI scan__ – to produce detailed images of the inside of the body. 

Sometimes 2 of these are requested; 1 while you’re resting from exercise, and 1 when you’ve started exercising again. The 2 results are then compared.

A compartment pressure measurement is when a needle is inserted into your muscle before and after exercise to measure the pressure inside it. It’s only carried out if other tests suggest you have compartment syndrome.

## What’s the treatment?

Chronic compartment syndrome, which comes on gradually, may be treated with [self-care](https://www.livehealthily.com/health-library/conditions/compartment-syndrome#selfcare-tips). Although in some severe cases, you may need medical treatment.

But acute compartment syndrome always needs to be treated urgently. This usually includes:

- __surgery__ – carried out as soon as possible to relieve pressure inside the muscle (a fasciotomy). You may also need a skin graft to cover the incision 
- __medicine__ – given after the operation to help ease any pain
- __physical therapy__ – with the help of a physical therapist, who can help you regain full movement in the affected body part again.

## Self-care tips for compartment syndrome

If your symptoms have come on gradually and they seem to be caused by repetitive exercises, or an overuse injury, you could try:

- __avoiding the activity that caused them__ – if you run, and if you’re getting pain in your lower limbs, switch to a lower-impact exercise, such as cycling, or reduce how often you exercise, while you recover
- __having physical therapy__ – where a physical therapist helps you improve the strength and flexibility of your muscles, after a period of rest
- __using painkillers__ – to reduce pain and discomfort, such as ibuprofen (check if this is suitable for you to take)
- __getting inserts (orthotics) for your shoes__ – they can be helpful in supporting your muscles if you decide to start running again
- __for runners, try changing your stride from a heel strike to pushing off on your toes__ — this change may help, but it depends on where the injury is coming from.

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References

Amelia Glean

Fiona Bugler

Dr Ewan O'Farrell

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